Diagnosis of endometrial cancer in patients with postmenopausal bleeding by analysis of the lactate dehydrogenase isoenzyme activity profile in uterine fluid

Niklasson, O.; Skude, G.; Maršál, Karel; Casslén, Bertil

doi:10.1016/j.ygyno.2004.02.014

Cited by 3 publications

(7 citation statements)

References 24 publications

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“…Since the second‐level diagnostic method must have close to 100% sensitivity as well as negative predictive value, regardless of thickness of the endometrium and the sample size, aspiration biopsy does not recommend itself. We have shown that the LD isoenzyme activity profile has 100% sensitivity and 100% negative predictive value for endometrial malignancy (this study and Niklasson et al (5) ). The present study furthermore showed that the LD profile reliably detects endometrial malignancy also in cases with endometrial thickness ≥5 mm.…”

Section: Discussionsupporting

confidence: 72%

“…with experience of endometrial diagnosis with TVS as well as the aspiration method. In this study, 66 of 72 patients, including all cases with endometrial cancer, have been presented in an earlier study in which, however, the results of TVS were not reported (5) . Another patient with endometrial cancer presented in that study was excluded from the present study because of cervical stenosis, since aspiration for LD analysis was done at the time of curettage.…”

Section: Methodsmentioning

confidence: 95%

“…The relative activity level of each isoenzyme fraction was subsequently calculated. In uterine aspirates obtained from a set of 11 patients with endometrial cancer, the cutoff levels for isoenzyme fractions LD2–LD5 were subsequently established as the lowest level in any of these cases (5) . It is possible that even lower cutoff levels for each isoenzyme could have been used since a gradual increase in LD activity, ie, LD1 < LD2 < LD3 < LD4 < LD5 is pathologic.…”

Section: Discussionmentioning

confidence: 99%

“…The activity of LD1 was set to 1.0 and used as an internal standard. An abnormal LD profile was defined as LD1 = 1.0, LD2 ≥ 1.5, LD3 ≥ 2.5, LD4 ≥ 2.6, and LD5 ≥ 3.8 (5) .…”

Section: Methodsmentioning

confidence: 99%

“…Endometrial processes, malignant as well as inflammatory, are reflected in the uterine fluid. We have recently reported that the lactate dehydrogenase (LD) isoenzyme activity profile in uterine fluid aspirates identifies endometrial malignancy with 100% sensitivity and 100% negative predictive value (5) . Most importantly, accuracy of this test is not dependent on endometrial thickness.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Transvaginal ultrasound and lactate dehydrogenase isoenzyme activity profile in uterine aspirate for diagnosis of endometrial carcinoma in women with postmenopausal bleeding

Niklasson

Skude²,

Lingman

et al. 2007

Int J Gynecol Cancer

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Postmenopausal patients with vaginal bleeding (n=72) were evaluated with the combination of transvaginal ultrasonography (TVS) and analysis of the lactate dehydrogenase (LD) isoenzyme activity profile in uterine fluid aspirates. TVS evaluation of the endometrium was classified as < 5 mm, ≥ 5 mm, or poorly defined. The LD isoenzyme activity profile was characterized as abnormal or normal. Pathological findings were further evaluated with diagnostic curettage. TVS found the endometrium to be ≥ 5 mm or poorly defined in 44 patients (61%). Endometrial carcinoma was found in 6 out of 72 patients (8 %). They appeared in the TVS groups endometrium > 5 mm (n=2) and endometrium poorly defined (n=4), but not in the endometrium < 5mm. The LD isoenzyme activity profile was abnormal in the 6 malignant cases and in 10 benign cases. Thus, the need for further evaluation with hysteroscopy and curettage was reduced to 16 cases. Since TVS had 100% sensitivity but only 42% specificity, it is suitable for first level examination in patients with postmenopausal bleeding. The second level method should have similarly high sensitivity, but much higher specificity. The LD isoenzyme activity profile in uterine fluid aspirates had 100% sensitivity and 85% specificity. Another important feature is that the method is not sensitive to endometrial thickness, amount of sample, sampling device or dilution. Thus, it is more reliable than aspiration histology. For every hysteroscopy or curettage that can be replaced by LD analysis, the cost is reduced by approximately EUR 720 or 540, respectively.

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Section: Discussionsupporting

confidence: 72%

Section: Methodsmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

“…The activity of LD1 was set to 1.0 and used as an internal standard. An abnormal LD profile was defined as LD1 = 1.0, LD2 ≥ 1.5, LD3 ≥ 2.5, LD4 ≥ 2.6, and LD5 ≥ 3.8 (5) .…”

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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Transvaginal ultrasound and lactate dehydrogenase isoenzyme activity profile in uterine aspirate for diagnosis of endometrial carcinoma in women with postmenopausal bleeding

Niklasson

Skude²,

Lingman

et al. 2007

Int J Gynecol Cancer

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Diagnostic accuracy of uterine fluid lactate dehydrogenase isoenzyme activity profile and vaginal ultrasound in detecting endometrial cancer in women with postmenopausal bleeding

Behery

Huda

Kamal

et al. 2009

Arch Gynecol Obstet

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LD isoenzyme profile of uterine fluid could be added as a marker for endometrial cancer in postmenopausal women with vaginal bleeding and endometrial thickness >5 mm on transvaginal ultrasound. Uterine fluid sampling is easy, highly reliable, minimally invasive, with high patient compliance, and can be performed as an office procedure. Furthermore, this method is insensitive to endometrial thickness, amount of sample, sampling device, and dilution.

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Uterine fluid lactate dehydrogenase isoenzyme activity profile

Galal

Meleis

2016

Evidence Based Womenʼs Health Journal

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Diagnosis of endometrial cancer in patients with postmenopausal bleeding by analysis of the lactate dehydrogenase isoenzyme activity profile in uterine fluid

Cited by 3 publications

References 24 publications

Transvaginal ultrasound and lactate dehydrogenase isoenzyme activity profile in uterine aspirate for diagnosis of endometrial carcinoma in women with postmenopausal bleeding

Transvaginal ultrasound and lactate dehydrogenase isoenzyme activity profile in uterine aspirate for diagnosis of endometrial carcinoma in women with postmenopausal bleeding

Diagnostic accuracy of uterine fluid lactate dehydrogenase isoenzyme activity profile and vaginal ultrasound in detecting endometrial cancer in women with postmenopausal bleeding

Uterine fluid lactate dehydrogenase isoenzyme activity profile

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