The significance of sonographically thickened endometrium in asymptomatic postmenopausal women

Abstract

Objective To investigate the correlation between sonographic, hysteroscopic, and pathological findings in postmenopausal asymptomatic patients with sonographically thickened endometrium. Methods The records of postmenopausal patients who attended the Menopause Outpatient Clinic of a tertiary women's hospital in Ankara, Turkey between January 1, 2012 and December 15, 2013 were retrieved. A total of 266 postmenopausal women without vaginal bleeding underwent hysteroscopic evaluation and endometrial sampling. Patients whose pathological records indicated an endometrial thickness equal to or greater than 6 mm (double layer) on transvaginal ultrasonography without any symptoms were included in the study. Results The most frequently detected focal intrauterine lesions in asymptomatic women were endometrial polyps, which were diagnosed in 168 (63.1%) cases. Twenty-four (9%) patients were diagnosed as having simple hyperplasia, 4 (1%) atypical hyperplasia, and 8 (3%) endometrial adenocarcinoma. Two of the patients with adenocarcinoma were diagnosed based on endometrial polyps, and 6 cases showed endometrial hyperplasia on hysteroscopy, while histological examination showed endometrial carcinoma. Conclusion We suggest 10.5 mm as the cutoff value for endometrial thickness and recommend hysteroscopy following dilatation and curettage to increase diagnostic efficacy and provide definitive treatment in asymptomatic postmenopausal women with thickened endometrium.

Can a higher endometrial thickness threshold exclude endometrial cancer and atypical hyperplasia in asymptomatic postmenopausal women? A systematic review

“…1). [10][11][12][13][14][15][16][17][18][19][20][21] The quality of evidence in each of these studies was evaluated.…”

Clinical study of risk factors and ultrasonographic correlation of endometrial hyperplasia according to the WHO classification 2014

“…There are many studies showing the cut off of endometrial thickness in asymptomatic postmenopausal women to predict premalignant and malignant lesion-the cut off being 10-11mm. [8][9][10] Asymptomatic postmenopausal women with ET>12mm and positive doppler flow signals are best predictor of malignancy. 11 Postmenopausal women with recurrent bleeding, who are diabetic have higher risk of endometrial malignancy with ET>11mm.In a study by Ulu et al ET of 15 mm and above, risk of malignancy is 3.043 times higher and symptomatic women have higher risk than asymptomatic women.…”

Expression of Markers of Hypoxia, Angiogenesis, as Microcirculatory-Tissue Factors in Proliferative Processes of the Endometrium

“…HIF-1α, the best studied, is expressed in cells of many tissues and organs, where it functions as a regulator of oxygen homeostasis. The HIF-1α subunit is constantly present in the cell under normoxia, but with an extremely short half-life, so its concentration is maintained at a low level [5,8,25].…”

“…Studies have demonstrated the role of angiogenic factors and their receptors in vascularization of tumor tissue, as well as the relationship with the prospect of the disease and the effectiveness of treatment [6,9,18]. The authors found a significant increase in the concentration of VEGF in the late stages of adenocacin, in the initial processes and EHP no difference was found [18,20,25].…”