폐경 후 자궁출혈에 대한 자궁경의 효과

Abstract

Objective: To compare the diagnostic accuracy of ultrasonographic endometrial thickness and hysteroscopy, to establish the most appropriate exam for the diagnosis of endometrial cancer and other endometrial diseases in postmenopausal women with abnormal uterine bleeding(AUB). Methods: This prospective study was conducted on 105 consecutive postmenopausal patients with AUB, who underwent ultrasonographic evaluation of endometrial thickness, hysteroscopy and endometrial biopsy. Evaluation of sensitivity and specificity was performed. Results: Histological findings for <4 mm level revealed that atrophy was present in 30 (71.4%) and in 1 cases (2.4%) endometrial cancer was found; for ≥4 mm values polyps and myomas were present in 31 (49.2%) and there were 3 (4.8%) endometrial cancer. Sensitibity and specificity for trans-vaginal ultrasound, with a cut-off value ≥4 mm, was 75% and 40.6%. Conclusions: In conclusion, endometrial thickness <4 mm can miss malignancies but trans-vaginal ultrasound remains the first line diagnostic procedure in postmenopausal women without AUB, because it is not invasive and has high sensitivity for detecting endometrial cancer and other endometrial disease; according to our experience, hysteroscopy with biopsy is mandatory in all postmenopausal women with AUB.