Evaluation of the diagnostic role of transvaginal ultrasound measurements of endometrial thickness to detect endometrial malignancy in asymptomatic postmenopausal women.
PURPOSE
To assess the diagnostic accuracy of endometrial thickness measurements of transvaginal ultrasound (TVUS) in asymptomatic postmenopausal women in the detection of endometrial malignancy.


METHODS
A retrospective cohort study in a university hospital was undertaken with 276 consecutive asymptomatic postmenopausal women undergoing dilatation and curettage (D&C) and hysteroscopy for an incidental finding of thickened endometrium (≥4 mm) between 2003 and 2012. Different endometrial thickness cutoff values were tested on the basis of a pathologic report with carcinoma conditions (endometrial hyperplasia with atypia and endometrial carcinoma).


RESULTS
The mean age of patients was 59.8 ± 9.0 years. The mean duration of menopause was 11.2 ± 8.9 years. The final pathology diagnoses included 107 (38.8 %) patients with polyps, 42 (15.2 %) with atrophic endometrium, 39 (14.1 %) with estrogen exposure, and 19 (6.9 %) with normal endometrium. With regard to carcinoma conditions, nine patients (3.3 %) had endometrial hyperplasia with atypia and eight patients (2.9 %) had endometrial carcinoma. The area under the ROC curve was 0.52 (95 % CI 0.44-0.57), which indicated a poor accuracy of endometrial thickness of TVUS for carcinoma conditions.


CONCLUSIONS
Routine use of endometrial thickness measurement with TVUS does not seem to be an effective diagnostic tool for endometrial cancer because it has a low diagnostic performance in asymptomatic postmenopausal women. Further prospective studies are required to assess the endometrial thickness measurement with TVUS as a screening method in these women.
['Yasa|Cenk|C|', 'Dural|Ozlem|O|', 'Bastu|Ercan|E|', 'Ugurlucan|Funda Gungor|FG|', 'Nehir|Aslı|A|', 'İyibozkurt|Ahmet Cem|AC|']
D000368:Aged D004107:Dilatation and Curettage D004714:Endometrial Hyperplasia D016889:Endometrial Neoplasms D004717:Endometrium D005260:Female D006801:Humans D015907:Hysteroscopy D008875:Middle Aged D011127:Polyps D017698:Postmenopause D011247:Pregnancy D012372:ROC Curve D012189:Retrospective Studies D014463:Ultrasonography D014592:Uterine Hemorrhage
Endometrial thickness Asymptomatic postmenopausal women Endometrial hyperplasia with atypia Endometrial cancer Transvaginal ultrasonography