Endometrial Thickness As A Test For Endometrial Cancer In Women With Abnormal Postmenopausal And Perimenopausal Vaginal Bleeding & Its Histopathological Correlation
Endometrial Thickness As A Test For Endometrial Cancer
DOI:
https://doi.org/10.70284/njirm.v4i2.2166Keywords:
Endometrial thickness, endometrial cancer, abnormalpostmenopausalbleedingAbstract
Introduction: The menopausal & perimenopausal age are characterized by a deficiency of progesterone and relative hyperestrogenism leading to increased risk of carcinoma endometrium. Transvaginal ultrasonography is used to evaluate the thickness of endometrium in perimenopausal & postmenopausal women presenting with abnormal bleeding per vaginum & its histopathological classification was done. Material & Methods: This retrospective study was carried out in R D Gardi Medical College and Hospital, Ujjain. Seventy five cases were selected from May 2010 - May 2012 and studied in respect to age,parity,socio-economic status, and endometrial thickness in women with abnormal bleeding per vaginum & its relation to histopathology findings of endometrium obtained through D & C. Results:Out of seventy five cases, 49(65.5%) were in perimenopausal age group, and 26(34.5%) in postmenopausal age group. Endometrial thickness greater than 12mm was in 73.4% of perimenopausal and 25.3% of postmenopausal women. In perimenopausal women with abnormal bleeding,histopathology showed‘Benign Hyperplasia’in 51%, ‘Proliferative endometrium’in 26.5%, ‘Secretary endometrium’ in 4.08%, ‘Atrophic endometrium’ in 2.04%, ‘Atypical Hyperplasia’ in 10.2%, andcarcinoma in 6.12%.Whereas in postmenopausal women, Atypical Hyperplasia in 11.4%, carcinoma in 46.12%,benign hyperplasia in 7.6%, proliferative endometrium in 15.33%, secretary endometrium in 7.69%, and atrophic in 11.4%. Conclusion: In majority endometrial thickness by TVS may be helpful in planning investigation protocol and further management
References
2. Shipley CF 3rd, Simmons CL, Nelson GH. Comparison of transvaginal sonography with endometrial biopsy in asymptomatic postmenopausal women. J Ultrasound Med 1994; 13:99-104.
3. Hanggi W, Bersinger N, Altermatt HJ, Birkhauser MH. Comparison of transvaginal ultrasonography and endometrial biopsy in surveillance in postmenopansal HRT users.Maturitas 1997; 27:133-143.
4. Langer RD, Pierce JJ, O'Hanlan KA, et al. Transvaginal ultrasonography compared with endometrial biopsy for the detection of endometrial disease. Postmenopausal Estrogen/Progestin Intervention Trial. N Engl J Med 1997; 337:1792-1798.
5. Fleischer AC, Wheeler JE, Lindsay I, et al. An assessment of the value of ultrasonographic screening for endometrial disease in postmenopausal women without symptoms. Am J ObstetGynecol 2001; 184:70-75.
6. The Writing Group for the PEPI Trial Effects of hormone replacement therapy on endometrial histology in postmenopausal women. The Postmenopausal,Estrogen/Progestin Interventions (PEPI) Trial.The Writing Group for the PEPI Trial.JAMA. 1996;275:370–5.[PubMed]7. Castelo-Branco C, Puerto B, Duran M, et al. Transvaginal sonography of the endometrium in postmenopausal women: monitoring the effect of hormone replacement therapy. Maturitas 1994; 19:59-65.
8. Paraskevaidis E, Papadimitriou D, Kalantaridou SN, et al. Screening transvaginal uterine ultrasonography for identifying endometrial pathology in postmenopausal women. Anticancer Res 2002; 22:1127-1130.
9. Epplein M, Reed SD, Voigt LF, Newton KW, Holt VL, Weiss NS. Endometrial hyperplasia risk in relation to characteristics and exposures that influence endogenous hormone levels.Am J Epidemiol. 2008.
10. Tavassoli FA. World Health Organization Classification of Tumors: Pathology and Genetics of Tumors of the Breast and Female Genital Organs. IARC Press; Lyon: 2003.
11. Figueroa-Casas PR, Ettinger B, Delgado E, Javkin A, Vieder C. Reversal by medical treatment of endometrial hyperplasia caused by estrogen replacement therapy. Menopause. 2001;8:420–3.
12. Kurman RJ, Kaminski PF, Norris HJ. The behavior of endometrial hyperplasia.A long-term study of “untreated†hyperplasia in 170 patients.Cancer. 1985;56:403–12.