L Giannella1, K Mfuta2, T Setti2, F Boselli3, E Bergamini2, L B Cerami2. 1. Local Health Authority of Reggio Emilia, Division of Obstetrics and Gynaecology, Cesare Magati Hospital, Scandiano, Italy. Electronic address: lucazeta1976@libero.it. 2. Local Health Authority of Reggio Emilia, Division of Obstetrics and Gynaecology, Cesare Magati Hospital, Scandiano, Italy. 3. Mother-Infant Department, Institute of Obstetrics and Gynaecology, University of Modena and Reggio Emilia, Modena, Italy.
Abstract
OBJECTIVE: To measure the diagnostic accuracy of endometrial thickness for the detection of intra-uterine pathologies among asymptomatic postmenopausal women, and to test the diagnostic accuracy and appropriateness of performed hysteroscopies. STUDY DESIGN: Prospective study of 268 asymptomatic postmenopausal women with endometrial thickness ≥4 mm referred to diagnostic hysteroscopy. The diagnostic accuracy of various endometrial thickness cut-off values was tested. Histological and hysteroscopic results were compared to measure the diagnostic accuracy of outpatient hysteroscopies. RESULTS: No endometrial thickness cut-off values had optimal diagnostic accuracy [positive likelihood ratio (LR+) >10 and negative likelihood ratio (LR-) <0.1]. The best endometrial thickness cut-off value for the detection of all intra-uterine pathologies was ≥8 mm (LR+ 10.05 and LR- 0.22). An endometrial thickness cut-off value ≥10 mm did not miss any cases of endometrial cancer. The success rate of diagnostic hysteroscopy was 89%, but 97% of these revealed a benign intra-uterine pathology. The diagnostic accuracy of hysteroscopy was optimal for all intra-uterine pathologies, except endometrial hyperplasia (LR- 0.52). CONCLUSION: Using an endometrial thickness cut-off value ≥4 mm, only 3% of performed hysteroscopies were useful for the detection of pre-malignant or malignant lesions. Despite the finding that endometrial thickness did not show optimal diagnostic accuracy, using the best cut-off value (≥8 mm) may be helpful to decrease the number of false-positive results. No cases of endometrial cancer were diagnosed in asymptomatic postmenopausal women with endometrial thickness <10mm.
OBJECTIVE: To measure the diagnostic accuracy of endometrial thickness for the detection of intra-uterine pathologies among asymptomatic postmenopausal women, and to test the diagnostic accuracy and appropriateness of performed hysteroscopies. STUDY DESIGN: Prospective study of 268 asymptomatic postmenopausal women with endometrial thickness ≥4 mm referred to diagnostic hysteroscopy. The diagnostic accuracy of various endometrial thickness cut-off values was tested. Histological and hysteroscopic results were compared to measure the diagnostic accuracy of outpatient hysteroscopies. RESULTS: No endometrial thickness cut-off values had optimal diagnostic accuracy [positive likelihood ratio (LR+) >10 and negative likelihood ratio (LR-) <0.1]. The best endometrial thickness cut-off value for the detection of all intra-uterine pathologies was ≥8 mm (LR+ 10.05 and LR- 0.22). An endometrial thickness cut-off value ≥10 mm did not miss any cases of endometrial cancer. The success rate of diagnostic hysteroscopy was 89%, but 97% of these revealed a benign intra-uterine pathology. The diagnostic accuracy of hysteroscopy was optimal for all intra-uterine pathologies, except endometrial hyperplasia (LR- 0.52). CONCLUSION: Using an endometrial thickness cut-off value ≥4 mm, only 3% of performed hysteroscopies were useful for the detection of pre-malignant or malignant lesions. Despite the finding that endometrial thickness did not show optimal diagnostic accuracy, using the best cut-off value (≥8 mm) may be helpful to decrease the number of false-positive results. No cases of endometrial cancer were diagnosed in asymptomatic postmenopausal women with endometrial thickness <10mm.
Authors: Stephanie R DeJong; Jamie N Bakkum-Gamez; Amy C Clayton; Michael R Henry; Gary L Keeney; Jun Zhang; Trynda N Kroneman; Shannon K Laughlin-Tommaso; Lisa J Ahlberg; Ann L VanOosten; Amy L Weaver; Nicolas Wentzensen; Sarah E Kerr Journal: Cancer Med Date: 2021-09-16 Impact factor: 4.711
Authors: Carlo Saccardi; Amerigo Vitagliano; Matteo Marchetti; Alice Lo Turco; Sofia Tosatto; Michela Palumbo; Luciana Serena De Lorenzo; Salvatore Giovanni Vitale; Marco Scioscia; Marco Noventa Journal: Diagnostics (Basel) Date: 2020-04-27