Roles of Sonography and Hysteroscopy in the Detection of Premalignant and Malignant Polyps in Women Presenting with Postmenopausal Bleeding and Thickened Endometrium

Cavkaytar, Sabri; Kokanali, Mahmut Kuntay; Ceran, Ufuk; Topcu, Hasan Onur; Sirvan, Levent; Doganay, Melike

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자료유형: 학술저널

저자정보: Cavkaytar, Sabri (Department of Gynecology, Dr Zekai Tahir Burak Woman's Health Education and Research Hospital) Kokanali, Mahmut Kuntay (Department of Gynecology, Dr Zekai Tahir Burak Woman's Health Education and Research Hospital) Ceran, Ufuk (Department of Gynecology, Dr Zekai Tahir Burak Woman's Health Education and Research Hospital) Topcu, Hasan Onur (Department of Gynecology, Dr Zekai Tahir Burak Woman's Health Education and Research Hospital) Sirvan, Levent (Department of Pathology, Dr Zekai Tahir Burak Woman's Health Education and Research Hospital) Doganay, Melike (Department of Gynecology, Dr Zekai Tahir Burak Woman's Health Education and Research Hospital)

저널정보: 아시아태평양암예방학회 Asian Pacific journal of cancer prevention : APJCP Asian Pacific journal of cancer prevention : APJCP 제15권 제13호

발행연도: 2014.1

수록면: 5,355 - 5,358 (4page)

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Background: To assess the role of sonographic endometrial thickness and hysteroscopic polyp size in predicting premalignant and malignant polyps in postmenopausal women. Materials and Methods: A total of 328 postmenopausal women with abnormal uterine bleeding and thickened endometrium underwent operative hysteroscopy due to detection of endometrial polyps were included in this retrospective study. Preoperative endometrial thickness measured by transvaginal ultrasonography and polyp size on hysteroscopy were noted. Hysteroscopic resection with histology was performed for endometrial polyps. Endometrial thickness and polyp size were evaluated on the basis of final diagnosis established by histologic examination. Receiver operator characteristic curves were calculated to assess the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of endometrial thickness and polyp size for detecting pemalignant and malignant polyps. Results: Premalignant and malignant polyps were identified in 26 (7.9%) of cases. Sonographic measurement showed a greater endometrial thickness in cases of premalignant and malignant polyps when compared to benign polyps. On surgical hysteroscopy, premalignant and malignant polyps were also larger. Endometrial thickness demonstrated a sensitivity of 53.8%, specificity of 85.8%, PPV of 24.6% and NPV of 95.6% at a cut-off limit of 11.5 mm with diagnostic accuracy of 83.2%. Polyp size has a diagnostic accuracy of 94.8% with a sensitivity of 92.3%, specificity of 95.0%, PPV of 61.5% and NPV of 99.3% at a cut-off point of 19.5mm. Conclusions: Endometrial thickness measured by transvaginal ultrasonography is not sufficient in predicting premalignant and malignant endometrial polyps in postmenopausal women with abnormal uterine bleeding and thickened endometrium. Polyp size on hysteroscopy is a more accurate parameter, because of better sensitivity and specificity. However, while polyp size ${\geq}19.5mm$ seems to have a great accuracy for predicting premalignancy and malignancy, histologic evaluation is still necessary to exclude premalignant and malignant polyps.

#Endometrial polyps #ultrasonography #hysteroscopy #malignancy #postmenopausal women

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Cavkaytar, Sabri

소속기관 Obstetrics and Gynecology Department, Dr Zekai Tahir Burak Woman's Health Education and Research Hos