잠시만 기다려 주세요. 로딩중입니다.

Rate of premalignant and malignant endometrial lesion in “low-risk” premenopausal women with abnormal uterine bleeding undergoing endometrial biopsy

Obstetrics & Gynecology Science 2021년 64권 6호 p.517 ~ 523
Jha Sangam, Singh Akanksha, Sinha Hemali Heidi, Bhadani Poonam, Anant Monika, Agarwal Mukta,
소속 상세정보
 ( Jha Sangam ) - All India Institute of Medical Science Patna Department of Obstetrics and Gynecology
 ( Singh Akanksha ) - All India Institute of Medical Science Patna Department of Obstetrics and Gynecology
 ( Sinha Hemali Heidi ) - All India Institute of Medical Science Patna Department of Obstetrics and Gynecology
 ( Bhadani Poonam ) - All India Institute of Medical Science Patna Department of Pathology
 ( Anant Monika ) - All India Institute of Medical Science Patna Department of Obstetrics and Gynecology
 ( Agarwal Mukta ) - All India Institute of Medical Science Patna Department of Obstetrics and Gynecology

Abstract


Objective: To determine the incidence of endometrial hyperplasia and endometrial cancer (EH/EC) in low-risk premenopausal women with abnormal uterine bleeding (AUB) undergoing endometrial biopsy and to build a predictive model that includes clinical variables for predicting EH/EC in these women.

Methods: This retrospective study was conducted between January 2015 and March 2020. All premenopausal women aged <55 years with AUB who underwent endometrial sampling during a specified time period were included. Data regarding baseline characteristics, sonographic findings, and histological reports were collected from patient record sheets.

Results: During the specified time period, 1,089 premenopausal women underwent endometrial biopsy for AUB. Complete data analysis was done for 1,084 women. Of the endometrial samples, 95.3% revealed benign pathology, whereas 4.7% of the samples had major endometrial pathology EH/EC. On step-wise logistic regression analysis, intermenstrual bleeding (IMB) (OR, 3.15), body mass index (BMI) >25 kg/m2 (odds ratio [OR], 4.4705), age >40 years (OR, 1.14), endometrial thickness (ET) >13 mm (OR, 2.59), and hypothyroidism (OR, 1.35) were significantly associated with EH/ EC. Considering the pretest probability for an EH/EC of 4.7%, this prediction model with a likelihood ratio of 14.2% demonstrated a post-test probability of 41% in the presence of the above-mentioned variables.

Conclusion: The risk of EH/EC was lower in low-risk premenopausal women with AUB. However, premenopausal women with IMB aged >40 years, hypothyroidism, BMI >25 kg/m2, and thickened endometrium (ET >13 mm) are at high risk of EH/EC; therefore, endometrial biopsy should be considered early in their management plan.

키워드

Endometrial hyperplasia; Endometrial cancer; Biopsy; Premenopausal; Hypothyroidism

원문 및 링크아웃 정보

등재저널 정보