Relationship between ultrasound-measured endometrial thickness and risk of endometrial cancer in postmenopausal women: A single-center observational study

Abstract

Introduction: Endometrial cancer is the most frequent oncological pathology in postmenopause and is associated with abnormal uterine bleeding. Different studies have found a significant relation-ship between increased endometrial thickness and the risk of endometrial cancer. This study aimed to measure the association between these variables and perform diagnostic tests in a regional reference center in Guayaquil, Ecuador.

Methodology: This analytical study was carried out at the University Pediatric-Obstetric-Gynecological Hospital of the city of Guayaquil-Ecuador from January to December 2018, with a nonprobabilistic sample, including postmenopausal women with uterine bleeding and endometrial thickening equal to or greater than 3 millimeters to the transvaginal ultrasound study who were subjected to curettage with a histopathological report. The dependent variable was the histological -ence of endometrial neoplasia; the independent variable was the ultrasound endometrial thickness.

Results: The analysis included 148 patients, with a mean age of 57.9 ± 5.4 years. Obesity was ob-served in 22 cases (10.9%), type 2 diabetes in 20 cases (9.95%), and hypertension in 11 cases (5.47%). There were 19 cases of endometrial cancer and 129 cases of endometrial hyperplasia. The mean endometrial thickness was 3.560 ± 0.49969 mm. Thickness >3.5 mm OR 54.03 (95% CI 3.19-914.34) P=0.0057. The sensitivity was 100%, the specificity was 58.1%, the positive predictive value was 26.0%, and the accuracy was 63.5%.

Conclusion: The sensitivity of measuring endometrial thickness >3.5 mm as a predictor of endometrial cancer in symptomatic postmenopausal women is high; however, it does not have reasonable specificity or positive predictive value, which limits its clinical use.