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

Sangam Jha; Akanksha Singh; Hemali Heidi Sinha; Poonam Bhadani; Monika Anant; Mukta Agarwal

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자료유형: 학술저널

저자정보: Sangam Jha (All India Institute of Medical Science Patna) Akanksha Singh (All India Institute of Medical Science Patna) Hemali Heidi Sinha (All India Institute of Medical Science Patna) Poonam Bhadani (All India Institute of Medical Science Patna) Monika Anant (All India Institute of Medical Science Patna) Mukta Agarwal (All India Institute of Medical Science Patna)

저널정보: 대한산부인과학회 Obstetrics & Gynecology Science Obstetrics & Gynecology Science 제64권 제6호

발행연도: 2021.11

수록면: 517 - 523 (7page)

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ObjectiveTo determine the incidence of endometrial hyperplasia and endometrial cancer (EH/EC) in low-risk premenopausalwomen with abnormal uterine bleeding (AUB) undergoing endometrial biopsy and to build a predictive model thatincludes clinical variables for predicting EH/EC in these women. MethodsThis 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. Dataregarding baseline characteristics, sonographic findings, and histological reports were collected from patient recordsheets. ResultsDuring the specified time period, 1,089 premenopausal women underwent endometrial biopsy for AUB. Completedata analysis was done for 1,084 women. Of the endometrial samples, 95.3% revealed benign pathology, whereas4.7% of the samples had major endometrial pathology EH/EC. On step-wise logistic regression analysis, intermenstrualbleeding (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. ConclusionThe risk of EH/EC was lower in low-risk premenopausal women with AUB. However, premenopausal women with IMBaged >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.

#Endometrial hyperplasia #Endometrial cancer #Biopsy #Premenopausal #Hypothyroidism

참고문헌 (19)

참고문헌 신청

Fraser IS / 2009 / Health-related quality of life and economic burden of abnormal uterine bleeding / Expert Rev Obstet Gynecol 4:179~189

Munro MG / 2011 / FIGO classification system(PALM-COEIN)for causes of abnormal uterine bleeding in nongravid women of reproductive age / Int J Gynaecol Obstet 113:3~13

Bignardi T / 2009 / Abnormal uterine and post-menopausal bleeding in the acute gynaecology unit / Best Pract Res Clin Obstet Gynaecol 23:595~607

Lacey JV Jr / 2009 / Endometrial hyperplasia and the risk of progression to carcinoma / Maturitas 63:39~44

Lacey JV Jr / 2010 / Absolute risk of endometrial carcinoma during 20-year follow-up among women with endometrial hyperplasia / J Clin Oncol 28:788~792

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