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Obstet Gynecol Sci > Accepted Articles
DOI: https://doi.org/10.5468/ogs.22053    [Accepted]
Published online April 29, 2022.
Value of endometrial thickness and Doppler parameters of uterine artery in predicting endometrial cancer in postmenopausal women with abnormal uterine bleeding: a cross-sectional study in Vietnam
Phuc Nhon Nguyen1  , Van Tuan Nguyen2
1Department of High-risk Pregnancy, Tu Du Hospital, Ho Chi Minh, Vietnam
2Department of High-risk Pregnancy, Hue University College of Medicine, Ho Chi Minh, Vietnam
Correspondence:  Phuc Nhon Nguyen,
Email: docternhon@gmail.com
Received: 27 January 2022   • Revised: 30 March 2022   • Accepted: 5 April 2022
Abstract
Objective
To determine the value of endometrial thickness and Doppler indices of the uterine artery as markers for predicting endometrial cancer in postmenopausal women with abnormal uterine bleeding.
Methods
This cross-sectional study was conducted at the Hue University Hospital and Hue Central Hospital between June 2016 and June 2019. The study enrolled all women who complained of postmenopausal bleeding and were followed by Doppler transvaginal ultrasound. Their definitive histopathological examination was the gold standard for comparison.
Results
The Doppler parameters of the uterine artery, such as resistance index (RI), pulsatility index (PI), and peak systolic velocity (PSV), were significantly lower in the malignant group than in the benign group. The threshold values of the uterine artery, RI ≤0.73 and PI ≤1.42, were found with an area under ROC curve (AUC) of 0.85-0.88, and the sensitivity and specificity were 91.3% and 83.3%, respectively. Unlike PSV, the diagnostic value was the lowest, with an AUC of 0.72. Endometrial thickness (ET) was a good predictor for the diagnosis of endometrial cancer, with an AUC of 0.89. In women with postmenopausal bleeding, when using the cut-off value of an endometrial thickness more than 12.5 mm, the sensitivity and specificity were 93.8% and 77.8%, respectively. In addition, the higher the stage of endometrial cancer, the lower the RI and PI and the greater the endometrial thickness.
Conclusion
ET, and RI, PI, and PSV of the uterine artery could help in differentiating malignant from benign endometrial changes. Pulsed ultrasonic Doppler velocimetry seems to predict the higher stages of endometrial carcinoma. Further studies are needed to confirm these findings.
Key Words: Endometrial thickness, Uterine artery, Endometrial cancer, Postmenopausal bleeding, Doppler transvaginal ultrasound
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