Hyperplastic processes in the endometrium of postmenopausal women

Yu. A. Lyzikova, А. Н. Лызиков
In: Health and Ecology Issues · 2021 · pp. 48–54 · doi:10.51523/2708-6011.2021-18-1-7 · W3167497954
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⚙ AI-generated summary by claude@2026-06, 2026-06-12 ⓘ

This study identified an M-echo value greater than 7 mm by ultrasound as an indication for endometrial biopsy in postmenopausal women, finding no specific risk factors for hyperplasia.

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This retrospective case-control study evaluated 60 postmenopausal women referred for endometrial biopsy due to endometrial pathology detected by ultrasound, comparing 30 with histologically confirmed endometrial pathology to 30 with histologically normal endometrium. The authors found no statistically significant differences in clinical/anamnestic factors between groups, but ultrasound showed a significantly greater uterine M-echo thickness in those with confirmed pathology (median 10.00 mm vs 7.80 mm). Using an M-echo threshold of >7 mm yielded reported sensitivity of 76.67% and specificity of 46.65% (AUC 0.706, p7 mm is an indication for biopsy, while 5–7 mm with no symptoms allows dynamic ultrasound follow-up; a stated limitation is that they did not identify specific risk factors and suggest further work on genetic markers of estrogen metabolism disruption. Relevance to endometriosis: the paper focuses on postmenopausal endometrial hyperplasia rather than endometriosis, and it is included in the corpus via keyword overlap with endometrial pathology rather than via explicit endometriosis discussion.

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Abstract

Objective: to specify indications for endometrial biopsy in postmenopausal women with endometrial pathology revealed by ultrasound, to study the structure of comorbidity, the parity of pregnancies and childbirth in patients with endometrial hyperplasia. Material and methods. We performed an observational retrospective case-control study. The study included 60 postmenopausal patients with endometrial pathology revealed by ultrasound referred for further endometrial biopsy. After the results of the histological examination of the endometrium had been obtained, 30 patients who had detected endometrial pathology were included in the study group, 30 patients with histologically normal endometrium were included in the comparison group. Results. In comparing clinical and anamnestic data, no statistically significant differences have been found between the groups. The comparison of the indices of the ultrasound study of the uterus has revealed a statistically significant M-echo value in patients with confirmed endometrial pathology — 10.00 (8.00; 13.00) mm, in the comparison group — 7.80 (6.00; 9.75) mm. If an M-echo value is > 7 mm with a sensitivity of 76.67 % and a specificity of 46.65%, endometrial pathology is likely to develop. The area under the curve (AUC) was 0.706 (95 % CI 0.574 — 0.816; p < 0.001). Conclusion. The obtained data determine an M-echo value more than 7 mm detected by ultrasound as an indication for endometrial biopsy in postmenopausal patients. If an M-echo value is from 5 to 7 mm and clinical manifestations are absent, dynamic observation with ultrasound control can be performed. No specific risk factors for the disease have been found in the postmenopausal patients with endometrial hyperplasia, which necessitates the search for the genetic markers of estrogen metabolic disorders.
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Гиперпластические процессы эндометрия в постменопаузе https://doi.org/10.51523/2708-6011.2021-18-1-7 Аннотация Цель исследования: уточнить показания к биопсии эндометрия при патологии эндометрия в постменопаузе, выявленной по данным ультразвукового исследования, изучить структуру сопутствующей патологии, паритета беременностей и родов у пациенток с гиперплазией эндометрия. Материал и методы. Выполнено обсервационное ретроспективное «случай-контроль» исследование. В исследование включено 60 пациенток постменопаузального периода, направленных для проведения биопсии эндометрия по поводу патологии, выявленной при ультразвуковом исследовании. После получения результатов гистологического исследования в основную группу включено 30 пациенток, у которых была выявлена патология эндометрия, 30 пациенток с гистологически нормальным эндометрием составили группу сравнения. Результаты. При анализе клинико-анамнестических данных не установлено статистически значимых различий между группами. При сравнении показателей ультразвукового исследования матки отмечено статистически значимо большая величина М-эхо у пациенток с подтвержденной патологией эндометрия — 10,00 (8,00;13,00) мм, в группе сравнения — 7,80 (6,00; 9,75) мм. При величине М-эхо > 7 мм с чувствительностью 76,67 % и специфичностью 46,65 % вероятна патология эндометрия. Площадь под кривой (AUC) составила 0,706 (95 % ДИ 0,574–0,816, p < 0,001). Заключение. Полученные данные определяют показанием для проведения биопсии эндометрия у пациенток в постменопаузе величину М-эхо по данным ультразвукового исследования более 7 мм. При величине М-эхо от 5 до 7 мм и отсутствии клинических проявлений возможно динамическое наблюдение с ультразвуковым контролем. У пациенток с гиперплазией эндометрия не выявлены специфические факторы риска заболевания, что обуславливает необходимость поиска генетических маркеров нарушения метаболизма эстрогенов в постменопаузе. Об авторах Ю. А. ЛызиковаБеларусь Лызикова Юлия Анатольевна, доцент кафедры акушерства и гинекологии, г. Гомель А. Н. Лызиков Беларусь Лызиков Анатолий Николаевич, д.м.н., профессор, профессор кафедры хирургических болезней № 1, г. Гомель Список литературы 1. Goncharenko VM, Beniuk VA, Kalenska OV, Demchenko OM, Spivak MY, Bubnov RV. Predictive diagnosis of endometrial hyperplasia and personalized therapeutic strategy in women of fertile age. EPMA J. 2013 Dec 6;4(1):24. https://doi.org/10.1186/1878-5085-4-24 2. Пономаренко ИВ, Полонников АВ, Чурносов МИ. Гиперпластические процессы эндометрия: этиопатогенез, факторы риска, полиморфизм генов-кандидатов. Акушерство и гинекология. 2019;1:13-18. https://dx.doi.org/10.18565/aig.2019.1.13-18 3. Apostolou G, Apostolou N, Moulos P, Chatzipantelis P. Endometrial cytopathology. An image analysis approach using the Ki-67 biomarker. Cytopathology. 2017;28:385–390. https://doi.org/10.1111/cyt.12435 4. Gao Y, Lin P, Lydon JP, Li Q. Conditional abrogation of transforming growth factor-β receptor 1 in PTEN-inactivated endometrium promotes endometrial cancer progression in mice. J Pathol. 2017 Sep;243(1):89-99. https://doi.org/10.1002/path.4930 5. Клинышкова ТВ, Турчанинов ДВ, Фролова НБ. Клинико-эпидемиологические аспекты рака тела матки с позиции профилактики рецидивирования гиперплазии эндометрия. Акушерство и гинекология. 2020;1:135-140 https://dx.doi.org/10.18565/aig.2020.1.135-140 6. Mitsuhashi A, Shozu M. New therapeutic approaches for the fertility-sparing treatment of endometrial cancer. The Journal of Obstetrics & Gynecology Research. 2020;46(2):215–222. https://doi.org/10.1111/jog.14155 7. Palmer JE, Perunovic B, Tidy JA. Endometrial hyperplasia. The Obstetrician & Gynaecologist. 2008;10:211–216. https://doi.org/.10.1576/toag.10.4.211.27436 8. Лызикова ЮА. Особенности продукции и рецепции половых гормонов у пациенток с хроническим эндометритом. Акушерство и Гинекология. 2020;12:144–148. https://dx.doi.org/10.18565/aig.2020.12.144-148 9. Refaiea MMM, El-Hussieny M. The role of interleukin-1b and its antagonist (diacerein) in estradiol benzoate-induced endometrial hyperplasia and atypia in female rats. Fundamental and Clinical Pharmacology. 2017;31(4):438-446. https://doi.org/10.1111/fcp.12285 10. Husby A, Wohlfahrt J, Melbye M. Pregnancy duration and endometrial cancer risk: nationwide cohort study. British Medical Journal. 2019;366:14693. https://doi.org/10.1136/bmj.l4693 11. Trabert B, Sherman ME, Kannan N, Stanczyk FZ. Progesterone and Breast Cancer. Endocrine Reviews. 2020; 41(2):320–344. https://doi.org/10.1210/endrev/bnz001 12. Sladkevicius P, Installe A, Van den Bosch T, Timmerman D, Benacerraf B, Jokubkiene L et al. International Endometrial Tumor Analysis (IETA) terminology in women with postmenopausal bleeding and sonographic endometrial thickness≥4.5mm: agreement and reliability study. Ultrasound in Obstetrics and Gynecology. 2018;51:259–268. https://doi.org/10.1002/uog.18813 13. Ozer A, Ozer S, Kanat-Pektas M. Correlation between transvaginal ultrasound measured endometrial thickness and histopathological findings in Turkish women with abnormal uterine bleeding. The Journal of Obstetrics & Gynecology Research. 2016;42(5):573–578. https://doi.org/:10.1111/jog.12937 Рецензия Для цитирования: Лызикова Ю.А., Лызиков А.Н. Гиперпластические процессы эндометрия в постменопаузе. Проблемы здоровья и экологии. 2021;18(1):48-54. https://doi.org/10.51523/2708-6011.2021-18-1-7 For citation: Lyzikova Yu.A., Lyzikov A.N. Hyperplastic processes in the endometrium of postmenopausal women. Health and Ecology Issues. 2021;18(1):48-54. (In Russ.) https://doi.org/10.51523/2708-6011.2021-18-1-7 JATS XML

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