Transvaginal ultrasonography and endometrial histology in peri- and postmenopausal women on hormone replacement therapy

R. Lindgren, L A Mattsson, L.‐Å. Mattsson, K Andersson, Kerstin Andersson, A. Lagrelius, Kristina Sandin, K Sandin, K. Karlsson, B Risberg, Bjørn Risberg
British journal of obstetrics and gynaecology · 1999 · vol. 106(5) , pp. 421–426 · doi:10.1111/j.1471-0528.1999.tb08294.x · PMID:10430191 · W2037092969
Non-randomised trial OA: closed CC0 ⤵ 1 in-corpus citation
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Transvaginal ultrasonography and endometrial histology showed no association between endometrial thickness and pathology in HRT users, with a >4mm threshold having low specificity and positive predictive value.

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Abstract

OBJECTIVE: To determine the association between endometrial thickness and endometrial histology in a large sample of women using HRT. DESIGN: Results from three multi-centre studies were combined. PARTICIPANTS: Five hundred and sixty-four climacteric women were treated with either sequential, continuous combined or long-cycle therapy. MAIN OUTCOME MEASURES: The women underwent 717 examinations with both transvaginal ultrasonography and histological examination of the endometrium. Endometrial thickness was measured and associated with the histological findings. RESULTS: Eight cases of endometrial hyperplasia were diagnosed. All the hyperplasias were simple without atypia. Two cases had an endometrial thickness 8 mm. The > 4 mm threshold for abnormal endometrium had a sensitivity of 75%, a specificity of 47%, a positive predictive value of 2% and a negative predictive value of 99%. CONCLUSION: No association could be found between the endometrial thickness measured by transvaginal ultrasonography and endometrial pathology. In six out of eight women with simple hyperplasia the endometrium measured > 4 mm.

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MeSH descriptors

Endometrial Hyperplasia Hormone Replacement Therapy Administration, Cutaneous Endometrial Hyperplasia Endometrial Hyperplasia Estradiol Estradiol Female Hormone Replacement Therapy Humans Menopause Middle Aged Norethindrone Norethindrone Sensitivity and Specificity Ultrasonography

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