Xue H, Shen WJ, Zhang Y. Pathological pattern of endometrial abnormalities in postmenopausal women with bleeding or thickened endometrium . World J Clin Cases 2022; 10(7): 2159-2165 [PMID: 35321190 DOI: 10.12998/wjcc.v10.i7.2159]
Corresponding Author of This Article
Yi Zhang, MD, PhD, Chief Doctor, Department of Gynecology, The First Affiliated Hospital of China Medical University, No. 155 North Nanjing Street, Shenyang 110001, Liaoning Province, China. syzi@163.com
Research Domain of This Article
Obstetrics & Gynecology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Mar 6, 2022; 10(7): 2159-2165 Published online Mar 6, 2022. doi: 10.12998/wjcc.v10.i7.2159
Pathological pattern of endometrial abnormalities in postmenopausal women with bleeding or thickened endometrium
Hui Xue, Wen-Jing Shen, Yi Zhang
Hui Xue, Wen-Jing Shen, Yi Zhang, Department of Gynecology, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Author contributions: Zhang Y designed the study; Xue H and Shen WJ performed in the data acquisition and analysis, drafted and revised the manuscript; all authors have read and approved the final manuscript to be submitted.
Supported byKey Research and Development Project in Department of Science and Technology, Liaoning Province, No. 2017225025.
Institutional review board statement: This study was reviewed and approved by the Science and Research Office of First Affiliated Hospital of China Medical University (Shenyang, China).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items and the manuscript was prepared and revised accordingly.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi Zhang, MD, PhD, Chief Doctor, Department of Gynecology, The First Affiliated Hospital of China Medical University, No. 155 North Nanjing Street, Shenyang 110001, Liaoning Province, China. syzi@163.com
Received: August 6, 2021 Peer-review started: August 6, 2021 First decision: September 1, 2021 Revised: September 11, 2021 Accepted: January 17, 2022 Article in press: January 17, 2022 Published online: March 6, 2022 Processing time: 208 Days and 4.2 Hours
Abstract
BACKGROUND
Postmenopausal bleeding and an endometrial thickness ≥ 5 mm on sonograms of menopausal women can indicate the presence of endometrial lesions. Diagnostic hysteroscopy is a powerful method for endometrial diseases.
AIM
To investigate the pathological pattern of endometrial abnormalities in postmenopausal women with bleeding or asymptomatic thickened endometrium diagnosed by hysteroscopy.
METHODS
A total of 187 postmenopausal women with bleeding or asymptomatic thickened endometrium underwent diagnostic hysteroscopy. The women were subsequently divided into three groups: Postmenopausal bleeding (PMB) group (n = 84), asymptomatic group (n = 94), and additional group (n = 9). Women in the additional group manifested abdominal pain and leukorrhagia.
RESULTS
Among the 187 patients examined, 84 (44.9%) were diagnosed with PMB and 94 (50.3%) with asymptomatic thickened endometrium. Endometrial polyp was the most common endometrial abnormality, which was detected in 51.2%, 76.6% and 77.8% of the PMB, asymptomatic, and additional groups, respectively. In the PMB group, 7 (8.3%) women had hyperplasia with atypia and 14 (16.7%) had endometrial adenocarcinoma. Fewer malignant lesions were detected in the asymptomatic group. Endometrial hyperplasia without atypia was found in 8.3% of the PMB group and 7.4% of the asymptomatic group.
CONCLUSION
Endometrial polyp was the most common pathology in the PMB group. Diagnostic hysteroscopy is recommended for women with PMB and asymptomatic thickened endometrium.
Core Tip: Postmenopausal bleeding and thickened endometrium in menopausal women indicate the presence of endometrial lesions. These women should undergo further examination to rule out malignancy. In particular, diagnostic hysteroscopy is recommended based on its lower cost, lower rate of complications, and high accuracy.
