Klinik ve Sonografik Bulguların Endometriyal Histopatolojik Sonucu Öngörmesi

Year 2023, Volume: 56 Issue: 2, 56 - 59, 30.09.2023

Deniz Oluklu , Yusuf Ustun , Hasan Uçkan Ayşe Hazırbulan , Osman Aydın

https://doi.org/10.20492/aeahtd.688136

Abstract

Amaç: Endometrial patolojilere tanı koymada yaygın olarak kullanılan ve güvenilir olan yöntem endometrial biyopsidir. Daha geniş kitleleri taramak endometrial biyopsi ile mümkün olmadığından; non-invaziv ve daha kolay uygulanabilen bir yöntem olan transvajinal ultrasonografi kullanılmaktadır. Bu çalışmada endometrial biyopsi yapılan hastaların patoloji sonuçları ile ultrasonogrofik bulguları arasındaki ilişkinin incelenmesi amaçlandı.
Gereç ve yöntem: Ocak 2017- Aralık 2018 tarihleri arasında jinekoloji polikliniğine başvuran, postmenopozal dönemde endometrial biyopsi yapılan 761 hasta çalışmaya dahil edildi.
Bulgular: 761 hastanın ortalama yaşı 57 yıl, ortalama postmenopoz süresi ise 7 yıldı. Başvuru anında 428 (% 56.2) hastanın kanama şikayeti vardı, 333 (% 42.8) hasta ise asemptomatikti. Yaş, postmenopozal süre ve endometrial kalınlığın histopatolojik tanı açısından risk faktörü olup olmadığını belirlemek için multivaryant analiz uygulandı. Histopatolojik tanısı yetersiz materyal olan 338 hasta ve endometial kalınlık ölçümü 4 mm den daha az ve asemptomatik 24 hasta analiz dışında bırakıldı ve 399 hasta multivaryant analize dahil edildi. Analiz sonucunda yaş ve postmenopozal sürenin risk faktörü olmadığı (sırasıyla p=0.232, p=0.757 ), endometrial kalınlığın ise bağımsız bir risk faktörü olduğunu bulduk (p=0.024, RR=1.063 (1.008-1.121)).
Sonuç: Çalışmamızın kısıtlılıklarından biri, endometriyal premalign ve malign nedenlerinin analizini sınırlayan retrospektif tasarımda olmasıdır. Bu nedenle, daha büyük prospektif çalışmalar gereklidir ve özellikle asemptomatik postmenopozal kadınlarda endometriyal patoloji riskini arttıracak faktörlerin analizine dayalı bireysel bir değerlendirme yapılmalıdır.
Aim: Endometrial biopsy is a widely used and reliable method for diagnosing endometrial pathologies. Since it is not possible to screen larger societies with endometrial biopsy, transvaginal ultrasonography, which is a non-invasive and easier method, is used. It aimed to examine the relationship between pathology results and ultrasonographic findings of patients who underwent endometrial biopsy in this study.
Material and method: 761 patients who applied to the gynecology outpatient clinic between January 2017 and December 2018 and underwent endometrial biopsy in the postmenopausal period were included in the study.
Results: The mean age of 761 patients was 57 years, and the mean postmenopausal time was 7 years. At the time of admission, 428 (56.2 %) patients had bleeding complaints, and 333 (42.8 %) patients were asymptomatic. Multivariate analysis was performed to determine whether age, postmenopausal duration, and endometrial thickness were risk factors for histopathological diagnosis. 338 patients with histopathological diagnosis of insufficient material and 24 asymptomatic patients with an endometrial thickness measurement of less than 4 mm were excluded from the analysis, and 399 patients were included in the multivariate analysis. As a result of the analysis, we found that age and postmenopausal duration were not risked factors (p=0.232, p=0.757, respectively), while endometrial thickness was an independent risk factor (p=0.024, RR=1.063 (1.008-1.121)).
Conclusion: One of the limitations of our study is that it is a retrospective design that limits the analysis of endometrial premalignant and malignant causes. Therefore, larger prospective studies are required and an individual assessment based on analysis of factors that will increase the risk of endometrial pathology, especially in asymptomatic postmenopausal women.

Keywords

Menopoz, postmenopozal kanama, sonografi, endometriyal patoloji, Menopause, postmenopausal bleeding, , sonography, endometrial pathology

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