Menopause-specific ROC-based cutoff values for endometrial thickness and the role of heterogeneous endometrial morphology in predicting EIN/endometrial carcinoma

Meryem Bekmezci; Ramazan Bülbül; Melike Ordu

Menopause-specific ROC-based cutoff values for endometrial thickness and the role of heterogeneous endometrial morphology in predicting EIN/endometrial carcinoma

Abstract

Aims: To evaluate the diagnostic value of transvaginal ultrasonography in differentiating benign and malignant endometrial conditions and to determine menopause-specific endometrial thickness cutoff values. Methods: This retrospective study included 6,333 women with abnormal uterine bleeding who underwent transvaginal ultrasonography followed by histopathological evaluation between January 2020 and December 2025. Demographic characteristics, endometrial thickness and morphology, and histopathological findings were recorded. Diagnostic performance was assessed using ROC analysis, optimal cutoff values were determined using the Youden index, and independent predictors were evaluated by multivariable logistic regression. Results: Endometrial thickness was significantly greater in patients with hyperplasia, endometrial intraepithelial neoplasia (EIN), and endometrial carcinoma than in those with benign histopathology (p<0.001). For predicting EIN/carcinoma, AUC values were 0.807, 0.855, and 0.788 in premenopausal, perimenopausal, and postmenopausal women, respectively. Optimal endometrial thickness cutoffs were >12 mm in premenopausal and perimenopausal women and >14.2 mm in postmenopausal women. Increasing age (OR 1.06), endometrial thickness (OR 1.11), postmenopausal status (OR 3.14), and heterogeneous endometrial morphology (OR 10.32) were independent predictors of EIN/endometrial carcinoma. Conclusion: Endometrial thickness is a valuable predictor of EIN/endometrial carcinoma. Combining menopause-specific cutoff values with endometrial morphology and clinical factors may improve diagnostic accuracy and support individualized clinical decision-making.

Keywords

Supporting Institution

This study received no financial support from any institution or funding agency

Project Number

2025/233

Ethical Statement

This study was approved by the Aksaray University Ethics Committee (No: 2025/233, Date: November 11, 2025). Since this is a retrospective study, informed consent was not obtained. The study was conducted in accordance with the Helsinki Declaration.

Thanks

None

References

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Details

Primary Language

English

Subjects

Obstetrics and Gynaecology

Journal Section

Research Article

Authors

Meryem Bekmezci ^*
0000-0002-1861-3556
Türkiye

Ramazan Bülbül
0000-0003-3321-3718
Türkiye

Melike Ordu
0000-0001-8863-817X
Türkiye

Publication Date

October 25, 2026

Submission Date

July 18, 2026

Acceptance Date

August 19, 2026

Published in Issue

Year 2026 Volume: 7 Number: 5

IZ

https://izlik.org/JA55UN52RE

Cite

RIS / Bibtex

APA

Bekmezci, M., Bülbül, R., & Ordu, M. (2026). Menopause-specific ROC-based cutoff values for endometrial thickness and the role of heterogeneous endometrial morphology in predicting EIN/endometrial carcinoma. Journal of Medicine and Palliative Care, 7(5), 911-916. https://izlik.org/JA55UN52RE

AMA

1.Bekmezci M, Bülbül R, Ordu M. Menopause-specific ROC-based cutoff values for endometrial thickness and the role of heterogeneous endometrial morphology in predicting EIN/endometrial carcinoma. J Med Palliat Care / JOMPAC / jompac. 2026;7(5):911-916. https://izlik.org/JA55UN52RE

Chicago

Bekmezci, Meryem, Ramazan Bülbül, and Melike Ordu. 2026. “Menopause-Specific ROC-Based Cutoff Values for Endometrial Thickness and the Role of Heterogeneous Endometrial Morphology in Predicting EIN Endometrial Carcinoma”. Journal of Medicine and Palliative Care 7 (5): 911-16. https://izlik.org/JA55UN52RE.

EndNote

Bekmezci M, Bülbül R, Ordu M (October 1, 2026) Menopause-specific ROC-based cutoff values for endometrial thickness and the role of heterogeneous endometrial morphology in predicting EIN/endometrial carcinoma. Journal of Medicine and Palliative Care 7 5 911–916.

IEEE

[1]M. Bekmezci, R. Bülbül, and M. Ordu, “Menopause-specific ROC-based cutoff values for endometrial thickness and the role of heterogeneous endometrial morphology in predicting EIN/endometrial carcinoma”, J Med Palliat Care / JOMPAC / jompac, vol. 7, no. 5, pp. 911–916, Oct. 2026, [Online]. Available: https://izlik.org/JA55UN52RE

ISNAD

Bekmezci, Meryem - Bülbül, Ramazan - Ordu, Melike. “Menopause-Specific ROC-Based Cutoff Values for Endometrial Thickness and the Role of Heterogeneous Endometrial Morphology in Predicting EIN Endometrial Carcinoma”. Journal of Medicine and Palliative Care 7/5 (October 1, 2026): 911-916. https://izlik.org/JA55UN52RE.

JAMA

1.Bekmezci M, Bülbül R, Ordu M. Menopause-specific ROC-based cutoff values for endometrial thickness and the role of heterogeneous endometrial morphology in predicting EIN/endometrial carcinoma. J Med Palliat Care / JOMPAC / jompac. 2026;7:911–916.

MLA

Bekmezci, Meryem, et al. “Menopause-Specific ROC-Based Cutoff Values for Endometrial Thickness and the Role of Heterogeneous Endometrial Morphology in Predicting EIN Endometrial Carcinoma”. Journal of Medicine and Palliative Care, vol. 7, no. 5, Oct. 2026, pp. 911-6, https://izlik.org/JA55UN52RE.

Vancouver

1.Meryem Bekmezci, Ramazan Bülbül, Melike Ordu. Menopause-specific ROC-based cutoff values for endometrial thickness and the role of heterogeneous endometrial morphology in predicting EIN/endometrial carcinoma. J Med Palliat Care / JOMPAC / jompac [Internet]. 2026 Oct. 1;7(5):911-6. Available from: https://izlik.org/JA55UN52RE