Investigation of risk factors for benign or malignant endometrial pathology in patients presenting with abnormal uterine bleeding

Abstract

Aims: The aim of this study was to determine the risk factors associated with benign or malignant endometrial pathologies by comparing endometrial biopsy results of women presenting with abnormal uterine bleeding (AUB). Methods: In this cross-sectional study using retrospective record review method, 100 women over 18 years of age who presented to the gynecology and obstetrics clinic with AUB and underwent endometrial biopsy were included. Age, body mass index (BMI), obstetric and gynaecological history, medical history and pathology results were recorded. Endometrial pathology results were classified as normal, benign and malignant. The effects of demographic and clinical characteristics of the patients on the risk of benign and malignant pathology were analysed. Results: The mean age and BMI of the participants were 48.7±7.7 and 29.3±5.9 kg/m2, respectively. 59 (59.0%) of the patients were in the premenopausal period and 41 (41.0%) were in the postmenopausal period. Ultrasonographic endometrial thickness was below 8 mm in 23 patients (23.0%), between 8-11 mm in 27 patients (27.0%) and 12 mm or more in 50 patients (50.0%). Pathological results were normal in 35 patients (35%), benign pathology in 45 patients (45.0%) and malignant pathology in 20 patients (20.0%). In multivariate analyses, each 1 year increase in the age of the patients increased the risk of developing malignant endometrial pathology 1.17 times and each 1 mm increase in ultrasonographic endometrial thickness increased the risk of developing malignant endometrial pathology 1.16 times. The cut-off point for ultrasonographic endometrial thickness was found to be >12 mm. According to this cut-off point, the sensitivity and specificity of ultrasonographic endometrial thickness in predicting endometrial pathology were found to be 70% and 62.9%, respectively. Conclusion: It is important to determine the risk factors of malignant disease in women presenting with AUB and to perform invasive methods such as endometrial biopsy in the early period in women with risk factors to affect the success of treatment directly.

Keywords

• Abnormal uterine bleeding
• endometrial biopsy
• benign pathology
• malignant pathology
• endometrial cancer

References

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