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Revista chilena de obstetricia y ginecología

versión On-line ISSN 0717-7526

Resumen

RABY B, Trinidad et al. Capacidad diagnóstica de la ecografía para detectar cáncer de endometrio en mujeres posmenopaúsicas sintomáticas y asintomáticas: experiencia de la Universidad Católica de Chile. Rev. chil. obstet. ginecol. [online]. 2014, vol.79, n.3, pp.166-172. ISSN 0717-7526.  http://dx.doi.org/10.4067/S0717-75262014000300004.

Introduction: 10% of postmenopausal women with abnormal uterine bleeding (AUB) have endometrial cancer. Endometrial biopsy is recommended in all postmenopausal women with AUB and endometrial thickness >5 mm on ultrasound. Recent studies suggest that the use of a lower value (3 mm) improves the ability of ultrasound to detect endometrial cancer. In asymptomatic postmenopausal women, endometrial biopsy is recommended if the endometrial thickness is >11mm. Objective: To determine the diagnostic accuracy of ultrasound for detecting endometrial cancer, using a cutoff value of 3 and 5 mm in symptomatic and 11 mm in asymptomatic postmenopausal women. Methods: Retrospective review of endometrial biopsies and clinical history of women attending UC Health Network (2007-2012). Results: 132 cases were analyzed, 63.6 % had AUB. There were 17 cases of endometrial cancer (12.9%), with a mean endometrial thickness of 18 mm. 88 % of women with endometrial cancer had SUA. In symptomatic women the sensitivity for the diagnosis of endometrial cancer was 100% and 93% using a cutoff value of 3 and 5 mm respectively. In asymptomatic women, the cutoff value of 11 mm, had a sensitivity of 50 % and a specificity of 65 % for endometrial cancer. Conclusion: We recommend endometrial biopsy in all postmenopausal women with AUB and endometrial thickness >3 mm. In postmenopausal women without AUB we do not recommend routine endometrial ultrasound evaluation.

Palabras clave : Endometrium; ultrasound; endometrial cancer; abnormal uterine bleeding.

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