DIAGNOSTIC ACCURACY OF ENDOMETRIAL THICKNESS ON ULTRASOUND AND ITS CORRELATION WITH HISTOPATHOLOGY IN FEMALES WITH POSTMENOPAUSAL BLEEDING

Abstract

iBackground: The ultrasonic diagnostic represents an accurate and noninvasive approach to examine endometrial thickness in the early diagnosis of endometrial cancer as well as during postmenopausal bleeding. However, there is a paucity of studies in the Pakistani population assessing risk in PMB patients through demographic and clinical factors to inform low-risk early detection strategies. Objective: To compare the diagnostic accuracy of endometrial thickness on ultrasound with histopathological results and investigate associations of endometrial thickness with demographic and clinical risk factors. Methods: This prospective cross-sectional study was carried out in Department of Obstetrics and Gynecology, Hameed Latif Hospital, Lahore, Pakistan. Demographic and clinical information such age, BMI, smoking, and other risk factors were documented which were independent variables, and ultrasound (US) was conducted to assess ET, which was dependent variable and abnormal if >4 mm. Endometrial biopsy for histopathological diagnosis was done in all the participants.  Data was analyzed using SPSS V. 27. Results: Participants' mean age was 59.9 ± 6.3 years, mean BMI was 29.1 ± 4.5 kg/m², and mean endometrial thickening was 5.1 ± 3.6 mm. Upon ultrasound, 30.5% had elevated ET, whereas histopathology established abnormalities in 20.5%. Ultrasound showed 90.2% sensitivity, 84.9% specificity, 60.7% positive predictive value PV, 97.1% negative predictive value (NPV), and overall diagnostic accuracy of 86.0%. Conclusion: Endometrial thickening measured by US has been found to be highly sensitive and specific diagnostic test for assessment of PMB with an excellent NPV, and thus an ideal non-invasive screening test.