Rate of premalignant and malignant endometrial lesion in “low-risk” premenopausal women with abnormal uterine bleeding undergoing endometrial biopsy

Objective To determine the incidence of endometrial hyperplasia and endometrial cancer (EH/EC) in low-risk premenopausal women with abnormal uterine bleeding (AUB) undergoing endometrial biopsy and to build a predictive model that includes clinical variables for predicting EH/EC in these women. Meth...

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Autores principales:	Sangam Jha, Akanksha Singh, Hemali Heidi Sinha, Poonam Bhadani, Monika Anant, Mukta Agarwal
Formato:	article
Lenguaje:	EN KO
Publicado:	Korean Society of Obstetrics and Gynecology 2021
Materias:	endometrial hyperplasia endometrial cancer biopsy premenopausal hypothyroidism Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/8b05ea131e234ae2a3beada1a3de9d09
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spelling	oai:doaj.org-article:8b05ea131e234ae2a3beada1a3de9d092021-11-15T00:50:16ZRate of premalignant and malignant endometrial lesion in “low-risk” premenopausal women with abnormal uterine bleeding undergoing endometrial biopsy2287-85722287-858010.5468/ogs.21150https://doaj.org/article/8b05ea131e234ae2a3beada1a3de9d092021-11-01T00:00:00Zhttp://www.ogscience.org/upload/pdf/ogs-21150.pdfhttps://doaj.org/toc/2287-8572https://doaj.org/toc/2287-8580Objective To determine the incidence of endometrial hyperplasia and endometrial cancer (EH/EC) in low-risk premenopausal women with abnormal uterine bleeding (AUB) undergoing endometrial biopsy and to build a predictive model that includes clinical variables for predicting EH/EC in these women. Methods This retrospective study was conducted between January 2015 and March 2020. All premenopausal women aged <55 years with AUB who underwent endometrial sampling during a specified time period were included. Data regarding baseline characteristics, sonographic findings, and histological reports were collected from patient record sheets. Results During the specified time period, 1,089 premenopausal women underwent endometrial biopsy for AUB. Complete data analysis was done for 1,084 women. Of the endometrial samples, 95.3% revealed benign pathology, whereas 4.7% of the samples had major endometrial pathology EH/EC. On step-wise logistic regression analysis, intermenstrual bleeding (IMB) (OR, 3.15), body mass index (BMI) >25 kg/m2 (odds ratio [OR], 4.4705), age >40 years (OR, 1.14), endometrial thickness (ET) >13 mm (OR, 2.59), and hypothyroidism (OR, 1.35) were significantly associated with EH/ EC. Considering the pretest probability for an EH/EC of 4.7%, this prediction model with a likelihood ratio of 14.2% demonstrated a post-test probability of 41% in the presence of the above-mentioned variables. Conclusion The risk of EH/EC was lower in low-risk premenopausal women with AUB. However, premenopausal women with IMB aged >40 years, hypothyroidism, BMI >25 kg/m2, and thickened endometrium (ET >13 mm) are at high risk of EH/EC; therefore, endometrial biopsy should be considered early in their management plan.Sangam JhaAkanksha SinghHemali Heidi SinhaPoonam BhadaniMonika AnantMukta AgarwalKorean Society of Obstetrics and Gynecologyarticleendometrial hyperplasiaendometrial cancerbiopsypremenopausalhypothyroidismGynecology and obstetricsRG1-991ENKOObstetrics & Gynecology Science, Vol 64, Iss 6, Pp 517-523 (2021)
institution	DOAJ
collection	DOAJ
language	EN KO
topic	endometrial hyperplasia endometrial cancer biopsy premenopausal hypothyroidism Gynecology and obstetrics RG1-991
spellingShingle	endometrial hyperplasia endometrial cancer biopsy premenopausal hypothyroidism Gynecology and obstetrics RG1-991 Sangam Jha Akanksha Singh Hemali Heidi Sinha Poonam Bhadani Monika Anant Mukta Agarwal Rate of premalignant and malignant endometrial lesion in “low-risk” premenopausal women with abnormal uterine bleeding undergoing endometrial biopsy
description	Objective To determine the incidence of endometrial hyperplasia and endometrial cancer (EH/EC) in low-risk premenopausal women with abnormal uterine bleeding (AUB) undergoing endometrial biopsy and to build a predictive model that includes clinical variables for predicting EH/EC in these women. Methods This retrospective study was conducted between January 2015 and March 2020. All premenopausal women aged <55 years with AUB who underwent endometrial sampling during a specified time period were included. Data regarding baseline characteristics, sonographic findings, and histological reports were collected from patient record sheets. Results During the specified time period, 1,089 premenopausal women underwent endometrial biopsy for AUB. Complete data analysis was done for 1,084 women. Of the endometrial samples, 95.3% revealed benign pathology, whereas 4.7% of the samples had major endometrial pathology EH/EC. On step-wise logistic regression analysis, intermenstrual bleeding (IMB) (OR, 3.15), body mass index (BMI) >25 kg/m2 (odds ratio [OR], 4.4705), age >40 years (OR, 1.14), endometrial thickness (ET) >13 mm (OR, 2.59), and hypothyroidism (OR, 1.35) were significantly associated with EH/ EC. Considering the pretest probability for an EH/EC of 4.7%, this prediction model with a likelihood ratio of 14.2% demonstrated a post-test probability of 41% in the presence of the above-mentioned variables. Conclusion The risk of EH/EC was lower in low-risk premenopausal women with AUB. However, premenopausal women with IMB aged >40 years, hypothyroidism, BMI >25 kg/m2, and thickened endometrium (ET >13 mm) are at high risk of EH/EC; therefore, endometrial biopsy should be considered early in their management plan.
format	article
author	Sangam Jha Akanksha Singh Hemali Heidi Sinha Poonam Bhadani Monika Anant Mukta Agarwal
author_facet	Sangam Jha Akanksha Singh Hemali Heidi Sinha Poonam Bhadani Monika Anant Mukta Agarwal
author_sort	Sangam Jha
title	Rate of premalignant and malignant endometrial lesion in “low-risk” premenopausal women with abnormal uterine bleeding undergoing endometrial biopsy
title_short	Rate of premalignant and malignant endometrial lesion in “low-risk” premenopausal women with abnormal uterine bleeding undergoing endometrial biopsy
title_full	Rate of premalignant and malignant endometrial lesion in “low-risk” premenopausal women with abnormal uterine bleeding undergoing endometrial biopsy
title_fullStr	Rate of premalignant and malignant endometrial lesion in “low-risk” premenopausal women with abnormal uterine bleeding undergoing endometrial biopsy
title_full_unstemmed	Rate of premalignant and malignant endometrial lesion in “low-risk” premenopausal women with abnormal uterine bleeding undergoing endometrial biopsy
title_sort	rate of premalignant and malignant endometrial lesion in “low-risk” premenopausal women with abnormal uterine bleeding undergoing endometrial biopsy
publisher	Korean Society of Obstetrics and Gynecology
publishDate	2021
url	https://doaj.org/article/8b05ea131e234ae2a3beada1a3de9d09
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Rate of premalignant and malignant endometrial lesion in “low-risk” premenopausal women with abnormal uterine bleeding undergoing endometrial biopsy

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