Structured Hysteroscopic Evaluation of Endometrium in Women With Postmenopausal Bleeding

摘要: Abstract Study Objective To evaluate visual pattern parameters obtained with hysteroscopy for the prediction of endometrial cancer, to observer variation these parameters, and present a scoring system malignancy compared subjective evaluation. Design A prospective controlled study (Canadian Task Force classification II-1). Setting university clinic. Patients One hundred forty-nine consecutive women postmenopausal bleeding an endometrium thickness ≥ 5 mm. Sixty-one (41%) had cancer. Forty-six 149 were referred based on suspected malignancy. Interventions Endometrial characteristics cancer evaluated in hysteroscopic video clips. The reference standard was pathologic evaluation resectoscopic samples or hysterectomy. Using multivariate logistic regression, image correlated presence Measurements Main Results score lesion surface, necrosis, vessels area under curve (AUC) 0.89, 0.87, respectively. (HYCA) unsmooth papillary projections, surface “candy floss” white hyperintense spots, irregular branching vessels, distribution able predict (AUC = 0.964) higher accuracy than 0.859, p  Conclusion systematic optimal by HYCA systematically defined terms may increase diagnosis should be further elaborated external validity tested unselected bleeding.