Endometriald volume as predictor of malignancy in womend with postmenopausal bleeding

Objective: To assess endometrial volume as a predictor of endometrial malignancy in women with postmenopausal bleeding. Methods: Endometrial volume was measured by virtual organ computer-aided analysis in 170 women with postmenopausal bleeding, and histopathologic results of endometrial biopsies were obtained for all. A group of 100 women without postmenopausal bleeding was used for control. Results: There were 90 cases of benign disease, 53 cases of atypia, and 27 cases of endometrial cancers in the study group. Whereas endometrial thickness was 9.61 +/- 5.12 mm (range, 5-20 mm) and endometrial volume was 31.1 mL (range, 1.8-5.4 mL) in women with atypia or cancer, theywere 4.87 +/- 3.43 mm (range, 2-8 mm) and 1.52 +/- 0.82 (range, 0.6-2.2 mL), respectively, in women with benign disease. In the control group, endometrial volume was 1.15 +/- 0.14 mL (range, 0.6-1.3 mL). Volume was more sensitive than thickness for predicting malignancy, and a cutoff value of 1.35 mL was found to provide the best sensitivity. Conclusion: An endometrial volume of 1.35 mL or greater may predict malignancy in women with postmenopausal bleeding. (c) 2007 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.