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. 2025 Mar 8;25(1):105.
doi: 10.1186/s12905-025-03641-2.

Association of endometrial thickness with lesions in postmenopausal asymptomatic women: risk factors and diagnostic thresholds

Wei Liu  1 , Wenpei Bai  2
Affiliations

Association of endometrial thickness with lesions in postmenopausal asymptomatic women: risk factors and diagnostic thresholds

Wei Liu et al. BMC Womens Health. .

Abstract

Purpose: This study aimed to explore the relationship between endometrial thickness and lesions in asymptomatic postmenopausal women and identify diagnostic thresholds for lesions.

Methods: A total of 279 postmenopausal asymptomatic women aged 40 years or older with endometrial thickness ≥ 4 mm were retrospectively selected in our hospital, from January 2018 to June 2023, there were 33 cases's operations which were failed due to the cervical stenosis, 8cases who used hormone replacement therapy within the past year, 7 cases with hysteromyoma that affect the shape of the uterine cavity line, and 5cases's hysteroscopic tissue acquisition were failed. Finally, A retrospective study was conducted on the endometrial thickness of 226 postmenopausal asymptomatic women measured by transvaginal ultrasound and those with thickening were subjected to hysteroscopy and pathological examination of endometrial biopsy tissues, and were divided into a normal group (80 cases), benign lesion group (143 cases), and malignant lesion group (3 cases) according to the pathology results. The endometrial thickness results measured by vaginal ultrasound were compared with the endometrial histopathologic results.

Results: 1. There were 226 cases in all, including 117 cases of endometrial polyps (51.7%);2. BMI ≥ 25 kg/m² is a risk factor to postmenopausal asymptomatic women. OR = 1.132 P < 0.05,95%CI (1.039,1.234);3. endometrial thickness ≥ 4 mm is a risk factor to postmenopausal asymptomatic women. OR = 7.927 P < 0.05, 95%CI (3.015,20.839);4. The results of the Receiver Operating Characteristic (ROC) analysis of the subjects show that the optimal cut-off value for screening endometrial pathology by endometrial thickness in asymptomatic postmenopausal women is 5.65 mm, and its area under the curve for identifying endometrial lesion was 0.679.

Conclusion: 1. The main cause of endometrial thickening after menopause was endometrial polyps (51.7%). 2. Overweight (BMI ≥ 25 kg/m²) is a risk factor for asymptomatic endometrial thickening after menopause. 3. endometrial thickness ≥ 4 mm is a risk factor to postmenopausal asymptomatic women. 4. The appropriate diagnostic threshold of vaginal ultrasound diagnosis is 5.65 mm in asymptomatic postmenopausal women.

Keywords: Asymptomatic; Endometrial lesions; Endometrial thickening; Menopause.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Clinical Trial: All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (The Ethics Committee of Shunyi District Hospital of Beijing) and with the Helsinki Declaration of 1964 and later versions. Informed consent was obtained from all patients for being included in the study. Ethics approval documents have been uploaded to related files. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
ROC curve analysis showed that the optimal cut-off value of endometrial thickness for screening endometrial lesions in asymptomatic postmenopausal women was 5.65 mm, the area under the curve was 0.679, the sensitivity was 0.555, the specificity was 0.712, and Youden index was 0.267
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References

    1. Mahdi H, Chelariu-Raicu A, Slomovitz BM. Immunotherapy in endometrial cancer [J]. Int J Gynecol Cancer 2023;33(3):351–7. - PMC - PubMed
    1. American College of Obstetricians and Gynecologists, Committee Opinion ACOG. No. 734 Summary:the role of transvaginal ultrasonography in evaluating the endometrium of women with postmenopausal bleeding [J]. Obstet gynecol, 2018;131(5):945–6. - PubMed
    1. Yao L, Li C, Cheng J. The relationship between endometrial thickening and endometrial lesions in postmenopausal women [J]. Arch Gynecol Obstet 2022;306(6):2047–54. - PubMed
    1. Bel S, Billard C, Godet J, et al. Risk of malignancy on suspicion of polyps in menopausal women[J]. Eur J Obstet Gynecol Reprod Biol. 2017;216:138–42. - PubMed
    1. Gregoriou O, Konidaris S, Vrachnis N et al. Clinical parameters linked with malignancy in endometrial polyps [J]. Climacteric, 2009;12(5):454–458. - PubMed

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