Endometrial volume as predictor of malignancy in women with postmenopausal bleeding

ObjectiveTo assess endometrial volume as a predictor of endometrial malignancy in women with postmenopausal bleeding.MethodsEndometrial 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.ResultsThere 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 3 ± 1.1 mL (range, 1.8–5.4 mL) in women with atypia or cancer, they were 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.ConclusionAn endometrial volume of 1.35 mL or greater may predict malignancy in women with postmenopausal bleeding.