Comparison of Endometrial Biopsy Results of Premenopausal and Postmenopausal Patients

Year 2020, Volume: 6 Issue: 1, 59 - 64, 30.04.2020

Gökçe Turan , Pinar Yalcin Bahat , Berna Aslan Çetin , Pınar Kadiroğulları

https://doi.org/10.19127/mbsjohs.693457

Abstract

Objective: To evaluate the histopathological results of endometrial biopsy specimens obtained from patients who referred to our clinic with a complaint of abnormal uterine bleeding (AUB) and to compare the results of premenopausal and postmenopausal patients.
Methods: In this retrospective study, the records of patients who referred to our clinic due to AUB between 2013 and 2017, and who had undergone endometrial biopsy with pipelle were evaluated. Demographic data and menopausal status of the patients were recorded. Endometrial biopsy results of all patients were investigated. In addition, the patients were divided into two groups as premenopausal and postmenopausal. Endometrial biopsy results of both groups were compared.
Results: While 2808 (56.1%) of the 5000 patients who referred with AUB and who had undergone endometrial sampling were premenopausal, 2192 (43.8%) were postmenopausal. The mean age of the premenopausal and postmenopausal groups was found to be 41.6 ± 1.8 and 54.2 ± 5.9, respectively. Secretory endometrium was significantly higher in the premenopausal group than the postmenopausal group (p <0.001). While atrophic endometrium and malignancy were significantly higher in the postmenopausal group than the premenopausal group, chronic endometritis was significantly higher in the premenopausal group.
Conclusion: Endometrial biopsy, which is a simple, inexpensive and easy technique, is the most preferred method for the exclusion of malignancy in patients with complaint of AUB. In patients with complaint of AUB, malignancy exclusion decision by endometrial biopsy must be made considering the age interval, risk factors that may cause estrogen exposure, and menopausal status of the patients.

Keywords

Pipelle, Endometrial sampling, Abnormal uterine bleeding, Premenopausal

References

• Abdullah LS, Bondagji NS. Histopathological pattern of endometrial sampling performed for abnormal uterine bleeding. Bahrain Med Bull 2011; 33(4):195-98.
• Brinton LA, Felix AS, McMeekin DS, Creasman WT, Sherman ME, et al. Etiologic heterogeneity in endometrial cancer: Evidence from a Gynecologic Oncology Group trial. Gynecol Oncol 2013; 129(2):277-84.
• Britton H, Huang L, Lum A, Leung S, Shum K, Kale M et al. Molecular classification defines outcomes and opportunities in young women with endometrial carcinoma. Gynecol Oncol 2019; 153(3):487-95.
• Burbos N, Musonda P, Crocker SG, Morris EP, Duncan TJ, Nieto JJ. Outcome of investigations for postmenopausal vaginal bleeding in women under the age of 50 years. Gynecol Oncol 2012; 125(1):120-23.
• Dangal G. A study of endometrium of patients with abnormal uterine bleeding at Chitwan Valley. Kathmandu Univ Med J (KUMJ) 2003; 1(2):110–12
• Ewies, A. A., Musonda P. Managing postmenopausal bleeding revisited: What is the best first line investigation and who should be seen within 2 weeks? A cross-sectional study of 326 women. Eur J Obstet Gyneco. Reprod Biol 2010; 153(1):67-71.
• Jairajpuri Z, Jetley S, Rana S. Morphological spectrum of endometrial pathology in middle-aged women with atypical uterine bleeding: A study of 219 cases. J Midlife Health 2013; 4(4):216.
• Jayawickcrama WIU, Abeysena C. Risk factors for endometrial carcinoma among postmenopausal women in Sri Lanka: a case control study. BMC Public Health 2019; 19(1):1387.
• Khare, A., Bansal, R. E a. Morphological spectrum of endometrium in patients presenting with dysfunctional uterine bleeding. People’s J Sci Res 2012; 5(2):13–16
• Michail G, Karahaliou A, Skiadopoulos S, Kalogeropoulou C, Terzis G, Boniatis, I. et al. Texture analysis of perimenopausal and post-menopausal endometrial tissue in grayscale transvaginal ultrasonography. Br J Radiol 2007; 80(956):609-16.
• Munro MG, Critchley HOD, Broder MS, Fraser IS. 2011. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int. J. Gynecol. Obstet. 113(1):3-13.
• Takreem A, Danish N, Razaq S. Incidence of endometrial hyperplasia in 100 cases presenting with polymenorrhagia/menorrhagia in perimenupausal women. J Ayub Med Coll Abbottabad 2009; 21(2):60–63
• Turan G, Yalcin Bahat P, Aydin A, Yuksel Özgor B. Evaluation of platelet-rich plasma injection activity in the treatment of abnormal uterine bleeding. J Turkish Soc Obstet Gynecol 2018; 15(4):222-26.
• Wright JD, Chen L, Gabor L, Burke WM, Tergas AI, et al. Patterns of Specialty-Based Referral and Perioperative Outcomes for Women with Endometrial Cancer Undergoing Hysterectomy. Obstet Gynecol 2017; 130(1):81-90.