Evaluation of endometrial changes and p53 expression in tamoxifen treated women: comparison of various methods.
OBJECTIVE
To compare transvaginal sonography (TVS), sonohysterography (SHG), hysteroscopy and endometrial aspiration (EA) and p53 expression in assessing endometrial abnormalities in women on tamoxifen.


METHODS
In a cross sectional study of 50 pre- and post-menopausal women receiving tamoxifen for > 2 years, all participants underwent TVS and EA. Those with endometrial thickness > 4 mm on TVS underwent hysteroscopy and SHG. Serum p53 antibody and p53 immunohistochemistry were tested in all women.


RESULTS
The sensitivity and specificity when compared with histopathology as the reference standard were as follows: TVS 100% and 33.3%, SHG 85.7% and 50%, hysteroscopy 92.8% and 80.8%, serum p53 50% and 83.3%, and p53 immunohistochemistry 57.1% and 61.1%. Prevalence of endometrial abnormalities was not significantly different in asymptomatic and symptomatic women.


CONCLUSIONS
Tamoxifen-users require routine testing for endometrial evaluation. TVS followed by hysteroscopy and biopsy is an effective option. p53 expression correlates with histological abnormalities.
Pokharel
H P
HP
Department of Gynaecology and Obstetrics, BP Koirala Institute of Health Sciences, Dharan, Nepal.
Bhatla
N
N
Kriplani
A
A
Mukhopadhyay
A
A
Srivastava
A
A
Ralhan
R
R
D000328:Adult; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects* / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D004717:Endometrium / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology*; D005260:Female; D006801:Humans; D015907:Hysteroscopy; D008875:Middle Aged; D013629:Tamoxifen / Q000009:adverse effects* / Q000627:therapeutic use*; D014463:Ultrasonography
D018931:Antineoplastic Agents, Hormonal; D013629:Tamoxifen