title: Ovarian volume assessment in relation to histologic findings and sex hormone levels in women with postmenopausal bleeding and thickened endometrium.
abstract: OBJECTIVE
  In postmenopausal women, ovarian stromal hyperplasia and endometrial cancer are often identified concurrently. The aim of the present study was to verify the association of ovarian volume with histologic findings and sex hormones levels in women with postmenopausal bleeding and thickened endometrium.
  
  
  METHODS
  Prospective observational study conducted in a teaching hospital between March 2008 and February 2010
  
  
  METHODS
  Ninety women with postmenopausal bleeding and thickened endometrium (>=5 mm) were enrolled. They underwent vaginal sonography for ovarian volume measurement. Blood samples were collected for sex steroid hormones assay. In addition, endometrial sampling was done for definitive histologic diagnosis.
  
  
  RESULTS
  According to histologic results, 18 cases (20%) had endometrial adenocarcinoma, 24 cases (26.7%) had endometrial hyperplasia with or without atypia and 48 cases (53.3%) had benign histologic findings. Large ovaries were significantly associated with higher body mass index (BMI>=30) (P=.002) and endometrial adenocarcinoma (P < .001). After adjustment for age and BMI, increased ovarian volume in adenocarcinoma was associated with high serum level of estradiol (P < .001), serum total testosterone (P=.04) and serum free testosterone (P < .01) compared with other histologic findings.
  
  
  CONCLUSIONS
  Large ovaries among women with postmenopausal bleeding and thick endometrium were associated with elevated serum sex steroid hormones and represent a marker of risk for endometrial adenocarcinoma.
authors: Department of Obstetrics and Gynecology, Faculty of Medicine, Taibah University, Al Madinah 30001, Saudi Arabia. amr.fyomy@yahoo.com
authors: Amr K
authors: AK
authors: Elfayomy
authors: Shereen A
authors: SA
authors: El Tarhouny
mesh_terms: D001706:Biopsy; D004714:Endometrial Hyperplasia / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D004717:Endometrium / Q000000981:diagnostic imaging / Q000473:pathology*; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D012739:Gonadal Steroid Hormones / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D009929:Organ Size; D010053:Ovary / Q000000981:diagnostic imaging / Q000473:pathology*; D017698:Postmenopause; D011446:Prospective Studies; D012720:Severity of Illness Index; D014592:Uterine Hemorrhage / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D014594:Uterine Neoplasms / Q000097:blood / Q000150:complications / Q000175:diagnosis
chemical_list: D012739:Gonadal Steroid Hormones
references: J Ultrasound Med. 2001 Oct;20(10):1025-36
references: 11587008
references: Endocr Relat Cancer. 2008 Jun;15(2):485-97
references: 18509001
references: JAMA. 1998 Nov 4;280(17):1510-7
references: 9809732
references: Oncogene. 2004 Aug 23;23(38):6365-78
references: 15322511
references: Maturitas. 2006 Mar 20;53(4):405-12
references: 16111843
references: World Health Organ Tech Rep Ser. 2000;894:i-xii, 1-253
references: 11234459
references: Br J Cancer. 2001 Apr 6;84(7):975-81
references: 11286480
references: Radiology. 1977 Nov;125(2):477-83
references: 910061
references: Cancer Epidemiol Biomarkers Prev. 2006 Aug;15(8):1550-4
references: 16896048
references: J Natl Cancer Inst. 2002 Apr 17;94(8):606-16
references: 11959894
references: Best Pract Res Clin Obstet Gynaecol. 2004 Feb;18(1):125-43
references: 15123062
references: Acta Obstet Gynecol Scand. 2002 Sep;81(9):799-816
references: 12225294
references: Pharmacol Rev. 2005 Sep;57(3):359-83
references: 16109840
references: Ultrasound Obstet Gynecol. 1996 Oct;8(4):272-6
references: 8916382
references: BJOG. 2006 May;113(5):502-10
references: 16637894
references: Eur J Endocrinol. 2001 Jul;145(1):1-9
references: 11415846
references: Cancer Epidemiol Biomarkers Prev. 2002 Dec;11(12):1531-43
references: 12496040
references: J Clin Endocrinol Metab. 2005 Jul;90(7):3847-53
references: 15827095
references: Maturitas. 2002 Oct 25;43(2):77-85
references: 12385855
references: Menopause. 2000 Jan-Feb;7(1):53-61
references: 10646704
references: Gynecol Oncol. 2007 Dec;107(3):431-5
references: 17720234
references: Maturitas. 2009 Apr 20;62(4):334-7
references: 19231117