title: Hysteroscopy as a valid tool for endometrial pathology in patients with postmenopausal bleeding or asymptomatic patients with a thickened endometrium: hysteroscopic and histological results.
abstract: OBJECTIVE
  This study compares hysteroscopic and histopathological results in postmenopausal women with abnormal uterine bleeding (AUB) and asymptomatic postmenopausal women with a thickened endometrium.
  
  
  METHODS
  This is a retrospective study of 570 cases hysteroscopically examined between January 2008 and July 2012. The patients were followed up at the Istituto Tumori 'Giovanni Paolo II', Bari, Italy.
  
  
  RESULTS
  A total of 320 of the 570 cases were selected. The inclusion criteria were transvaginal ultrasound, hysteroscopy and endometrial biopsy. In the AUB group, if the hysteroscopy results were normal, a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 100, 95, 71 and 100%, respectively, were achieved, while in the asymptomatic group these values were 100, 97, 90 and 100%, respectively. For both the group with polyps and that with myomas, the sensitivity, specificity, PPV and NPV were 100%. For endometrial hyperplasia, hysteroscopy showed a sensitivity, specificity, PPV and NPV of 81, 96, 87 and 93%, respectively, in the AUB group, while in the asymptomatic group, the sensitivity was 60%, the specificity and PPV were 100%, and the NPV was 98%. The sensitivity of hysteroscopy for endometrial cancer was 63%, the specificity 97%, the PPV 77%, and the NPV 95%.
  
  
  CONCLUSIONS
  In postmenopausal women with a thickened endometrium with or without AUB, hysteroscopy allows for an accurate diagnosis in benign endometrial pathology. Hysteroscopy also allows directed biopsies of suspicious lesions, which is useful in malignant endometrial pathology.
authors.affiliation: Division of Gynaecologic Oncology, Apulian Cancer Registry, National Cancer Research Centre, Istituto Tumori 'Giovanni Paolo II', Bari, Italy.
authors.forename: Rosalia Maria Rita
authors.initials: RM
authors.lastname: Loiacono
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Trojano
authors.forename: Nicola
authors.initials: N
authors.lastname: Del Gaudio
authors.forename: Anila
authors.initials: A
authors.lastname: Kardhashi
authors.forename: Maria Assunta
authors.initials: MA
authors.lastname: Deliso
authors.forename: Gaetano
authors.initials: G
authors.lastname: Falco
authors.forename: Rita
authors.initials: R
authors.lastname: Sforza
authors.forename: Anna Franca
authors.initials: AF
authors.lastname: Laera
authors.forename: Ida
authors.initials: I
authors.lastname: Galise
authors.forename: Vito
authors.initials: V
authors.lastname: Trojano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004714:Endometrial Hyperplasia / Q000175:diagnosis* / Q000473:pathology; D004717:Endometrium / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015907:Hysteroscopy / Q000379:methods*; D007558:Italy; D008875:Middle Aged; D017698:Postmenopause; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014592:Uterine Hemorrhage / Q000175:diagnosis*; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000473:pathology