Diagnostic Value of Ultrasonography and Hysteroscopy in Endometrial Carcinoma of Premenopasal Women

Objective:To evaluate the diagnostic value of ultrasound,diagnostic curettage and hysteroscopy in patients with endometrial carcinoma before menopause.Methods:103 cases with primary endometrial cancer varied from 23 years old to 55 years old before menopause. All cases were performed ultrasound examination within 1 month when the abnormal symptoms appeared. Directed biopsy was performed during hysteroscopy. Cases in negative result after diagnostic curetting should be performed hysteroscopy. The clinical features were compared with the reports of ultrasound and hysteroscopy.Results:84 cases (81.6%) showed irregular vaginal bleeding with staging difference from Ⅰ～Ⅳ. The endometrial thickness was more than 5 mm in all cases and the average thickness was (9.3±5.6) mm. Most of the patients had been treated as benign disease for 2 to 9 months or even longer before diagnosis. The accuracy of biopsy and hysteroscopy combined with biopsy were 86.5% and 100%,respectively. The percentages of the case diagnosed definitely within 3 months,3 to 9 months and longer than 9 months were 35.9%,25.2% and 38.8%,respectively.Conclusion:The chief symptom of endometrial cancer before menopause is irregular vaginal bleeding. It is long until they were diagnosed in young patients. Ultrasound reports could not replaced biopsy and hysteroscopy which would be the best method to diagnose endometrial cancer and avoid the prolongation of diagnosis or misdiagnosis.