HETEROGENEITY OF ENDOMETRIUM – AN INCREASED RISK FACTOR FOR ENDOMETRIAL MALIGNANCY

Abstract

Introduction. The normal postmenopausal endometrium should appear thin, homogeneous and echogenic. Endometrial cancer causes the endometrium to thicken, appear heterogeneous, have irregular or poorly defined margins, and show increased color Doppler signals. Aim. To examine the correlation between endometrial echogenicity and the risk of endometrial malignancy in postmenopausal women. Methods. This was a prospective clinical study involving 120 postmenopausal patients treated at the University Clinic for Gynecology and Obstetrics-Skopje, divided into two groups: control and examined. The coнtrol group included 40 postmenopausal patients, hospitalized and operated on due to urogenital pathology. The examined group consisted of 80 patients divided into two subgroups – a group with uterine bleeding and the other one without uterine bleeding. According to the ultrasound verified thickness of the endometrium, the two subgroups were divided according to endometrial thickness into: the first group with endometrial thick ness from 5-8 mm; the second from > 8-11mm and the third group above 11 mm. We made ultrasound examination by measuring the echogenicity of the endometrium in both groups of patients as well as in sub groups, which were also divided into other subgroups according to endometrial thickness. Results. The probability of endometrial malignancy was significantly increased by 4,938 in heterogenous endometrium. Conclusion. There are many examples of intratumor heterogeneity in endometrial malignancy, either at the morphologic or the molecular level. Attention should be paid so as not to miss minor subpopulations of tumor cells with diagnostic and prognostic relevance.