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Predicting Pre-Malignant and Malignant Endometrial Conditions Among Postmenopausal Filipino Women Based on Ultrasound Measurement of Ovarian Volume
Cheryl T. Tiuseco, MD; Nephtali M. Gorgonio, MD, FPOGS
Department of Obstetrics and Gynecology, Cardinal Santos Medical Center
Objective: To determine the relation of ovarian volume measurements using a reference value generated by an ROC curve with endometrial tissue biopsy diagnosis of pre-malignant and malignant endometrium among Filipino postmenopausal women.
Methodology: Fifty menopausal women with vaginal bleeding were included in a six-year review from January 2008 to December 2013. All had transvaginal ultrasonography and underwent endometrial sampling. A receiver operating characteristic (ROC) curve was generated and the most valid ovarian volume was obtained. The ROC curve – generated ovarian volume was used as the cut-off value and was correlated with histopathologic diagnoses.
Results: Among the fifty patients, 30 with benign endometrium had an ovarian volume of <3.51 ml, and 10 patients had an ovarian volume of > 3.51 ml. Among the 10 patients with malignant endometrium, 9 had an ovarian volume of > 3.51 ml, and one had an ovarian volume of < 3.51 ml. The sensitivity of predicting endometrial cancer using ovarian volume of > 3.51 ml as cut-off is 90% (95% CI 55.46 % to 98.34%), while the specificity is 75% (95% CI of 58.80% to 87.29%). Using the chi-square test, it showed a significant association between ovarian volume of > 3.51 ml and malignant endometrium (P=0.0001).
Conclusion: The ROC curve-generated cut-off value of > 3.51 ml for Filipino postmenopausal women may serve as a useful diagnostic tool for classifying patients with pre-malignant and malignant endometrial conditions.
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