Relationship Between Endometrial Thickness And Endometrial Pathology In Postmenopausal Women

OBJECTIVE : The aim of this study was to determine the relationship between endometrial pathologies and endometrial thickness of less than or greater than 5mm in postmenopausal women.METHODS: An electronic search was conducted using National Library of Medicine's MEDLINE database,EMBASE and PUBMED.Included studies consisted of observational studies comparing the endometrial thikcness and endometrial pathologies.Pooled estimated for odds ratio(OR)95% confidence intervals were obtained for catagorical variables using Rev Man version 5.3.RESULTS: Our search resulted in 421 citations within which only 5 studies were included after elimination of duplicates,case studies,meta-analyses.These five studies which have been included in this systematic review and meta-analysis consisted of a total of 2,643 patients.With endometrial thickness<5mm and >5mm,among them 1369 patients had endometrial thickness <5mm and remaining 1274 had endometrial thickness >5mm.The pooled analysis showed that the frequency of endometrial pathologies differed significantly between two groups of endometrial thickness as endometrial cancer(OR0.07,95% CI 0.01�0.33,P=0.0009,I2=83%),polyp(OR 0.28,95% CI 0.19�0.40,P<0.00001,I2=0%),hyplerplasia(OR 0.05,95% CI 0.02�0.12,P<0.00001,I2=67%),atrophy OR 6.61(95%CI 0.75-58.73,P=0.09,I2=99%)but one result was statistically non-significant with OR of 0.23(95%CI 0.05-1.02).CONCLUSION: The sensitivity of using 5 mm a cut off value is high for diagnosing all types of common endometrial pathologies included in this meta-analysis.The frequency of endometrial cancer,polyps and endometrial hyperplasia is significantly higher with endometrial thickness greater than5 mm.More research is needed in this subject using large samples,gather information on large(prospective studies)of patients with post menopausal bleeding.