Document Detail

Transvaginal ultrasound and lactate dehydrogenase isoenzyme activity profile in uterine aspirate for diagnosis of endometrial carcinoma in women with postmenopausal bleeding.
MedLine Citation:
PMID:  17367317     Owner:  NLM     Status:  MEDLINE    
Postmenopausal patients with vaginal bleeding (n = 72) were evaluated with the combination of transvaginal ultrasonography (TVS) and analysis of the lactate dehydrogenase (LD) isoenzyme activity profile in uterine fluid aspirates. TVS evaluation of the endometrium was classified as <5 mm, > or =5 mm, or poorly defined. The LD isoenzyme activity profile was characterized as abnormal or normal. Pathologic findings were further evaluated with diagnostic curettage. TVS found the endometrium to be > or =5 mm or poorly defined in 44 patients (61%). Endometrial carcinoma was found in 6 of 72 patients (8%). They appeared in the TVS groups endometrium >5 mm (n = 2) and endometrium poorly defined (n = 4) but not in the endometrium <5 mm. The LD isoenzyme activity profile was abnormal in the six malignant cases and in ten benign cases. Thus, the need for further evaluation with hysteroscopy and curettage was reduced to 16 cases. Since TVS had 100% sensitivity but only 42% specificity, it is suitable for first-level examination in patients with postmenopausal bleeding. The second-level method should have similarly high sensitivity but much higher specificity. The LD isoenzyme activity profile in uterine fluid aspirates had 100% sensitivity and 85% specificity. Another important feature is that the method is not sensitive to endometrial thickness, amount of sample, sampling device, or dilution. Thus, it is more reliable than aspiration histology. For every hysteroscopy or curettage that can be replaced by LD analysis, the cost is reduced by approximately EUR 720 or 540, respectively.
O Niklasson; G Skude; G Lingman; B Casslén; K Marsál
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2007-03-15
Journal Detail:
Title:  International journal of gynecological cancer : official journal of the International Gynecological Cancer Society     Volume:  17     ISSN:  1048-891X     ISO Abbreviation:  Int. J. Gynecol. Cancer     Publication Date:    2007 Nov-Dec
Date Detail:
Created Date:  2007-11-13     Completed Date:  2008-01-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111626     Medline TA:  Int J Gynecol Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1322-6     Citation Subset:  IM    
Department of Obstetrics and Gynecology, University Hospital, Lund, Sweden.
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MeSH Terms
Aged, 80 and over
Carcinoma / enzymology*,  pathology,  ultrasonography*
Endometrial Neoplasms / enzymology*,  pathology,  ultrasonography*
Endometrium / pathology
Isoenzymes / metabolism
L-Lactate Dehydrogenase / metabolism*
Middle Aged
Sensitivity and Specificity
Uterine Hemorrhage / etiology
Reg. No./Substance:
0/Isoenzymes; EC Dehydrogenase

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