Postmenopozal Kanamalı Olgularda Maligniteye İlerleyişte Yaş, Endometrium Kalınlığı ve Vücut Kitle İndekslerinin Karşılaştırılması

Amaç: Bu çalışmada postmenopozal kanamalı (PMK) olgularda maligniteye ilerleyişte yaş, endometrium kalınlığı (EK) ve vücut kitle indeksinin (VKİ) karşılaştırılmasını amaçladık. Gereç ve Yöntem: Bu çalışmada, 168 postmenopozal kanamalı hastanın patolojik ve klinik özellikleri retrospektif incelendi. Tüm olguların yaş, gravida, parite, menopoz süresi, VKİ, EK değerleri kaydedildi. Hipertansiyon, diyabet gibi kronik hastalığı olanlar ile overde kitlesi olan hastalar çalışma dışında tutuldu. Verilerin istatistiksel analizi için SPSS 17.0 programı kullanıldı. Önce Kruskall Wallis varyans analizi yapıldı, p

Comparison of Age, Endometrial Thickness and Body Mass Index in Progression of Malignancy in Post menopausal Bleeding Cases

Objective: In this study, we aimed to compare age, endometrial thickness (ET) and body mass index (BMI) in progression of malignancy with postmenopausal bleeding (PMB) . Material and Method: The clinical and pathological features of 168 patients with PMB were analyzed retrospectively. All cases age, gravida, parity, duration of menopause, BMI, ET values were recorded. Patients with chronic diseases such as hypertension, diabetes and mass in ovary were excluded from the study. SPSS 17.0 software was used for statistical analysis. Kruskal Wallis was performed for analysis of variance, for the parameters that were p <0.05, Mann-Whitney U test was used in comparison between groups. p <0.05 was considered significant. Results: Benign causes and endometrial cancer groups were included to study. Group 1 (n = 78): Patients with PMB caused by benign pathologies. Group 2 (n = 12): Endometrial cancer cases diagnosed at PMB. In comprasion with the G1 and G2, endometrial thickness and age had a significant relationship with the malignancy, but not with BMI. With increase at cases age and ET, there was an increase at the progression to malignancy. Although BMI increased in malignant group compared to the benign group, there were no statistically significant differences. Conclusion: Increase at menopause age, endometrial thickness and BMI, risk increases for malignancy. However, in our study, age and endometrial thickness are more decisive than body mass index in progression of malignancy in patients with PMB. Endometrial thickness should be measured at women in the menopausal and must be managed according to the results

Kaynakça

Creinin MD. Evaluation of postmenapouseal bleeding. Am J Obstet Gynecol 1998;178: 868-9.

Oriel KA, Schrager S. Abnormal uterine bleeding. American Family Physician 1999; 60: 1371-82.

Bray F, dos SSI, Moller H, Weiderpass E. Endometrial cancer incidence trends in Europe: underlying determinants and prospects for prevention. Cancer Epidemiol Biomarkers Prev 2005; 14: 1132-42.

Reeves GK, Pirie K, Beral V, Green J, Spencer E, Bull D. Cancer incidence and mortality in relationto body mass index in the Million Women Study: cohort study. Br Med J 2007; 335: 1134. 5

Beral V, Bull D, Reeves G. Endometrial cancer and hormone replacement therapy in the Million Women Study. Lancet 2005; 365: 1543-51. 6

Gallagher EJ, Le Roith D. Diabetes,anti hyperglycemic medications and cancer risk: smokeor fire? Curr Opin Endocrinol Diabetes Obes 2013; 20: 485-94. 7

Mac Kinthos ML, Crosbie EJ. Obesity-driven endometrial cancer: is weight loss the answer? BJOG 2013; 120: 791-4.

Goldstein SR, Zeltser I, Horan CK, Snyder JR, Schwartz LB. Ultrasonography based triage for perimenopausal patients with abnormal uterine bleeding. Am J Obstet Gynecol 1997; 177: 102-108.

Moschos E, Ashfaq R, McIntire DD, Liriano B, Twickler DM. Obstet Gynecol 2009; 113: 881.

Arslan S, Yüksel K, Samay ÖG, Yeşilyurt H, Yalçın H, Gökmen O. Office hysteroscopy versus transvaginal ultrasonography in the evaluation of patients with excessive uterine bleeding. Gynecol Obstet Reprod Med 2001; 7: 36-40.

Şimşek P, Üner M, Karaveli Ş, Trak B, Erman O. Endometrial patolojilerin değerlendirilmesinde diagnostik histeroskopi ve sonografik endometrial kalınlığın değeri. T Klin J Gynecol Obst 1999; 9: 272- 75.

Lurain JR. Uterine Cancer. In: Berek JS, Adashi EY, Hillard PA, eds. Novak's Gynecology. Baltimore, Maryland: Williams&Wilkins, 1996: 1061-92.

Vitoratos N, Gregoriou O, Hassiakos D, Zourlas PA. The role of androgens in the late-premenopausal woman with adenomatous hyperplasia of the endometrium. Int J Gynaecol Obstet 1991; 34:157-61.

Disaia PJ, Creasman WT. Adenocarcinoma of the uterus. Clinical Gynecologic Oncology, third edition, The CV Mosby Company, Missouri 1989: 161-97.

Granberg S, Karlsson B, Wikland M, Gull B. Uterus ve Endometriyum Hastalıklarının Transvajinal Sonografisi. In: Fleischer AC, Manning FA, Jeanty P, Romero R, (eds.) Obstetrik ve Jinekolojide Sonografi, beşinci baskı, Ulusal Tıp Kitabevi, 2000: 851-68.

Wilailak S, Jirapinyo M, Theppisai U. Transvaginal Doppler sonography: is there a role for this modality in the evaluation of women with postmenopausal bleeding? Maturitas 2005; 50: 111-6.

Giannella L, Mfuta K, Setti T, Cerami LB, Bergamini E, Boselli F. A risk-scoring model for the prediction of endometrial cancer among symptomatic postmenopausal women with endometrial thickness & gt; 4 mm.Biomed Res Int doi: 10.1155/2014/130569

Gull B, Karlsson B, Milsom I, Granberg S. Factors associated with endometrial thickness and uterine size in a random sample of postmenopausal women. Am J Obstet Gynecol 2001; 185: 386-391.

Famuyide AO, Breitkopf DM, Hopkins MR, Laughlin- Tommaso SK. Asymptomatic thicken edendometrium in postmenopausal women: malignancy risk.J Minim Invasive Gynecol 2014; 21: 782-6.

Chandavarkar U, Kuperman JM, Muderspach LI, Opper N, Felix JC, Roman L. Endometrial echo complex thickness in postmenopausal endometrial cancer. Gynecol Oncol 2013; 131: 109-12.

Andolf E, Dahlander K, Aspenberg P. Ultrasonic thickness of the endometrium correlated to body weight in asymptomatic postmenopausal women. Obstet Gynecol 1993; 82: 936-40.

Mihu D, Ciortea R, Mihu CM. Abdominal adiposity through adipocyte secretion products, a risk factor for endometrial cancer.Gynecol Endocrinol 2013; 29: 448-51.

Ali AT. Risk factors for endometrial cancer. Ceska Gynekol 2013; 78: 448-59.

Smith B, Porter R, Ahuja K, Craft I. Ultrasonic assesment of endometrial changes in stimulated cycles in an invitro fertilization and embryo transfer program. J InVitro Fertil Embryo Transfer 1984; 1: 233-8.

Barboza IC, Depesde B, ViannaJşnior I, et al. Analysis of endometrial ultrasonography in obese patients.Einstein (Sao Paulo) 2014; 12: 164-7. by transvaginal

Çorakçı A, Özeren S, Yücesoy G, Vural B, Erk A, Yücesoy İ. Postmenapozal Dönemde Vücut Ağırlığı Ve vücut Kütle Endeksinin Endometrial Kalınlık İle İlişkisi. Turkiye Klinikleri J Gynecol Obst 1998; 8: 13-16.

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