Gynecological Cancers by Antonio Giordano & Marcella Macaluso

Author:Antonio Giordano & Marcella Macaluso
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Morphological and Cytological Markers

Transvaginal ultrasonography (TVS) is a relatively simple and noninvasive diagnostic method that provides clinicians with useful information relevant for identifying and characterizing ovarian masses. Moreover, endometrial thickness measured using TVS is the most commonly used tumor marker of EC.

Screening studies using conventional and color Doppler US in apparently healthy postmenopausal women have established that EC can be detected at a preclinical stage and that TVS is more sensitive than blind endometrial biopsy. A review of data from approximately 2900 patients collected from 13 published studies demonstrated that an endometrial thickness cutoff of 5 mm on TVS resulted in a sensitivity of 90 % and a specificity of 54 % compared to 98 and 35 %, respectively, if the cutoff was reduced to 3 mm. In addition, the 3-mm cutoff could reduce the pretest probability of EC from 10 to 0.7 % in women with negative results. The reviewers concluded that a 3-mm endometrial thickness cutoff on TVS might reliably exclude EC in women with postmenopausal bleeding [97].

TVS can observe morphology of ovarian clearly; many studies suggested TVS can be used as a method for screening early-stage OC. TVS can accurately characterize about 90 % of adnexal masses and the reported sensitivity and specificity of US for detecting ovarian malignancies is 88–96 % and 90–96 %, respectively [98–101]. Various approaches have been used to characterize ovarian masses, including pattern recognition approach, simple scoring systems, statistically derived scoring systems, probability predictors based on logistic regression analysis, and complex mathematical models such as neural networks [102, 103].

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