Previous studies have reported a wide range of sensitivity and specificity for sonographic markers of endometrial polyps. The objective of this study is to evaluate the sensitivity and specificity of endometrial thickness for predicting endometrial polyps using hysteroscopy as the gold standard for diagnosis.METHODS:
This is a retrospective cohort study of women presenting for hysteroscopy between January 2, 2007 and October 21, 2011. Women diagnosed with endometrial polyps were evaluated for clinical and sonographic markers including age, body mass index (BMI), hypertension, hormone or tamoxifen therapy, and endometrial thickness. The cohort was stratified by menopausal status. Multivariate analyses were performed using logistic regression.RESULTS:
During the study period, 3,334 women underwent office hysteroscopy; 1,557 had an ultrasound within the past 3 months. For both pre and postmenopausal women, increased endometrial thickness was associated with polyps (P<.001). Sensitivity and specificity were maximized at an endometrial thickness cutoff equal or greater than 7.3 mm (sensitivity 73.6%, specificity 43.7%, AUC 0.614) and equal or greater than 6.5 mm (sensitivity 74.6%, specificity 60.4%, AUC 0.722) for pre and postmenopausal women, respectively. In multivariate analyses, for premenopausal women, endometrial thickness and age were predictive of endometrial polyps (OR 1.06, 95% CI 1.03–1.09 and OR 1.04, 95% CI 1.02–1.07, respectively). In postmenopausal women, endometrial thickness and BMI were predictive of endometrial polyps (OR 1.16, 95% CI 1.11–1.21 and OR 1.03, 95% CI 1.00–1.05, respectively).CONCLUSION:
Based on our results, endometrial thickness equal or greater than 6.5 mm is predictive of endometrial polyps in postmenopausal women.