Postmenopausal Bleeding Clinical Trial
Official title:
Relation Between Human Epididymis Protein 4 (HE4) and Endometrial Pathology in Patients With Postmenopausal Bleeding
All patients included in the study had single or multiple episodes of postmenopausal bleeding
with an endometrial thickness of more than 5mm.
full history, general and local examination were done. Transvaginal ultrasound (TVS) was
performed .The uterus was scanned in the sagittal plane. The double-layer ET was measured at
the widest point between the endometrial-myometrial interfaces.the level of HE4 was measured.
All women underwent hystrospopic guided endometrial biopsy. Definitive management was later
performed in the form of total abdominal hysterectomy, bilateral salpingo oophrectomy, with
or without pelvic lymph nodal dissection and histopathological examination.
All patients included in the study had single or multiple episodes of postmenopausal bleeding
with an endometrial thickness of more than 5mm.
Full history was taken , the number of episodes of postmenopausal bleeding, and previous
investigations and current medications), general examination was performed and local
examination was performed for all patients.
Transvaginal ultrasound (TVS) was performed .The uterus was scanned in the sagittal plane.
The double-layer ET was measured at the widest point between the endometrial-myometrial
interfaces by using electronic calipers. If there was fluid in the uterine cavity it was
recorded. Suspected polyp was also recorded.
For the level of HE4: 5 ml of venous blood were withdrawn from all patients. The samples were
left to clot. The separated sera were stored at -20˚ until all samples were obtained. Frozen
samples were allowed to reach room temperature prior to use. Samples were then mixed
thoroughly by gently inverting multiple times before analysis. HE4 was quantitatively assayed
using the enzyme immunoassay (EIA) method (Fujirebio Diagnostics, Inc. Göteborg, Sweden). The
functional sensitivity of the HE4 EIA is ≤ 25pM. The analytical specificity is 100 ± 15%.
All patients were then submitted to hysteroscopy under general anesthesia and endometrial
biopsy.
After hysteroscopy and biopsy, 2 patient proved to have cervical malignancy, 2 patients were
unfit for open surgery, and another 6 patients did not show up after. These 10 patients were
excluded from the study leaving 90 patients eligible for final analysis .
Definitive management was later performed in the form of total abdominal hysterectomy,
bilateral salpingo oophrectomy, with or without pelvic lymph nodal dissection and
histopathological examination.
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