Clinical-sonographic scoring system in noninvasive diagnosis of endometrial cancer

In 90% of all endometrial cancers vaginal bleeding is the leading clinical symptom. Nowadays, scoring systems have become acceptable in medicine as less invasive, adequate, diagnostic methods. The main goal of this study was to examine the clinical-sonographic scoring system as a noninvasive diagnostic method for endometrial cancer.

The study included 122 patients with postmenopausal bleeding (PMB). Transvaginal sonography was performed before curettage. Patients were divided in two groups (A and B). In group A included were patients without endometrial malignancy and in group B were patients with endometrial cancer. A clinical-sonographic scoring system named ONCO 1 was created. Each patient got her own score based on anamnesis, clinical examination, and transvaginal ultrasonography. Evaluations of the clinical-sonographic scoring system were performed by using the test for diagnostic accuracy and receiver operating characteristic (ROC) curve.

Patients with endometrial cancer were older (median age in group B 64.49 years vs. 58.81 in group A), the length of corpus uteri was longer (6.41 cm in group B vs. 5.25 cm in group A), and the postmenopausal period was longer (13.67 years median in group B vs. 9.11 in group A). All parameters were statistically significant. The average value of clinical-sonographic scoring system ONCO 1 in group A was 7.13, +/-3.07 SD and in group B it was 9.14, +/-2.32 SD. The difference was statistically significant.

Postmenopausal bleeding caused by endometrial cancer is usually diagnosed in older patients. It was possible to distinguish high-risk patients with neoplasia from those with benign changes of the endometrium using the clinical-sonographic systems ONCO 1. Nevertheless, histopathological examination is still unavoidable for the final diagnosis of endometrial cancer.