Találati lista | Tudóstér

001-es BibID:	BIBFORM103064
035-os BibID:	(WoS)000911496500001 (Scopus)85136295331
Első szerző:	Vitale, Salvatore Giovanni
Cím:	Risk of endometrial cancer in asymptomatic postmenopausal women in relation to ultrasonographic endometrial thickness : systematic review and diagnostic test accuracy meta-analysis / Vitale Salvatore Giovanni, Riemma Gaetano, Haimovich Sergio, Carugno Jose, Pacheco Luis Alonso, Perez-Medina Tirso, Parry John Preston, Török Peter, Tesarik Jan, Della Corte Luigi, Cobellis Luigi, Di Spiezio Sardo Attilio, De Franciscis Pasquale
Dátum:	2023
ISSN:	0002-9378
Megjegyzések:	Objective: To evaluate the risk of endometrial carcinoma (EC) and atypical endometrial hyperplasia (AEH) in asymptomatic postmenopausal women in relation to the endometrial thickness (ET) measured by transvaginal ultrasonography (TVS) stratified by threshold categories used for performing subsequent endometrial sampling and histologic evaluation. Data sources: MEDLINE, Scopus, ClinicalTrials.gov, Scielo, EMBASE, the Cochrane Library at the CENTRAL Register of Controlled Trials, LILACS, conference proceedings and international controlled trials registries were searched without temporal or geographical or language restrictions. Study eligibility criteria: Studies were selected if they had a cross-over design evaluating the risk for AEH and EC in postmenopausal asymptomatic women and calculated the diagnostic accuracy of TVS thresholds (at least 3.0 mm) confirmed by histopathological diagnosis. Study appraisal and synthesis methods: We conducted a systematic review and diagnostic test accuracy meta-analysis according to PRISMA-DTA and SeDATE guidelines. ET thresholds were grouped as follows: from 3.0 mm to 5.9 mm; between 6.0 and 9.9 mm; between 10.0 and 13.9 mm; and equal or greater than 14.0 mm. Quality assessment was performed using QUADAS-2 tool. Publication bias was quantified by Deek funnel plot test. Co-primary outcomes were risk for AEH or EC according to ET and diagnostic accuracy of each threshold group. Results: A total of 18 studies provided the data of 10,334 women who were all included in the final analysis. Overall, at an ET threshold of at least 3.0 mm, the risk for AEH or EC was increased three-fold relative to women below the cut-off (relative risk (RR) 3.77, 95% confidence interval (CI) 2.26 to 6.32, I2=74%). Similar degrees of risk were reported for thresholds between 3.0 and 5.9 mm (RR 5.08, 95% CI 2.26 to 11.41, I2=0%), 6.0 and 9.9 mm (RR 4.34, 95% CI 1.68 to 11.23, I2=0%), 10.0 and 13.9 mm (RR 4.11, 95% CI 1.55 to 10.87, I2=86%) and over 14.0 mm (RR 2.53, 95% CI 1.04 to 6.16, I2=78%) with no significant difference among subgroups (p=0.885). Regarding diagnostic accuracy, the pooled sensitivity decreased from thresholds below 5.9 mm (0.81, 95% CI 0.49 to 0.85) to above 14.0 mm (0.28 95% CI 0.18 to 0.40) Meanwhile, specificity increased from 0.70 (95% CI 0.61 to 0.78) for ET between 3.0 mm and 5.9 mm to 0.86 (95% CI 0.71 to 0.94) when the ET is 14.0 mm or greater. For 3.0-5.9 mm and 10.0-13.9 mm thresholds, the highest diagnostic odds ratio of 10 (95% CI 3 to 41) and 11 (95% CI 2 to 49), with an area under curve of 0.81 (95% CI 0.77 to 0.84) and 0.82 (95% CI 0.79 to 0.86) respectively were retrieved. The summary point analysis revealed that, compared to the other subgroups, the 3.0-5.9 mm cut off point was placed higher in the summary receiver operator curve space, indicating increased EC or AEH diagnosis using these cut-offs. Conclusions: Both low and high ET thresholds in postmenopausal asymptomatic women seem equally effective in detecting EC and AEH. However, although using a 3.0 to 5.9 mm cut off results in lower specificity, the offsetting improvement in sensitivity may justify using this cut off for further endometrial evaluation in patients with suspected endometrial malignancy.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Atypical Endometrial Hyperplasia Cut-off Endometrial cancer Endometrial thickness Transvaginal ultrasonography
Megjelenés:	American Journal Of Obstetrics And Gynecology. - 228 : 1 (2023), p. 22-35.e2. -
További szerzők:	Riemma, Gaetano Haimovich, Sergio Carugno, Jose Pacheco, Luis Alonso Perez-Medina, Tirso Parry, John Preston Török Péter (1975-) (szülész-nőgyógyász) Tesarik, Jan Della Corte, Luigi Cobellis, Luigi Di Spiezio Sardo, Attilio De Franciscis, Pasquale
Internet cím:	Szerző által megadott URL DOI Intézményi repozitóriumban (DEA) tárolt változat
Borító:
Saját polcon: