Efficacy of Endometrial Thickness in Predicting Endometrial Lesions in Perimenopausal Patients with Abnormal Uterine Bleeding

Zhong Qinfang

doi:10.3969/j.issn.1004-5775.2026.03.011

Abstract：Objective:To investigate the efficacy of endometrial thickness in predicting endometrial lesions in patients with abnormal uterine bleeding during perimenopause.Methods:A total of 120 perimenopausal women who underwent hysteroscopy in the gynecology department of our hospital from July 2023 to September 2024 were selected as subjects,and received vaginal ultrasonography to measure endometrial thickness.According to the results of the vaginal ultrasonography of the patients,whether the endometrial thickness reached or exceeded 5 mm and whether there was abnormal postmenopausal uterine bleeding was considered.The patients were divided into three groups.Group A included patients with endometrial thickness of≥5 mm with abnormal uterine bleeding(n=46).Group B consisted of patients with endometrial thickness less than 5 mm and abnormal uterine bleeding(n=39).Group C included patients with no abnormal uterine bleeding but with endometrial thickness of≥5 mm(n=35).The endometrial thickness and postoperative pathological results of the three groups were compared.At the same time,subgroup analysis was conducted for patients with abnormal uterine bleeding(patients in group A and group B)according to whether intrauterine lesions occurred,and differences in clinical data were observed.receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of endometrial thickness in early prediction of intrauterine lesions in postmenopausal women.Results:The endometrial thickness of group A was(9.56±1.28)mm,and that of group C was(9.11±1.19)mm,both of which were higher than that of group B(3.43±0.60)mm,and the difference was statistically significant(P＜0.001).There was no significant difference between group A and group C(P＞0.05).The pathological results showed that the proportion of endometrial polyps in group C was 62.86%,which was higher than that in group A(45.65%)and group B(12.82%).The proportion of submucosal fibroids in group C was 14.29%,higher than that in group A(6.52%)and higher than that in group B(0).In group A,21.74%of patients had endometrial cancer,in group C,there was 1 case(2.86%),and in group B,there was no secondary pathology.In group B,there were 64.10%of patients had normal intima,the proportion was higher than that in group C(11.43%)and group A(8.70%),and the difference was statistically significant(P＜0.05).In group B,23.08%of patients had endometritis,which was higher than that in group A(17.39%)and group C(8.58%),but the difference was not statistically significant(P＞0.05).The endometrial thickness of subgroup 1 was significantly higher than that of subgroup 2(P＜0.001).ROC curves were used to analyze endometrial thickness in patients with abnormal uterine bleeding to evaluate its diagnostic ability in early prediction of intrauterine lesions.The results showed that the sensitivity was 62.16%,the specificity was 84.78%,the area under curve(AUC)value was 0.714,and the optimal cut-off value was 7.92 mm.Conclusion:Endometrial thickness is a reliable index for evaluating uterine lesions in patients with abnormal uterine bleeding in perimenopause,which shows high diagnostic value.