Avaliação da influência dos fatores de risco, da presença de sangramento pós-menopausa e da espessura do eco endometrial em mulheres com diagnóstico de câncer de endométrio

Abstract

INTRODUCTION: Endometrial cancer is the most common gynecological malignancy in developed countries and the second most common in developing countries. The incidence of this type of cancer is increasing rapidly in recent years, and several risk factors are associated with the development of this type of cancer. OBJECTIVE: To evaluate the influence of risk factors, thickening of endometrial echo and the presence of postmenopausal bleeding in women with histological diagnosis of endometrial cell atypia or endometrial cancer. METHOD: a case-control study was carried out with 172 postmenopausal women who underwent hysteroscopy and biopsy for endometrial evaluation, between January 2018 and March 2019, in a Public Tertiary Hospital in the city of Fortaleza / CE. The women were divided into 2 groups: 170 in the group of women with benign histopathological results, and 22 in the group of women with histopathological results with endometrial cell atypias or endometrial cancer. RESULT: regarding the woman's age, the age of menopause, the presence of arterial hypertension and the personal history of breast cancer with the use of tamoxifen, the present study showed no statistical difference between the 2 groups. Women with Diabetes Mellitus have 2.18 (1.1 - 4.7 95% CI; p = 0.04) times more likely to have endometrial cell atypia or endometrial cancer, when compared to non-diabetic women. The presence of postmenopausal uterine bleeding increases the risk for endometrial cell atypia or endometrial cancer by 3.12 times (1.24 - 7.87 95% CI; p = 0.015). As for the measurement of endometrial echo, we show that the greater the thickness of the endometrium on ultrasound, the greater the prevalence of atypical cells or endometrial cancer. Thus, we found the following prevalences: endometrial thickness from 04 to 10 mm, prevalence of 8.1%; endometrial thickness from 11 to 15 mm, prevalence of 9.1%; endometrial thickness from 16 to 20 mm, prevalence of 17.6%; endometrial thickness greater than 20 mm, prevalence of 30.0% (p = 0.031). CONCLUSION: The presence of postmenopausal uterine bleeding is the most important risk factor for endometrial cancer or endometrial cell atypia among the cases studied; there is a correlation between the thickness of the endometrial echo and the risk of endometrial cancer.