COMPARATIVE-STUDY BETWEEN SONOGRAPHY, PATHOLOGY AND UGP IN WOMEN WITHPERIMENOPAUSAL BLEEDING

Adenocarcinoma is the commonest primary malignancy encountered in the endometrium. Adenomatous hyperplasia represents an important precancer ous endometrial lesion. In this study, different techniques have been applied in a trial to early detect endometrial carcinoma and to distin guish between hyperplasia with minimal and high risk of progression to endometrial adenocarcinoma. Eight women were included in this study a nd classified into 4 groups: 10 with adenocarcinoma, 28 with simple hy perplasia, 12 with hyperplasia with atypia and 30 normal healthy women . All individuals were subjected to Doppler endovaginal ultrasonograph y (EVS) for endometrial thickness and uterine artery resistance index (RI). Endometrial biopsy was taken for histopathological examination a nd DNA analysis. 24-hr urine was collected for the estimation of UGP b y ELISA rising reagents supplied by Ciba Coming Diagnostica, Alameda, CA, USA (Triton UGP-EIA). On referring to histopathological findings, no single parameter was seen to be specific and sensitive enough to di fferentiate between benign and malignant endometrial lesions. Doppler endovaginal ultrasonography could detect 76% of endometrial abnormalit ies. DNA ploidy and UGP showed equal sensitively rate (60%) in endomet rial carcinoma but DNA ploidy was more specific than UGP (0% and 10% f alse positively in benign endometrial diseases respectively). Combinat ion of UGP and DNA increased sensitivity to 80%.