Endometrial cancer risk factors in patients with endometrial echogenicity: a logistic regression analysis

This study aimed to investigate the factors associated with the risk of detecting endometrial cancer in women with endometrial echogenicity suggested by ultrasound diagnosis, using the results of hysteroscopic pathology and histology as the "gold standard". The study enrolled 160 hospitalized patients from January 2020 to January 2023, all exhibiting uneven endometrial echogenicity based on ultrasound findings. Following this, hysteroscopy was conducted on all patients, and the hysteroscopy pathological examination results were considered as the reference standard. Data on clinical and ultrasound examinations of the patients were gathered, and logistic regression analysis was employed to investigate the factors impacting the identification of endometrial cancer. Of the 160 patients whose ultrasound indicated uneven endometrial echogenicity, 119 (74.38%) were diagnosed with benign lesions, while 41 (25.63%) were found to have malignant lesions according to the hysteroscopy pathological examination. Results showed that compared to patients with benign lesions, patients with malignant endometrial lesions had higher ages, were more likely to be menopausal, had irregular vaginal bleeding, had endometrial thickening, and had realtime blood flow grading of the endometrium and adjacent myometrium graded II- III. These differences were statistically significant (p < 0.05). The endometrium and surrounding myometrium's real-time blood flow grading, which are ranked II-III (Odds Ratio (OR) = 3.473, 95% Confidence Interval (CI) 1.540-7.833), are independent variables. In conclusion, doctors should be aware that endometrial cancer may be present in postmenopausal women who have irregular vaginal bleeding, watch for strong realtime blood flow signals between the endometrium and surrounding muscle layers, and use transvaginal ultrasound (TVUS) to detect endometrial thickening.