OBJECTIVE To assess the performance of simultaneous endometrial aspiration and sonohysterography to screen for endometrial cancer or hyperplasia in women aged 50 years or older. METHODS We conducted a prospective study from February 2014 to October 2020 at the ultrasound unit of a large urban academic medical center. The study included 1,635 women aged 50 years or older referred for endometrial evaluation, with follow-up through January 2021. Participants underwent saline infusion sonohysterography combined with ultrasound-guided endometrial aspiration. The primary outcome measured was a diagnosis of endometrial cancer or hyperplasia within 1 year from screening. The diagnostic accuracy of the combined evaluation method, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV), was assessed. RESULTS Of 1,170 women who completed the study protocol, 82 (7.0%) had endometrial cancer and 42 (3.6%) had endometrial hyperplasia. Of all patients who developed cancer during the follow-up period, 85.5% were diagnosed within 1 year after evaluation. The application of simultaneous endometrial aspiration and sonohysterography together demonstrated a sensitivity of 99.1%, specificity of 24.9%, PPV of 11.8%, and NPV of 99.6%. Using a theoretical sequential approach, assuming an endometrial aspiration is performed only in patients determined to be high risk by sonohysterography, demonstrated a sensitivity of 93.4%, specificity of 99.9%, PPV of 99.0%, and NPV of 99.3%. CONCLUSION Simultaneous endometrial aspiration and sonohysterography is an effective one-stop outpatient screening tool for detecting endometrial cancer and hyperplasia in women aged 50 years or older. With the integration of two screening modalities into a single procedure, simultaneous endometrial aspiration and sonohysterography may overcome the limitations inherent in each of the currently recommended methods individually, potentially improving patient prognosis and streamlining the diagnostic process.

中文翻译：

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结合超声检查和子宫内膜抽吸作为子宫内膜瘤变的一站式筛查。


目的 评估同时进行子宫内膜抽吸和宫腔超声造影筛查 50 岁或以上女性子宫内膜癌或增生的性能。方法 我们于 2014 年 2 月至 2020 年 10 月在一家大型城市学术医疗中心的超声科进行了一项前瞻性研究。该研究包括 1,635 名 50 岁或以上的女性，她们被转诊进行子宫内膜评估，随访至 2021 年 1 月。参与者接受了生理盐水输注宫腔声学造影联合超声引导下子宫内膜抽吸。测量的主要结局是筛选后 1 年内诊断为子宫内膜癌或增生。评估联合评估方法的诊断准确性，包括敏感性、特异性、阳性预测值 （PPV） 和阴性预测值 （NPV）。结果 在完成研究方案的 1,170 名女性中，82 名 （7.0%） 患有子宫内膜癌，42 名 （3.6%） 患有子宫内膜增生。在随访期间发生癌症的所有患者中，85.5% 在评估后 1 年内被诊断出来。同时应用子宫内膜抽吸和宫腔声学造影显示敏感性为 99.1%，特异性为 24.9%，PPV 为 11.8%，NPV 为 99.6%。使用理论序贯方法，假设仅在宫腔超声检查确定为高风险的患者中进行子宫内膜抽吸，显示敏感性为 93.4%，特异性为 99.9%，PPV 为 99.0%，NPV 为 99.3%。结论 同时子宫内膜抽吸和宫腔超声造影是检测 50 岁或以上女性子宫内膜癌和增生的有效一站式门诊筛查工具。 通过将两种筛查方式整合到一个程序中，同时进行子宫内膜抽吸和宫腔超声造影可以单独克服目前推荐的每种方法所固有的局限性，从而有可能改善患者的预后并简化诊断过程。