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A prospective clinical study was performed to determine an appropriate cut-off point value of endometrial thickness for the detection of endometrial abnormalities among women with abnormal uterine bleeding. Two hundred and forty nine women with abnormal uterine bleeding who had indication for fractional uterine curettage were enrolled. Endometrial thickness was measured by transvaginal ultrasonographic examination in each patient before performing fractional uterine curettage on the same day. The results were compared with the final histological diagnosis from fractional uterine curettages. Endometrial abnormalities were identified in 69 out of 249 cases (27.7%) as hyperplasia in 57 cases(22.9%) and endometrial cancer in 12 cases (5.0%). The appropriate cut off point value of endometrial thickness was 4 mm below which no abnormal endometrial was found. This cut-off point yielded a sensitivity of 100%, a specificity of 18.3%, a positive predictive value of 31.9%, a negative predictive value of 100%, a false positive rate of 68.2%, a false negative rate of 0% and an accuracy of 40.5%. In conclusion, endometrial thickness measurement by transvaginal ultrasonography is a simple diagnostic method for identifying endometrial abnormalities in women with abnormal uterine bleeding. The cut-off point value of below 4 mm can identify endometrial abnormalities, thus unnecessary fractional uterine curettage can be avoided.
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