Endometriyal Patoloji ve Anormal Uterin Kanama ile Başvuran Hastaların Endometriyal Biyopsi Sonuçlarının Anti Müllerian Hormon, Östradiol, Ca125 ve He-4 Düzeyi ile İlişkisi

Abstract

DURU, S.A. Relation Between The AMH, Estradiol, CA125 and HE-4 Hormone Levels And The Endometrial Biopsy Results Of Patients With Abnormal Uterine Bleeding, Hacettepe University Faculty Of Medicine, Department Of Obstetrics And Gynecology, Dissertation, Ankara 2018. Abnormal uterine bleeding (AUB) is the most frequent symptom for attandence to gynecology clinics In a women with AUB it is important to identify endometrial cancer and hyperplasia. In this prospective, clinical study we aimed to evaluate the predictive values for AMH, E2, CA125 and HE-4 levels for endometrial malignancies in patients with AUB. Based on the histopathological findings of endometrial biopsies, the study participants were stratified as patients with benign pathologies (n=118, 59%), malignant & precancerous pathologies (n=63, 31,5%) and non-diagnostic pathologies (n=19, 9,5%). When all three groups of pathologies were included there was no significant differance in CA125 levels between all pathologies (p=0.443). The median AMH value was significantly higher with benign pathologies than other pathologies (p<0,001). The median HE4 value was significantly higher in patients with malignant & precancerous pathologies when compared with other groups (p<0,001). Also the mean E2 value was significantly lower in patients with malignant & precancerous pathologies when compared with benign pathologies, but higher than non-diagnostic group (p<0,001). The ROMA median score was significantly higher in patients with malignant & precancerous pathologies (p<0,001). In the sub-group analysis it was seen that CA125, HE-4 and ROMA score were not able to predict malignancy in the premenopausal group. In the postmenopausal group it was seen that HE-4 and ROMA score can predict malignancy but CA125 could not. As a result in patients with AUB AMH, E2, HE-4 and ROMA scores can be used to predict malignancy especially in postmenopausal patients. More research for new biomarkers is needed in premenopausal patients.