To explore the necessity of histological evaluation in asymptomatic postmenopausal women with thickened endometrium, and to evaluate the consistency of endometrial thickness, hysteroscopic diagnosis and histopathologic diagnosis.

The clinical and pathological data of 176 postmenopausal patients with endometrial thickening (≥5 mm) who were admitted to the Department of Obstetrics and Gynecology of Taiyuan Central Hospital from January 1, 2016 to December 31, 2019 were retrospectively analyzed.

⑴ In postmenopausal women with asymptomatic endometrial thickening, the most common intrauterine lesions were endometrial polyps in 90 cases (51.5%), followed by normal endometrium in 57 cases (32.4%). ⑵ The hysteroscopic manifestations of asymptomatic endometrial thickening women were not in accordance with histopathological diagnosis, and the coincidence rate of endometrial polyps was 95.8%. ⑶ With the increase of endometrial thickening, the risk of endometrial malignant lesions increased. There was a significant difference between the thickness of normal endometrium, endometrial polyps, leiomyoma, non typical endometrial hyperplasia and specimen insufficiency compared with that of endometrial carcinoma patients (P<0.05).

In postmenopausal women with asymptomatic endometrial thickening, endometrial polyps are the most common local intrauterine lesions, and the incidence of endometrial malignant lesions is relatively low. Therefore, further evaluation can not always rely on ultrasound to evaluate endometrial thickness, but should be combined with clinical factors and consider the high-risk factors of malignant lesions to make individualized judgment. It is very important to combine hysteroscopy and histopathology to get a final and accurate diagnosis.

Postmenopause; Endometrial thickness; Endometrial neoplasms