Publication: Evaluation of endometrial changes and p53 expression in tamoxifen treated women: Comparison of various methods
Date
2006
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
Objective: To compare transvaginal sonography (TVS), sonohysterography (SHG), hysteroscopy and endometrial
aspiration (EA) and p53 expression in assessing endometrial abnormalities in women on tamoxifen.
Methods: In a cross sectional study of 50 pre- and post-menopausal women receiving tamoxifen for > 2 years, all
participants underwent TVS and EA. Those with endometrial thickness > 4 mm on TVS underwent hysteroscopy
and SHG. Serum p53 antibody and p53 immunohistochemistry were tested in all women.
Results: The sensitivity and specificity when compared with histopathology as the reference standard were as
follows: TVS 100% and 33.3%, SHG 85.7% and 50%, hysteroscopy 92.8% and 80.8%, serum p53 50% and 83.3%,
and p53 immunohistochemistry 57.1% and 61.1%. Prevalence of endometrial abnormalities was not significantly
different in asymptomatic and symptomatic women.
Conclusion: Tamoxifen-users require routine testing for endometrial evaluation. TVS followed by hysteroscopy and
biopsy is an effective option. p53 expression correlates with histological abnormalities.
Key words: Tamoxifen, Sonography, Sonohysterography, Hysteroscopy, Endometrium, p53