Objective By collecting clinical data such as postmenopausal bleeding (PMB) patients, risk factors, and endometrial ultrasound imaging characteristics, a model that predicts the risk of endometrial malignant lesions in women with PMB was constructed. Methods A total of 358 PMB patients treated at Liuyang People's Hospital from December 2019 to December 2024 were enrolled. Based on pathological results, patients with endometrial cancer (EC) and atypical hyperplasia (AH) were assigned to the case group, while others formed the control group. Clinical data on endometrial ultrasound imaging features and risk factors were collected, and a logistic regression analysis was performed retrospectively. Results (1) Statistically significant differences were observed between groups in endometrial thickness, echo uniformity, and blood flow grading (grade 0, grade I, grade II, grade III); (2) Significant differences were found in high-risk factors for endometrial malignancy, including age, menopause age, endometrial thickness, recurrent vaginal bleeding, obesity, diabetes, hypertension, and CA125 levels; (3) Logistic regression identified recurrent vaginal bleeding, obesity, diabetes, endometrial thickening, non-uniform echogenicity, and CA125>21U/mL as independent risk factors; (4) The “FBDNTC” prediction model (Frequency of bleeding, Body mass index, Diabetes, Non-uniform echogenicity & Thickness, CA125) was established, with scores ranging from 0 to 21. At a cutoff of ≥8 points (maximizing Youden index), sensitivity was 84.7%, specificity 74.6%, and AUC 0.881(95%CI: 0.845-0.917). Conclusion The FBDNTC risk prediction model integrates clinical and ultrasound features to effectively assist clinicians in stratifying endometrial malignancy risk, optimizing diagnosis and treatment.
Key words
postmenopausal bleeding /
endometrial cancer /
endometrial atypical hyperplasia /
risk factors /
prediction model
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