Title: Association of endometrial thickness with lesions in postmenopausal asymptomatic
women:Risk Factors and Diagnostic Thresholds
Version: 1 Date: 27 Jan 2025
Reviewer's report:
Title; Correlation between endometrial thickness and endometrial lesions in postmenopausal
asymptomatic women
Strengths:
• Clarity: The title clearly indicates the variables of interest (endometrial thickness and
endometrial lesions) and the target population (postmenopausal asymptomatic women).
• Conciseness: The title is brief and to the point, which is appropriate for scientific studies.
Suggestions for Improvement:
• Specificity: Consider adding more details to the title to reflect the study's focus on diagnostic
thresholds, risk factors, or outcomes. For example:
o "Correlation between Endometrial Thickness and Lesions in Postmenopausal Asymptomatic
Women: Risk Factors and Diagnostic Thresholds"
• Broader Impact: If the study highlights clinical or practical implications, you could incorporate
that into the title to attract a wider audience. For example:
o "Endometrial Thickness as a Predictor of Lesions in Postmenopausal Asymptomatic Women:
Implications for Early Detection"
• Grammatical Adjustments: Changing "Correlation between" to "Association of" may improve
the readability and precision of the title. For instance:
o "Association of Endometrial Thickness with Lesions in Postmenopausal Asymptomatic
Women"
Consistency:
• Ensure that the terminology in the title matches the key terms in the abstract and methods
(e.g., "lesions" vs. "malignancy"). If the study is focused on malignancy risk, the title could be
refined accordingly:
o "Endometrial Thickness and Its Association with Malignancy in Postmenopausal
Asymptomatic Women"
Abstract
1. Purpose
o Pattern: "The purpose of this study was to investigate the correlation between endometrial
thickness and endometrial lesions in postmenopausal asymptomatic women..."
o Comment: Consider rephrasing to make it more concise. For example, "This study aimed
to explore the relationship between endometrial thickness and lesions in asymptomatic
postmenopausal women and identify diagnostic thresholds for malignancy."
2. Methods
o Pattern: "A retrospective study was conducted on the endometrial thickness of 226
postmenopausal asymptomatic women measured by transvaginal ultrasound in our hospital..."
o Comment: Provide more clarity on the inclusion/exclusion criteria briefly in the abstract to
ensure a complete overview.
3. Results
o Pattern: "The endometrial thicknesses measured by vaginal ultrasound in the normal group,
benign lesion group, and malignant lesion group are..."
o Comment: Simplify and summarize the statistical results to focus on the key findings that
support the conclusion.
4. Conclusion
o Pattern: "The appropriate diagnostic thresholds of vaginal ultrasound diagnosis is 0.679 cm
in asymptomatic postmenopausal women."
o Comment: Clarify the diagnostic threshold sentence to avoid confusion—state whether it is
6.79 mm or 0.679 cm clearly.
Introduction
1. Pattern: "Cancer of the endometrium is the most common type of gynecologic cancer in the
developed country..."
o Comment: Ensure grammatical accuracy. For example, "in developed countries" instead of
"in the developed country."
2. Pattern: "There are 15% of postmenopausal women with endometrial carcinoma is
asymptomatic."
o Comment: Rephrase for clarity and grammatical correctness, e.g., "Approximately 15% of
postmenopausal women with endometrial carcinoma are asymptomatic."
3. Pattern: "With the increase of people's health awareness and the widespread use of
transvaginal ultrasound..."
o Comment: Refine the sentence structure for smoother readability. For instance, "As health
awareness and the use of transvaginal ultrasound increase, asymptomatic postmenopausal
endometrial thickening is more frequently detected."
Methods
1. Pattern: "The hypoechoic halo sometimes seen surrounding the endometrial stripe was not
included."
o Comment: Consider clarifying how this might impact measurement accuracy or if there were
specific training provided to technicians to standardize measurements.
2. Pattern: "The uterine distension pressure was set to 80 mmHg..."
o Comment: Ensure consistency in units (e.g., mmHg). If using a specialized measurement
system, provide a brief rationale for the pressure and flow rates selected.
3. Pattern: "If placement failed, the cervical surface was anesthetized with oxybuprocaine..."
o Comment: Include information on how often such alternative measures were needed and their
potential impact on the results.
4. Pattern: "Statistical analysis was performed using SPSS 24.0 software."
o Comment: Expand slightly on why specific statistical tests were chosen (e.g., to determine
associations, compare groups, etc.).
Results
1. Pattern: "The mean BMI in the normal group is (25.08±3.42) kg/m²..."
o Comment: Highlight the clinical significance of the BMI differences. For example, does it
suggest a direct correlation with endometrial lesions?
2. Pattern: "The area under the curve for identifying endometrial disease was 0.679."
o Comment: Explain whether this AUC value represents good, moderate, or poor diagnostic
accuracy.
3. Pattern: "The main cause of endometrial thickening after menopause was endometrial polyps
(51.7%)."
o Comment: Strengthen this statement by briefly comparing it to other studies, if possible, for
validation.
Conclusion
1. Pattern: "Overweight (BMI >25kg/m2) is a high-risk factor for asymptomatic endometrial
thickening after menopause."
o Comment: Provide a stronger connection between this observation and its implications for
clinical practice, such as targeted screening.
2. Pattern: "There is an association between endometrial thickening and endometrial lesions..."
o Comment: Suggest emphasizing the diagnostic implications, such as how this association
might influence clinical decisions.
General Suggestions
1. Language and Grammar: Ensure consistency in terminology (e.g., "endometrial thickening"
vs. "thickened endometrium") and eliminate grammatical errors.
2. Statistical Interpretation: Provide more emphasis on the practical implications of the statistical
findings, especially the diagnostic thresholds.
3. Formatting: Use consistent formatting for all sections to ensure clarity and professionalism.