Clinical value of D-dimer combined with transvaginal ultrasonography in the postmenopausal population with endometrial carcinoma.

To evaluate the diagnostic value of plasma D-dimer combined with transvaginal ultrasonography for endometrial carcinoma in postmenopausal women, addressing the increasing incidence in China. This retrospective study analyzed 129 postmenopausal women (July 2021-January 2023) undergoing hysteroscopy, including 61 with endometrial carcinoma (mean age 56.5 ± 6.8 years) and 68 with benign lesions (60.2 ± 7.7 years). We assessed D-dimer levels, ultrasonographic parameters (endometrial thickness, uterine cavity occupation, blood flow signals), and postmenopausal bleeding. Diagnostic performance was evaluated using ROC curves. Multivariate analysis identified three independent predictors: intracavitary blood flow (OR 60.44, 95% CI 8.25-442.98, p < 0.001), postmenopausal bleeding (OR 5.84, 95% CI 1.82-18.75, p = 0.003), and elevated D-dimer (OR 3.12, 95% CI 1.06-9.22, p = 0.04). The comprehensive model achieved superior diagnostic performance (AUC = 0.920, sensitivity = 88.5%, specificity = 85.3%) compared to any individual parameter. Plasma D-dimer combined with transvaginal ultrasonography and clinical symptoms provides an effective screening approach for postmenopausal endometrial carcinoma, serving as a valuable risk assessment strategy for identifying candidates requiring definitive histopathological examination.