Gynecologic and Obstetric Investigation最新文献

{"title":"Endometriosis, Raynaud's Syndrome and Migraine: A Retrospective Study of 12 Million Women.","authors":"Hormoz Nassiri Kigloo, Eva Suarthana, Tina C Montreuil, Mohammad Jamal, Togas Tulandi","doi":"10.1159/000545204","DOIUrl":"https://doi.org/10.1159/000545204","url":null,"abstract":"<p><strong>Objective: </strong>Our study focused on evaluating a possible relationship between endometriosis, Raynaud's syndrome or migraine among women.</p><p><strong>Design: </strong>This was a cross-sectional population-based study.</p><p><strong>Participants/materials, setting, methods: </strong>We used 12,684,067 hospitalized patient records in the Healthcare Cost and Utilization Project (HCUP) database between 2007 and 2014. We calculated the prevalence of endometriosis, Raynaud's syndrome and migraine. We also evaluated the possible role of depression, anxiety and autoimmune diseases to eliminate confounding factors. Unadjusted and adjusted multivariate logistic regression were applied to evaluate the relationship between variables.</p><p><strong>Results: </strong>Unadjusted analysis revealed a strong association between endometriosis and Raynaud's syndrome and migraine. (OR=2.491 95%CI 1.677-3.699). After adjusting for sociodemographic characteristics as well as depression and anxiety, the association remained significant (OR=1.779; 95%CI 1.166-2.716). Among younger patients aged 18-35 with endometriosis, the associations were stronger with Raynaud's Syndrome (adjusted OR = 1.61, 95% CI = 1.20-2.16) and migraine (adjusted OR = 2.59, 95% CI = 2.47-2.72).</p><p><strong>Limitations: </strong>The HCUP database is cross-sectional in nature, and hence, we could not establish the temporal relationship between endometriosis, Raynaud's syndrome and migraine. Also, the severity of endometriosis and the treatment received by the patients were not included in the dataset, and it prevented us from investigating the role of potential confounding factors.</p><p><strong>Conclusion: </strong>Our study suggests an association between endometriosis, Raynaud's syndrome and migraine. It is possible that these conditions share a similar mechanism possibly vascular reaction and endothelial dysfunction related to chronic inflammation.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-21"},"PeriodicalIF":2.0,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between Luteinizing Hormone/Chorionic Gonadotropin Receptor Polymorphisms and Assisted Reproductive Technology Outcomes: A Systematic Review and Meta-analysis.","authors":"Sha Liu, Qi Cao, Yijing Zhou, Jiaming Zhou, Yang Hu, Yuanyuan Hu, Tian Tang","doi":"10.1159/000545556","DOIUrl":"https://doi.org/10.1159/000545556","url":null,"abstract":"<p><strong>Introduction: </strong>Variants of the luteinizing hormone/chorionic gonadotropin receptor (LHCGR) gene have been investigated for their close associations with assisted reproductive technology (ART) outcomes. However, available data are controversial. This meta-analysis aimed to elucidate the associations of LHCGR N312S polymorphism (rs2293275) with ART outcomes.</p><p><strong>Methods: </strong>A thorough search was performed in the databases of PubMed, EMBASE, Web of Science, and Cochrane Library from their inception to July 19, 2024. The analysis included five studies, encompassing 2,692 patients with infertility and subfertility. RevMan 5.4 was used for further comprehensive data analysis.</p><p><strong>Results: </strong>In this study, A allele homozygotes encoded asparagine (N/N), and G allele homozygotes encoded serine (S/S). The number of oocytes retrieved was higher in AA homozygotes than in GG homozygotes (mean difference [MD] 1.07, 95% confidence interval [CI] 0.09 to 2.05, I2 = 7%, P = 0.03) or AG heterozygotes (MD 1.26, 95% CI 0.32 to 2.20, I2 = 45%, P = 0.008). The number of mature oocytes and the distribution of the LHCGR (rs2293275) genotype (MD 0.60, 95% CI -0.25 to 1.45, I2 = 49%, P = 0.17; MD 0.85, 95% CI 0.02 to 1.68, I2 = 76%, P = 0.05; MD -0.36, 95% CI -1.20 to 0.49, I2 = 56%, P = 0.41) were not significantly different. G allele homozygotes and heterozygotes exhibited an increasing trend in the number of clinical pregnancies compared with A allele homozygotes (odds ratio [OR] 1.69, 95% CI 1.21 to 2.36, I2 = 0%, P = 0.002; OR 1.30, 95% CI 1.09 to 1.54, I2 = 0%, P = 0.003).</p><p><strong>Conclusion: </strong>This study revealed associations of LHCGR polymorphism with ART outcomes, implying that the LHCGR N312S polymorphism (rs2293275) may serve as a predictor for certain ART outcomes.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-18"},"PeriodicalIF":2.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of laparoscopic cystectomy for ovarian endometrioma on anti-Mullerian hormone levels: a systematic review and meta-analysis.","authors":"Caitlyn Murdock, Luis Sanchez-Ramos, Jordan Asher McKinney, Aakriti R Carrubba, Gregory Lewis","doi":"10.1159/000545230","DOIUrl":"https://doi.org/10.1159/000545230","url":null,"abstract":"<p><strong>Introduction: </strong>Endometriosis is a condition that leads to a chronic inflammatory state, which has been associated with pelvic pain and infertility. Ovarian endometriomas are commonly treated via laparoscopic cystectomy, however, there is some debate on the degree of ovarian damage after cystectomy. The aim of this systematic review and meta-analysis was to conduct a thorough assessment of post-operative anti-Müllerian hormone levels, a marker of ovarian reserve, after laparoscopic cystectomy for endometriomas.</p><p><strong>Methods: </strong>We conducted a search of PubMed, EMBASE, Web of Science, Google Scholar, and Science Direct from inception to March 31, 2024. We included randomized and non-randomized studies that assessed pre- and post-operative anti-Müllerian hormone levels after ovarian cystectomy for endometriomas. Outcomes of interest included the differences in anti-Müllerian hormone levels assessed within one month prior to surgery and up to 18 months post-operatively. These outcomes were categorized as short-term (up to six weeks), medium-term (seven weeks to six months), and long-term (six months to 18 months). Randomized and observational studies were pooled together for analysis, as only the intervention arm from the randomized trials was included in the meta-analysis. Continuous variables were extracted as means and standard deviations to produce a pooled weighted mean difference with 95% confidence intervals were calculated using a random-effects model.</p><p><strong>Results: </strong>Of the 2,396 articles identified, 30 studies were included. Primary outcomes showed a statistically significant (P < 0.001) decrease in anti-Müllerian hormone in the postoperative short-term period [-1.39 ng/mL, 95% CI, -2.01- (-0.76)], medium term period [-1.13 ng/mL (95% CI, -1.4- (-0.87)], and long term [-2.12 ng/mL (95% CI, -2.61- (-1.63)]. There was no significant difference when comparing anti-Müllerian hormone levels in the short term versus long-term period across all groups. There was no significant difference when comparing long term unilateral and bilateral cystectomies on anti-Müllerian hormone levels post operatively.</p><p><strong>Conclusions: </strong>This systematic review and meta-analysis highlights that there is a decline in serum AMH levels following laparoscopic cystectomy for endometriomas, suggesting a potential adverse impact on ovarian reserve. This outcome emphasizes the need to incorporate discussions about the implications of surgery on fertility into preoperative counseling.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-22"},"PeriodicalIF":2.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polycystic Ovary Syndrome, Endometriosis and Venous Thromboembolism: A population-based study.","authors":"Hormoz Nassiri Kigloo, Vicky Mai, Eva Suarthana, Togas Tulandi, Steeve Provencher","doi":"10.1159/000545518","DOIUrl":"https://doi.org/10.1159/000545518","url":null,"abstract":"<p><strong>Background: </strong>There is a paucity of studies on the association between polycystic ovary syndrome (PCOS) and endometriosis and the occurrence of venous thromboembolism (VTE).</p><p><strong>Objective: </strong>Our study aimed to evaluate the association between PCOS, endometriosis, deep vein thrombosis (DVT) and pulmonary embolism (PE).</p><p><strong>Methods: </strong>This was a retrospective study of prospectively collected data using the Healthcare Cost and Utilization Project database. We examined the association between PCOS and endometriosis with DVT and PE from a cohort of 12,814,970 female patients, aged 18 to 49 years, who were hospitalized between 2007 and 2014.</p><p><strong>Results: </strong>We observed increasing trends, with a relative increase of 140% (from 0.27% to 0.65%) for PCOS, 16% (from 0.43% to 0.50%) for DVT, and 39% (from 0.23% to 0.32%) for PE, whereas we observed a decline by 34% for endometriosis (from 0.85% to 0.56%). The unadjusted analysis showed an association between PCOS and VTE, which remained significant after adjustment for sociodemographic characteristics and comorbidities (OR=2.16; 95%CI 2.00-2.33 and 2.44; 95%CI 2.23-2.67 for DVT and PE, respectively). The association between endometriosis and VTE was age-dependent, with an increased risk of VTE among women 18-24 years whereas this risk was decreased among those 35 years and older.</p><p><strong>Conclusion: </strong>Our study indicates an association between PCOS and VTE, and an age-dependent association between endometriosis and VTE.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-14"},"PeriodicalIF":2.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zigui-Changqi decoction against premature ovarian insufficiency by moderating autophagy via EGFR/ERBB2/IL6/AKT1 signals.","authors":"Yiwen Wang, Sai Kong, Yanping Qian, Dongqiong Chen, Mengqiu Shao, Manyin Zhai, Lijuan Jiang","doi":"10.1159/000545205","DOIUrl":"https://doi.org/10.1159/000545205","url":null,"abstract":"<p><strong>Background: </strong>Autophagy defect has been detected in premature ovarian insufficiency (POI) patients.</p><p><strong>Aim: </strong>To evaluate the efficacy and explore the mechanism of Zigui-Changqi Decoction (ZCD) in the treatment of POI.</p><p><strong>Material and methods: </strong>Rat model of POI was established to evaluate the efficacy of ZCD on serum hormone levels, ovarian index, and ovarian cell apoptosis. The effect of ZCD on the autophagy of granulosa cell was assessed. Network pharmacology was used to predict potential targets of ZCD against POI.</p><p><strong>Results: </strong>ZCD attenuated tripterygium glycosides-induced damage to ovarian tissues in rats by improving ovarian index, moderating serum hormone levels, inhibiting ovarian cell apoptosis, and increasing the number of ovarian stromal cells. ZCD moderated the expression of autophagy-related markers, including BECN1, p62 and LC3. Through network pharmacological analysis, the predicted hub genes were EGFR, ERBB2, AKT1, IL6, PTEN, and TP53. After molecular docking and detection of cell expression levels, EGFR, ERBB2, AKT1, and IL6 were inhibited by ZCD, as well as mTORC1.</p><p><strong>Conclusion: </strong>ZCD can ameliorate POI, maybe by moderating autophagy via EGFR/ERBB2/IL6/AKT1 signals.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-16"},"PeriodicalIF":2.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143752397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Minimization Study of Glue versus Sutured Mesh Fixation in Laparoscopic Sacrocolpo(recto)pexy.","authors":"Ann-Sophie Page, Cindy Vandoren, Jan Deprest","doi":"10.1159/000545030","DOIUrl":"10.1159/000545030","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of the study was to conduct a cost-minimization analysis of laparoscopic sacrocolpo(recto)pexy (LSCP) using either synthetic glue or sutures alone for mesh fixation.</p><p><strong>Design: </strong>A cost-minimization study comparing two single-center consecutive cohorts (n = 20 each), evaluating differences in consumables and operating room costs for LSCP, performed either with sutures alone or synthetic glue for mesh fixation (January 2021 to December 2021).</p><p><strong>Participants: </strong>All patients underwent LSCP using the same standardized technique performed by one of two gynecologic surgeons experienced in LSCP (≥50 procedures per year), both proficient in using sutures or glue for LSCP, to minimize any learning curve bias.</p><p><strong>Methods: </strong>Consumables costs associated with mesh fixation were prospectively recorded. Additional patient data were extracted from the electronic medical record. Statistical analysis was performed using GraphPad Prism. The chi-square test or t test were applied as appropriate, with a significance level set at p < 0.05.</p><p><strong>Results: </strong>In the sutures-only group, consumables costs were EUR 194.54 ± 38.76, compared to EUR 298.16 ± 31.59 in the glue group (p < 0.0001; 95% CI [81.80, 125.4]). The mean procedure time was significantly shorter in the glue group (34.6 ± 6.2 min vs. 51.3 ± 12.7 min; p < 0.0001; 95% CI [-23.19, -10.21]), reducing operating room maintenance costs by 32% (EUR 477.22 ± 85.63 vs. EUR 707.22 ± 175.14). Based on the consumables and operating room maintenance costs (EUR 826.35 per hour) and time usage, the sutures-only method cost EUR 901.76 ± 171.97 compared to EUR 775.37 ± 86.62 for the glue group. In our setting, this translates to a cost saving of EUR 126.39 per patient (-14%) when using glue (p < 0.0001; 95% CI [-214.6, -38.19]).</p><p><strong>Limitations: </strong>The numbers above are specific to our setting. Our findings are also specific to laparoscopic approaches and cannot be directly applied to robotic sacrocolpopexy as suturing times and operating room maintenance costs would differ significantly.</p><p><strong>Conclusions: </strong>Using synthetic glue for mesh fixation increases consumables costs but reduces procedure time, resulting in overall cost savings that favor glue-based mesh fixation. These findings align with previous studies demonstrating reduced operation times with the use of glue. Our study is the first to formally assess and compare the costs of both techniques. We believe the overall cost saving is widely generalizable. To calculate the local impact, one can use the proportional differences reported here and substitute local consumables and operating room costs.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-5"},"PeriodicalIF":2.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endocrine Metabolic Syndrome and Metabolic Syndrome: Distinct but interrelated pathologies.","authors":"Samuel H Myers, Christophe O Soulage, Vittorio Unfer","doi":"10.1159/000545280","DOIUrl":"https://doi.org/10.1159/000545280","url":null,"abstract":"<p><p>Background Polycystic ovary syndrome, or endocrine metabolic syndrome (EMS) as recently proposed by the Expert Group on Inositol in basic and clinical research and on PCOS (EGOI-PCOS), manifests as a series of metabolic and hormonal alterations, which are primarily suspected to be underpinned by an underlying metabolic problem. Several of these metabolic issues are shared with metabolic syndrome (MetS), a separate but interrelated metabolic disorder typified by obesity, heightened glucose levels, dyslipidemia, and cardiovascular risk factors. Objectives This review sets out to expand upon the interplay between endocrine metabolic syndrome and metabolic syndrome, defining the key characteristics of each condition prior to discussing treatment options that may benefit both sets of patients. Methods A narrative review of all the relevant papers in English language was conducted. Outcome Both endocrine metabolic syndrome and metabolic syndrome share common features such as obesity, dyslipidemia, and cardiovascular risk factors, and thus can be treated in certain circumstances with similar therapeutic approaches. However, in both women and men metabolic syndrome does not feature alterations of androgen levels, as is the case with endocrine metabolic syndrome. Furthermore, these conditions tend to occur in different age groups, with metabolic syndrome primarily occurring during or after menopause, while endocrine metabolic syndrome.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-17"},"PeriodicalIF":2.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early versus late amniotomy for induction of labor: a systematic review and meta-analysis of randomized controlled trials.","authors":"Abdulrahim Gari, Saeed Baradwan, Afaf Tawfiq, Ghaidaa Hakeem, Alya Alkaff, Bandr Hafedh, Fahad Algreisi, Hassan M Latifah, Mohammad Alyafi, Hanin Hassan Abduljabbar, Nabigah Alzawawi, Hussein Sabban, Alaa Edrees, Ahmed Abu-Zaid","doi":"10.1159/000544831","DOIUrl":"https://doi.org/10.1159/000544831","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated the efficacy and safety of early amniotomy, performed before the active phase of labor, versus late amniotomy, conducted during the active phase.</p><p><strong>Methods: </strong>Six data sources were screened until April 2024 for relevant randomized controlled trials (RCTs). Outcomes were pooled using risk ratio (RR) or mean difference (MD) with 95% confidence intervals (CI) in fixed or random-effects models.</p><p><strong>Results: </strong>Sixteen RCTs involving 3,378 patients were included. Four RCTs had a low risk of bias, and 12 had some concerns. There was no significant difference in cesarean section rates (RR=1.00, 95% CI [0.79, 1.27], p=0.99) or normal vaginal delivery (RR=1.01, 95% CI [0.93, 1.10], p=0.81) between early and late amniotomy. However, early amniotomy reduced time-to-delivery by 2.42 hours (95% CI: -3.06, -1.54, p<0.0001) but increased the risk of chorioamnionitis (RR=1.46, 95% CI [1.06, 2.01], p=0.02). There was no difference in other maternal or neonatal outcomes, including endometritis, maternal fever, postpartum hemorrhage, cord prolapse, uterine hyperstimulation, APGAR score, neonatal sepsis, NICU admission, or meconium-stained amniotic fluid Conclusion: Early amniotomy significantly reduced time-to-delivery without increasing cesarean section rates but was associated with a higher risk of chorioamnionitis. Further research is needed to determine the optimal IOL protocol.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-17"},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes Post-Laparoscopic Intervention for Accessory and Cavitated Uterine Masses: A Review and a Molecular Insight.","authors":"Ella Barrett-Chan, Karim Alomar, Esra'a Bukannan, Kristy Cho, Jessica A Pilsworth, C Blake Gilks, Paul Yong, David G Huntsman, Mohamed Bedaiwy","doi":"10.1159/000543762","DOIUrl":"10.1159/000543762","url":null,"abstract":"<p><strong>Background: </strong>Accessory and cavitated uterine masses (ACUM) are rare Mullerian anomalies, defined as an isolated accessory cavitated mass lined with endometrial epithelium.</p><p><strong>Objectives: </strong>This article explores ACUM lesions from two aspects and integrates a case report of a successful laparoscopic-assisted intervention for ACUM in a 24-year-old woman with refractory dysmenorrhea with a review of current literature on laparoscopic surgical techniques. Unique to this case was the process of undergoing targeted genetic sequencing via the Find ITTM Panel Version 3.4 on the ACUM, looking for mutations in KRAS, PIK3CA, and FGFR2. A process that was inspired by recent reports that indicate that even normal endometrium can harbor cancer-associated mutations.</p><p><strong>Methods: </strong>A comprehensive search of Ovid MEDLINE and Embase was performed. Studies were selected if they explored laparoscopic surgery's impact on ACUM patients' outcomes related to fertility, menorrhagia, or dysmenorrhea. Risk of bias assessment was performed using the JBI Critical Appraisal Checklist.</p><p><strong>Outcome: </strong>From 160 articles identified, 25 full-text articles were analyzed with a total of 75 unique patients discussed. Dysmenorrhea was present in 100% of cases (n = 75/75), and laparoscopic resection improved patient symptoms in 84% (n = 63/75) of cases. The mass excised in the case was positive for somatic missense mutations in RET (R813W) and HRAS (G12S) genes, identified at low variant allele frequencies.</p><p><strong>Conclusions and outlook: </strong>These results demonstrated that laparoscopic surgical approaches are effective and frequently the first surgical approach chosen for the treatment of ACUM, but that techniques to treat these conditions are not standardized. This case is the first to demonstrate mutations in ACUM, suggesting a potential role for cancer-associated somatic mutations in their genesis. Future developments in this area may include sending more of these samples for genetic analysis, improving our understanding of how these lesions are formed, while also working to standardize how they are removed.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-11"},"PeriodicalIF":2.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Artificial Intelligence in Gynecologic Oncology Decision-Making: A Feasibility Study.","authors":"Iason Psilopatis, Nadezda Sipulina, Frederik A Stuebs, Felix Heindl, Patrik Poeschke, Simon Bader, Annika Krueckel, Peter A Fasching, Matthias W Beckmann, Julius Emons","doi":"10.1159/000544751","DOIUrl":"10.1159/000544751","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to examine the potential of artificial intelligence (AI) in gynecologic oncology decision-making.</p><p><strong>Design: </strong>A feasibility study was conducted.</p><p><strong>Participants: </strong>Fictitious case vignettes of patients with gynecologic carcinomas were used.</p><p><strong>Setting: </strong>The setting was a fictive one.</p><p><strong>Methods: </strong>Fictitious case vignettes of gynecologic carcinomas were created and evaluated by physicians with varying levels of professional experience, as well as by language models including ChatGPT 4.0, Google Gemini, and Bing Copilot. Treatment approval decisions were based on standardized clinical and laboratory criteria.</p><p><strong>Results: </strong>Two cases of breast cancer, 1 case of ovarian cancer, 1 case of cervical cancer, and 1 case of endometrial cancer were evaluated. All three language models were able to evaluate all clinical cases and make therapy-relevant suggestions, with ChatGPT providing the most clear and concise recommendations that were in 3 cases totally consistent with physician assessments.</p><p><strong>Limitations: </strong>This study was limited to a feasibility study based on five fictitious case vignettes.</p><p><strong>Conclusions: </strong>The study demonstrates that AI models, such as ChatGPT, can to some extent evaluate clinical cases, recognize clinical and/or laboratory abnormalities, and make therapy-related suggestions. Despite high overall agreement, differences were predominantly noted in the more complex cases, rendering human interpretation necessary. The findings underscore the benefits of AI in terms of clarity, time efficiency, and cost-effectiveness. Future research should further explore the application of AI to real patient data and development of hybrid decision models to optimize integration into clinical practice.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"1-9"},"PeriodicalIF":2.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}