Gynecologic and Obstetric Investigation最新文献

{"title":"Robotic-Assisted Surgical Staging with Sentinel Node Biopsy for Apparently Early-Stage Endometrial Cancer Using the Modular Multi-Arm Surgical Robot System Versius® (Cambridge Medical Robots): A Case Series.","authors":"Stefano Uccella, Liliana Galli, Chiara Casprini, Anna Festi, Mariachiara Bosco, Pier Carlo Zorzato, Andrea Caraffini, Biancamaria Del Prete, Simone Giacopuzzi, Alessandro Favilli, Massimo Franchi, Callisto Marco Bravi, Simone Garzon","doi":"10.1159/000543122","DOIUrl":"10.1159/000543122","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the study was to report the first cases of surgical staging for apparently early-stage endometrial cancer performed using the Versius® next-generation robotic surgical system (Cambridge Medical Robots [CMR] Surgical, Cambridge, UK).</p><p><strong>Design: </strong>The study used a prospective case series. Participants/Materials: Women who underwent surgical staging, including total hysterectomy, bilateral adnexectomy, and sentinel lymph node (SLN) biopsy, for apparently early-stage endometrial cancer using the Versius® next-generation robotic surgical system (CMR Surgical, Cambridge, UK) were included.</p><p><strong>Setting: </strong>The study was conducted at a Gynecologic Oncology Referral Center.</p><p><strong>Methods: </strong>We prospectively recorded data of all consecutive women who underwent the investigated surgical procedure.</p><p><strong>Results: </strong>Fourteen endometrial cancer patients were treated between March and August 2024 at the Azienda Ospedaliera Universitaria Integrata of Verona. The mean age was 69.4 ± 8.7 years, and the average body mass index was 27.2 ± 4.8. SLN biopsy was performed on all patients: 5 patients had unilateral and 9 bilateral successful SLN detection; 6 women underwent systematic pelvic lymphadenectomy in the unmapped areas. The median operative time was 122 (min-max, 77-185) minutes, and the median hysterectomy time was 34 (min-max, 18-68) minutes. None of the surgical procedures required conversion to conventional laparoscopic or open surgery for technical reasons, and no intraoperative complications were recorded. No readmissions, reoperations, or deaths were observed during the follow-up (median 102 days, min-max 39-249).</p><p><strong>Limitations: </strong>The limitations of the study are the first experience in a limited study population and the use of methylene blue for SLN mapping.</p><p><strong>Conclusions: </strong>Our preliminary results with the Versius® platform appear encouraging regarding surgical time, blood loss, rate of completion of the robotic procedures, and complications risk. Further studies will confirm the indications, feasibility, and safety of the Versius® surgical robot system for treating apparently early-stage endometrial cancer.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"319-327"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881954","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":"Oocyte Quality in Women with Endometriosis.","authors":"Rafael Trinchant, Juan Antonio García-Velasco","doi":"10.1159/000541615","DOIUrl":"10.1159/000541615","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis is a chronic gynecological condition that affects approximately 10% of women of reproductive age globally. It is associated with significant morbidity due to symptoms such as pelvic pain and infertility. Current knowledge suggests that endometriosis impacts oocyte quality, a critical factor for successful fertilization and pregnancy. Despite extensive research, the exact mechanisms remain unclear, and further updates are necessary to optimize treatment strategies.</p><p><strong>Objectives: </strong>This review aims to summarize current evidence regarding the impact of endometriosis on oocyte quality and its subsequent effects on fertility outcomes, particularly in the context of in vitro fertilization (IVF).</p><p><strong>Methods: </strong>A comprehensive search was conducted in PubMed using the terms \"endometriosis AND oocyte quality,\" \"endometriosis AND infertility, and \"endometriosis AND IVF.\" The review included studies published up to July 2024.</p><p><strong>Outcome: </strong>The review findings indicate that endometriosis may be associated with decreased oocyte quality, characterized by impaired morphological features and molecular abnormalities. These defects potentially lead to lower fertilization rates, impaired embryo development, and reduced pregnancy outcomes. However, some studies suggest that with controlled factors such as age and ovarian reserve, IVF outcomes may be comparable to those without endometriosis.</p><p><strong>Conclusions and outlook: </strong>For clinicians and scientists working in medically assisted reproduction, understanding the impact of endometriosis on oocyte quality is crucial for improving fertility treatment outcomes. Advances in assisted reproductive technologies and personalized treatment approaches may mitigate these adverse effects. The potential for using artificial intelligence to assess oocyte quality presents a promising avenue for future research, as currently there is no direct and objective measure to assess this parameter.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"173-181"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345576","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":"Advancements in Ultrasound Diagnosis of Superficial Endometriosis: Current Challenges and Emerging Techniques.","authors":"Shay M Freger, Mathew Leonardi","doi":"10.1159/000543075","DOIUrl":"10.1159/000543075","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Endometriosis is a chronic disease characterized by endometrial-like tissue outside the uterus. Superficial endometriosis (SE) is the most prevalent form, yet it remains underdiagnosed due to subtle clinical and imaging presentations. Traditionally, diagnosis relies on laparoscopy, which is relatively invasive and often contributes to diagnostic delay. With advancements in imaging techniques, especially transvaginal ultrasound (TVS), a reassessment of the diagnostic approach for SE is needed. This review updates the understanding of SE diagnostics and integrates both historical perspectives and contemporary clinical insights.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;The review aimed to explore advancements in the diagnosis of SE, focusing on the growing role of TVS as a non-invasive diagnostic tool. Additionally, it seeks to highlight emerging diagnostic challenges and present new approaches to managing SE to offer updated recommendations for clinicians.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A comprehensive literature search was conducted using PubMed, MEDLINE, and Google Scholar. The following keywords were used: \"superficial endometriosis,\" \"diagnostic pathways,\" \"endometriosis diagnosis,\" \"superficial lesions,\" \"transvaginal ultrasound,\" \"laparoscopy,\" \"non-invasive imaging,\" and \"diagnostic accuracy.\" Only English-language articles were included, focusing on original research, metanalyses, and clinical guidelines, offering historical and current perspectives. In addition to the literature review, contemporary insights were gathered from our clinical practice at a tertiary endometriosis clinic to offer real-world context to the literature findings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcome: &lt;/strong&gt;The review highlights TVS as a promising non-invasive method for diagnosing SE. While SE has historically been diagnosed through laparoscopy, TVS is gaining recognition as a valuable tool for detecting SE lesions, particularly through the identification of key sonographic features such as hyperechoic foci and cystic spaces. These advancements help overcome the challenges posed by the variability of SE presentation on imaging. Emerging techniques, such as sonoPODography, further enhance SE diagnosis and offer the potential for broader clinical application. Despite challenges such as the need for operator expertise and variability in lesion presentation, the literature and clinical insights support the growing utility of TVS in diagnosing SE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and outlook: &lt;/strong&gt;TVS has significant potential as a non-invasive diagnostic tool for SE. While limitations such as variability in sensitivity and the need for operator expertise remain, TVS can significantly reduce reliance on invasive methods like laparoscopy. Additionally, the review provides insights into managing cases, where TVS results are negative for SE. In such cases, clinicians must adopt a patient-centered approach that emphasizes symptom management, patient autonomy, an","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"363-373"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970569","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":"Retraction Statement.","authors":"","doi":"10.1159/000546086","DOIUrl":"10.1159/000546086","url":null,"abstract":"","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"381"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173632","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 Value of Human Epididymal Protein 4, Carcinoembryonic Antigen and Alpha-Fetoprotein in the Early Diagnosis of Cervical Cancer.","authors":"Xiaoyan Ye, Shanyan Xie","doi":"10.1159/000540855","DOIUrl":"10.1159/000540855","url":null,"abstract":"<p><strong>Objectives: </strong>This research aimed to unveil the value of human epididymal protein 4 (HE4), carcinoembryonic antigen (CEA) and alpha-fetoprotein (AFP) in the early diagnosis of cervical cancer.</p><p><strong>Design: </strong>This was a clinical study.</p><p><strong>Participants: </strong>Sixty patients with cervical cancer stage IA-IIA (early stage cervical cancer group), 60 patients with cervical intraepithelial neoplasia (CIN) (disease control group), and 60 healthy women who had passed the physical examination (healthy control group) were selected.</p><p><strong>Setting: </strong>The review was conducted in a Jiaxing First Hospital.</p><p><strong>Methods: </strong>Sixty patients with cervical cancer stage IA-IIA (early stage cervical cancer group), 60 patients with CIN (disease control group), and 60 healthy women who had passed the physical examination (healthy control group) were selected. The expression levels of serum HE4, CEA, and AFP in the three groups were detected, and the correlation between the levels of serum HE4, CEA, and AFP and the clinicopathological characteristics of patients with early stage cervical cancer were analyzed, and the receiver operating characteristic (ROC) curves were plotted to identify the value of the single and triple tests of serum HE4, CEA, and AFP for the early stage diagnosis of cervical cancer.</p><p><strong>Results: </strong>The levels of serum HE4, CEA, and AFP in the early stage cervical cancer group were higher than those in the disease control and the healthy control groups (p < 0.05). The levels of serum HE4, CEA, and AFP were related to the FIGO stage as well as the histological grading of patients with early stage cervical cancer (p < 0.05). The results of the ROC curves revealed that the AUC areas of HE4, CEA, and AFP for single as well as triple diagnosis of patients with early stage cervical cancer were 0.725, 0.679, 0.663, and 0.811, respectively, and the AUC of the three combined tests was markedly higher than that of HE4, CEA, AFP single test (p < 0.05).</p><p><strong>Limitations: </strong>There is a lack of larger sample sizes to test whether the combined HE4, CEA, and AFP detection has sufficient validity at the individual level and there are not enough serum samples in this study to perform circulating HPV-DNA detection and compare it with the levels of serum markers.</p><p><strong>Conclusion: </strong>The combination of HE4, CEA, and AFP has good clinical reference value analysis in the auxiliary diagnosis of early stage cervical cancer, and it is worthy of further validation and popularization.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"100-107"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142106887","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":"Screening for and Treatment of Bacterial Vaginosis Reduced Preterm Delivery in High-Risk Pregnant Women: A Systematic Review and Meta-Analysis.","authors":"Enav Yefet, Dalit Mirin, Manal Massalha, Adi Alter, Zohar Nachum","doi":"10.1159/000543502","DOIUrl":"10.1159/000543502","url":null,"abstract":"<p><strong>Introduction: </strong>Bacterial vaginosis (BV) is a risk factor for preterm delivery. Yet, previous studies have found BV treatment ineffective in preventing preterm delivery in unselected population. This study aimed to evaluate the effectiveness of BV screening and treatment in reducing the rate of preterm deliveries before 37 weeks in high-risk women.</p><p><strong>Materials and methods: </strong>Embase, PubMed, Ovid-Medline, and Web of Science were searched. Randomized controlled trials that evaluated antibiotic treatment for BV versus no treatment/placebo were included. The primary outcome was the rate of preterm delivery and/or late miscarriages in pregnant women with a history of preterm delivery. The pooled relative risks (with 95% CI) were estimated. The Cochrane's Q test of heterogeneity, and I2 were used to assess heterogeneity. In total, 4,701 papers were retrieved of which seven met inclusion criteria and were analyzed.</p><p><strong>Results: </strong>Among the participating women, 738 were at high risk for preterm delivery and included in the analysis. Among them, 397 and 341 women received active or placebo treatment, respectively. The included studies had a low risk of bias. In six out of seven studies, the risk factor for preterm delivery was a previous preterm delivery. One study (N = 16) was excluded from the analysis since no group had preterm deliveries. Treatment for BV in high-risk women reduced the rate of preterm deliveries (pooled relative risk with 95% CI, 0.65 [0.44-0.98]). The protective effect of BV treatment was statistically significant in women treated with clindamycin, and when treatment was started after 20 gestational weeks.</p><p><strong>Conclusion: </strong>Screening for and treatment of BV may be effective in preventing preterm delivery in high-risk pregnant women. Randomized clinical trials are needed to confirm the findings of this study.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"353-362"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12324754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproductive Outcomes in Infertile Women with Endometriosis Undergoing Assisted Reproductive Technology.","authors":"Can Benlioglu, Savci Bekir Telek, Baris Ata","doi":"10.1159/000543213","DOIUrl":"10.1159/000543213","url":null,"abstract":"<p><strong>Background: </strong>Endometriosis-related infertility and its treatment with assisted reproductive technologies (ART) have been broadly researched. Yet, underlying mechanisms of infertility, particularly in the absence of tubal dysfunction, remain unclear. While the impact of inflammatory milieu on the ovary and/or endometrium has been indicated as a contributing factor, recent evidence from euploid transfers and donor cycles questions the extent of these effects. Moreover, the frequent coexistence of other confounders, such as adenomyosis, further complicates the clinical picture, making it difficult to isolate the specific impact of endometriosis on ART outcomes.</p><p><strong>Objectives: </strong>The aim of the study was to evaluate the influence of endometriosis on various aspects of ART, including oocyte competence, ART success, and whether surgical or medical treatments improve these.</p><p><strong>Methods: </strong>We primarily focused on recent high-quality sources, including systematic reviews, large-scale observational studies, and meta-analyses, to provide a robust and reliable synthesis of the available evidence.</p><p><strong>Outcome: </strong>While oocyte yield can decrease in the presence of an endometrioma or history of endometrioma excision, oocyte quality, early embryo development indicators, aneuploidy rates, and clinical outcomes of endometriosis patients do not differ from other infertility diagnoses in ART setting. Surgical treatments and hormonal suppression before ART do not seem to improve outcomes. Ovarian stimulation for ART does not exacerbate endometriosis symptoms.</p><p><strong>Conclusions and outlook: </strong>Endometriosis, despite its high prevalence among infertile patients, does not inherently impair ART success, except in cases where ovarian reserve is compromised due to ovarian disease or its surgical treatment. The causal link between endometriosis and infertility remains an enigma, and future studies should continue to explore this association with other confounding factors.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"374-380"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046622","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":"Circ_0043314 Modulates Proliferation and Apoptosis of Ovarian Granulosa Cells in Polycystic Ovarian Syndrome via the MicroRNA-146b-3p/Apelin 13 Axis.","authors":"Wei Wang, Luni Tan, Liang Ge, Ruiqiang Gou, Li Gou, Lin Liu, Lili Zhang, Xiaoling Ma","doi":"10.1159/000540097","DOIUrl":"10.1159/000540097","url":null,"abstract":"<p><strong>Introduction: </strong>Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder in women. At present, the pathogenesis has not been clarified, and the clinical application of drugs and lifestyle intervention may not prevent disease progression. This study aimed to investigate how circ_0043314 regulates ovarian granulosa cell biological functions to provide a theoretical basis for the treatment of patients with PCOS. MicroRNA (miR)-146b-3p/Apelin 13 axis was used to investigate the mechanism by which circ_0043314 regulated ovarian granulosa cell proliferation and apoptosis in PCOS via miR-146b-3p/Apelin 13 axis. Participants/Materials, Methods: Ovarian tissues (cortical tissues) from 35 PCOS patients and 35 normal controls, as well as HEK293T and human ovarian granulosa cell line (KGN, COV434), were included in this study. We examined the expression levels of circ_0043314, miR-146b-3p, and Apelin 13 in PCOS tissues. Ovarian granulosa cells were transfected with corresponding plasmids to clarify the influence of circ_0043314, miR-146b-3p, or Apelin 13 on proliferation and apoptosis of ovarian granulosa cells through MTT and flow cytometry assays. Moreover, the relationships among circ_0043314, miR-146b-3p, and Apelin 13 were analyzed through dual-luciferase and RNA immunoprecipitation assays.</p><p><strong>Results: </strong>Circ_0043314 and Apelin 13 were highly expressed and miR-146b-3p was lowly expressed in ovarian tissues of PCOS compared with non-PCOS controls. Downregulation of circ_0043314 or upregulation of miR-146b-3p hindered ovarian granulosa cell proliferation and advanced its apoptosis. Downregulation of miR-146b-3p reversed the impacts of downregulation of circ_0043314, and overexpression of Apelin 13 counteracted the influences of upregulation of miR-146b-3p in ovarian granulosa cells. Mechanically, circ_0043314 could bind to miR-146b-3p, and miR-146b-3p directly targeted and modulated Apelin 13 expression.</p><p><strong>Limitations: </strong>This study was limited by the lack of animal experiments.</p><p><strong>Conclusion: </strong>Our data demonstrated that circ_0043314 enhances ovarian granulosa cell proliferation and suppresses its apoptosis via miR-146b-3p/Apelin 13 axis.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"18-29"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141619860","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":"Efficacy and Safety of Immune Checkpoint Inhibitors Combined with Chemotherapy or Tyrosine Kinase Inhibitors in Advanced Endometrial Cancer: A Systematic Review and Meta-Analysis.","authors":"Yuting Li, Shixiu Li, Juan Liang","doi":"10.1159/000541617","DOIUrl":"10.1159/000541617","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this meta-analysis was to conduct a comprehensive assessment of the therapeutic effectiveness and safety profile of the combination of immune checkpoint inhibitors (ICIs) with either chemotherapy or tyrosine kinase inhibitors (TKIs) in the treatment of advanced-stage endometrial cancer (EC).</p><p><strong>Methods: </strong>This meta-analysis conducted a thorough literature search across PubMed, Cochrane Library, Embase, and Web of Science databases from their earliest records up to November 18, 2023, identifying qualified randomized controlled trials (RCTs), cohort studies, and single-arm trials for inclusion in the analysis. The meta-analysis were performed to quantify and analyzed the evidence from the existing literature, focusing on outcomes including the objective response rate (ORR), disease control rate (DCR), duration of response, overall survival (OS), progression-free survival (PFS), and adverse events (AEs).</p><p><strong>Results: </strong>A total of 13 studies were included. In terms of ICI combined with chemotherapy, the single-arm trials showed that ICI combined with chemotherapy was effective in improving the ORR, but the overall rate of AE was higher. The results based on RCT suggested that ICI combined with chemotherapy resulted in a longer PFS of 12-24 months and OS of 18 months compared to the control group in advanced EC. In terms of ICI combined with TKI, the pooled ORR was 39.0%, the pooled DCR was 79.9%, the pooled OS rate was 50.4%, and the pooled overall AE rate was 95.8%, the pooled grade ≥3 AE rate was 73.8%, the pooled median progression-free survival was 6.126 months, and pooled OS was 15.099 months in advanced EC.</p><p><strong>Conclusions: </strong>The integrative therapeutic approach combining ICIs with chemotherapy or TKIs demonstrates notable clinical efficacy in advanced EC, which can prolong the survival and help disease control. Nevertheless, it is imperative for clinicians to be vigilant regarding the potential for adverse reactions to emerge. In addition, more RCTs are needed to solidify this study's efficacy and safety further.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"241-254"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575998","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":"Relation of Endocan Serum Levels with Patient Characteristics and Morphological Features of Uterine Fibroids: A Case-Control Study.","authors":"Inci Başkır, Şebnem Özyer","doi":"10.1159/000542405","DOIUrl":"10.1159/000542405","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to compare the serum endocan levels of patients with uterine fibroids and the healthy control group.</p><p><strong>Design: </strong>A case-control study was designed. Participants/Materials: The study group includes women diagnosed with uterine fibroids, and the control group includes healthy women.</p><p><strong>Setting: </strong>The study was conducted at a tertiary education and research hospital with 130 women (uterine fibroid group, n = 65; control group, n = 65).</p><p><strong>Methods: </strong>Serum endocan levels were determined in the study and control groups using the ELISA method. The number of uterine fibroids was identified, and the volume of uterine fibroids was calculated with ellipsoid formula by ultrasonography. The primary outcome parameter was serum endocan levels in patients with uterine fibroids and healthy control groups. Second, it is aimed to determine the distribution of the serum endocan level of patients according to uterine fibroid number, volume, and clinical presentation.</p><p><strong>Results: </strong>The mean serum endocan level of patient with uterine fibroid was 145.18 ± 169.86 (median: 94.10; Q25-Q75%: 54.50-116.50) pg/mL; it was 88.94 ± 54.21 (median: 76.9; Q25-Q75%: 64.20-152.65) pg/mL in the control group (p = 0.016). According to ROC analysis, cutoff value of the endocan level for uterine fibroid was determined as ≥133.1 pg/mL. For the cutoff value of 133.1 pg/mL, sensitivity was 36.92%, specificity was 89.23%, positive predictive value was 77.40%, and negative predictive value was 58.60%. Above this cutoff value, a 4.8-fold increased significant risk (OR) for uterine fibroid was detected.</p><p><strong>Limitations: </strong>The major limitation of the study is the lack of histopathological examination.</p><p><strong>Conclusion: </strong>Serum endocan levels were found to be higher in women with uterine fibroids compared to the control group, so endocan may be considered as a significant serum marker.</p>","PeriodicalId":12952,"journal":{"name":"Gynecologic and Obstetric Investigation","volume":" ","pages":"202-210"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142675647","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}