Journal of the Turkish German Gynecological Association最新文献

{"title":"Non-anatomical liver resection using Kelly clamp-crush technique during interval cytoreduction.","authors":"Ayush Heda, Shalini Rajaram, Nirjhar Raj Rakesh, Nilotpal Chowdhury","doi":"10.4274/jtgga.galenos.2026.2024-11-14","DOIUrl":"10.4274/jtgga.galenos.2026.2024-11-14","url":null,"abstract":"<p><p>Ovarian cancer is frequently diagnosed at an advanced stage, with liver metastases commonly observed, adversely affecting prognosis. Achieving complete cytoreduction (R0) is essential for improving overall survival in advanced ovarian cancer. Liver resections, particularly for isolated and resectable lesions, have demonstrated survival benefits. Non-anatomical resections, while preserving functional liver parenchyma, are increasingly employed in this context. This study showcases a surgical video illustrating a non-anatomical wedge liver resection performed for oligometastatic disease as part of interval cytoreductive surgery in advanced-stage ovarian cancer. A young multiparous woman in her 30 s with high-grade serous carcinoma of the right ovary and multiple hepatic metastases at diagnosis had a persistent dominant residual liver lesion following neoadjuvant chemotherapy. She had undergone prior right salpingo-oophorectomy. Interval cytoreductive surgery included peritoneal wash for cytology, hysterectomy with excision of left tube and ovary, retroperitoneal lymph node sampling, total omentectomy, peritoneal deposit excision, and non-anatomical liver resection. The surgical peritoneal cancer index was 7. Intra-operative ultrasound guided localization of a 2.5×2 cm intraparenchymal lesion in liver segments IVB/V. Wedge resection with adequate margins was performed using the Kelly clamp-crush technique, LigaSure, and monopolar cautery after ligation of the distal middle hepatic vein. The postoperative recovery proceeded without complications. Metastatic carcinoma in the liver lesion and peritoneal deposit, with no residual disease in other specimens were reported from histology. The patient received three cycles of adjuvant chemotherapy and remains disease-free at 18 months of follow-up. Non-anatomical liver resections are feasible and safe in advanced ovarian cancer with resectable oligometastatic hepatic disease and should be integrated into cytoreductive surgery when indicated. While recent evidence supports the safety and survival benefits of liver resections, additional research is needed to clarify their prognostic significance in advanced ovarian cancer.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"27 3","pages":"226-228"},"PeriodicalIF":1.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accessory cavitated uterine mass: a rare cause of severe dysmenorrhea","authors":"Mehmet Tunç, Göğşen Önalan, Mehmet Coşkun, Asuman Nihan Haberal, Ülkü Esra Kuşçu","doi":"10.4274/jtgga.galenos.2025.2025-10-5","DOIUrl":"10.4274/jtgga.galenos.2025.2025-10-5","url":null,"abstract":"<p><p>We present a rare Müllerian anomaly known as \"accessory cavitated uterine mass (ACUM),\" which causes severe, refractory dysmenorrhea, and review the literature. A 17-year-old patient experienced severe, cyclic left-sided pelvic pain, correlating with menstruation. Magnetic resonance imaging (MRI) revealed a cystic lesion surrounded by myometrial tissue. Medical treatment with oral contraceptives was unsuccessful. Laparoscopic excision of the mass was performed, and histopathology confirmed the diagnosis of ACUM. At six months postoperatively, she remained asymptomatic, and follow-up MRI showed a normal-appearing uterus. ACUM is a rare Müllerian anomaly that is challenging to diagnose preoperatively, even with advanced imaging. Surgical excision remains the definitive treatment. This case highlights the importance of clinicians considering Müllerian anomalies in adolescents presenting with severe dysmenorrhea.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":" ","pages":"222-225"},"PeriodicalIF":1.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146018911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unidirectional barbed versus single layer conventional suture for vaginal cuff closure in robotic hysterectomy: retrospective single-center study.","authors":"Anupama Bahadur, Megha Ajmani, Rajlaxmi Mundhra, Lakhwinder Singh, Latika Chawla, Ayush Heda","doi":"10.4274/jtgga.galenos.2026.2025-10-4","DOIUrl":"10.4274/jtgga.galenos.2026.2025-10-4","url":null,"abstract":"<p><strong>Objective: </strong>Successful vaginal cuff suturing remains a major challenge in robotic hysterectomy. This study compared the vault closure time by using Vicryl (polyglactin 910) and barbed (V-Loc) sutures.</p><p><strong>Material and methods: </strong>This retrospective study included patients undergoing robotic hysterectomy for benign disease over three years. Patients were grouped according to the suture used for vaginal vault closure. Surgical videos and hospital records were reviewed to obtain operative details, perioperative outcomes, and postoperative complications.</p><p><strong>Results: </strong>A total of 297 patients were included in final analysis with 106 (35.7%) patients in the Vicryl group and 191 (64.3%) patients in the barbed suture group. In the barbed compared to Vicryl group, the robotic vault closure time (6.84±1.42 vs. 9.93±2.77 minutes), average number of stitches used for vault closure (5.02±0.57 vs. 5.61±0.75), and time taken per stitch (1.36±0.3 vs. 1.75±0.43 minutes) were significantly lower. Operative time, anesthesia duration, and hospital stay were also significantly lower in the barbed group. On multivariable linear regression analysis, barbed suture use remained independently associated with shorter vault closure time (β =8.47 minutes, 95% confidence interval 5.46-11.48; p<0.001), while age, body weight, body mass index, parity, and preoperative anemia were not independently associated with vault closure time. On sexual function assessment, the overall score of female sexual function index in barbed (29.02±4.85) was significantly higher than the Vicryl (27.39±7.35) suture group (p=0.049).</p><p><strong>Conclusion: </strong>Barbed sutures may represent a feasible and time-efficient option for robotic vaginal vault closure; however, prospective randomized studies with longer follow-up are required to confirm their safety, and impact on functional outcomes.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"27 3","pages":"157-164"},"PeriodicalIF":1.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double stimulation in the same menstrual cycle (DuoStim): a comparative evaluation of follicular and luteal phase response.","authors":"Gülşen Doğan Durdağ, Didem Alkaş Yağınç, Selçuk Yetkinel, Pınar Çağlar Aytaç, Erhan Şimşek","doi":"10.4274/jtgga.galenos.2026.2025-11-2","DOIUrl":"10.4274/jtgga.galenos.2026.2025-11-2","url":null,"abstract":"<p><strong>Objective: </strong>Double ovarian stimulation (DuoStim) protocols, in which both follicular and luteal phase stimulations are performed within the same menstrual cycle, have emerged as a promising strategy for patients with diminished ovarian reserve. The aim of this study is to compare the outcomes of follicular and luteal phase stimulations in patients undergoing DuoStim protocols.</p><p><strong>Material and methods: </strong>This retrospective intra-patient paired comparative study included patients who underwent DuoStim between January 2018 and December 2024 at a university-based infertility clinic. Stimulation protocols, gonadotropin doses and trigger types were evaluated. Primary outcomes were retrieved oocyte and metaphase II (MII) oocyte numbers across both stimulation phases. Clinical pregnancy rates achieved by embryos derived separately from each stimulation phase were evaluated as a secondary outcome. Duration of stimulation, total gonadotropin doses administered, cumulative oocyte yield and embryos obtained, fertilization rates, implantation rates, and live birth rates were also assessed.</p><p><strong>Results: </strong>The study included 120 patients. Retrieved oocytes numbers [2 (1-3) and 2 (1-5) in follicular phase and luteal phase], MII oocytes [1 (1-2) and 2 (0-4)], and frozen cleavage stage embryos [1 (0-1) and 1 (0-2) in follicular phase and luteal phase] were higher in the luteal phase stimulation (p<0.001, p=0.001, and p=0.005 respectively). Oocyte yield, fertilization rates, implantation rates, and clinical pregnancy rates were similar between the two phases. Total gonadotropin doses and stimulation duration were significantly higher during follicular phase stimulation.</p><p><strong>Conclusion: </strong>In patients with diminished ovarian reserve undergoing DuoStim, luteal phase stimulation yielded significantly more retrieved oocytes and MII oocytes despite requiring lower gonadotropin doses and shorter stimulation duration. Fertilization rates, embryo development, and clinical pregnancy rates were comparable between phases, suggesting that luteal phase-derived embryos are equally competent. These findings support DuoStim as an effective strategy to maximize oocyte yield within a single menstrual cycle in this challenging population. Further prospective studies are warranted to evaluate cumulative reproductive outcomes.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"27 3","pages":"196-202"},"PeriodicalIF":1.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ovotesticular disorder of sex development presenting in adolescence with amenorrhea and clitoromegaly-what is your diagnosis?","authors":"Aparna Setty, Mishu Mangla, Kona Kiran Kumar Reddy, Madhavan Velladurai","doi":"10.4274/jtgga.galenos.2025.2025-10-17","DOIUrl":"10.4274/jtgga.galenos.2025.2025-10-17","url":null,"abstract":"","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":" ","pages":"211-215"},"PeriodicalIF":1.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145952452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suspected burned-out ovarian germ cell tumor in Turner mosaicism: a diagnostic challenge-what is your diagnosis?","authors":"Aparna Setty, Naina Kumar, Annapurna Srirambhatla, Seetu Palo, Jarathi Aparna, Divya Gurram","doi":"10.4274/jtgga.galenos.2026.2025-12-16","DOIUrl":"10.4274/jtgga.galenos.2026.2025-12-16","url":null,"abstract":"","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"27 3","pages":"216-221"},"PeriodicalIF":1.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic significance of lymphovascular space invasion in endometrial cancer and its relationship with other prognostic factors.","authors":"Vildan Nalbant Gürer, Mehmet Küçükbaş, Ateş Karateke","doi":"10.4274/jtgga.galenos.2026.2025-9-4","DOIUrl":"10.4274/jtgga.galenos.2026.2025-9-4","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the prognostic significance of lymphovascular space invasion (LVSI) and its relationship with other prognostic factors in patients with endometrial cancer.</p><p><strong>Material and methods: </strong>Patients with stage 1a/1b endometrial cancer who underwent hysterectomy and/or staging surgery between January 2016 and December 2020 at a tertiary referral center were retrospectively analyzed. Pathological data including histological type, stage, grade, LVSI (lymphatic invasion, vascular invasion), tumor size, depth of myometrial invasion, cervical involvement, lymph node evaluation (pelvic, paraaortic), and peritoneal wash cytology were analyzed using univariate and multivariate methods.</p><p><strong>Results: </strong>The study included 304 patients. Non-endometrioid tumors were associated with a 6.35-fold higher risk of LVSI. Each 1 mm increase in tumor size raised the risk by 1.03-fold. LVSI was present in 53.3% of cases with lymph node metastasis and was 7.2-fold more frequent in deceased patients (odds ratio: 7.209; 95% confidence interval: 3.137-16.570; p<0.001). Multivariate analysis identified tumor grade and survival as independent predictors of LVSI: grade 3 tumors had a 4.88-fold higher risk (p=0.014), and mortality was associated with a 4.16-fold higher risk (p=0.007). Survival was significantly linked to LVSI, tumor size ≥35 mm, and recurrence, but not to age, histological type, lymph node status, or peritoneal cytology.</p><p><strong>Conclusion: </strong>Our results demonstrated that LVSI was significantly associated with histological grade and survival. Furthermore, LVSI, tumor diameter ≥35 mm, and recurrence were found to significantly affect survival, highlighting their prognostic relevance for risk assessment and postoperative management.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":" ","pages":"173-186"},"PeriodicalIF":1.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal and neonatal outcomes following cesarean myomectomy: a comparison between fibroid-associated and fibroid-free cesarean deliveries.","authors":"Çağla Bahar Bülbül, Volkan Karataş, Simge Tezel Yozgat","doi":"10.4274/jtgga.galenos.2026.2025-12-17","DOIUrl":"10.4274/jtgga.galenos.2026.2025-12-17","url":null,"abstract":"<p><strong>Objective: </strong>To compare maternal and neonatal outcomes among women undergoing cesarean section (CS) with concomitant myomectomy, women with uterine fibroids managed conservatively at cesarean delivery, and women without uterine fibroids.</p><p><strong>Material and methods: </strong>This retrospective cohort study included women who delivered by CS between May 2017 and December 2024. Patients were classified into three groups: CS with myomectomy (Group 1), CS with fibroids without myomectomy (Group 2), and CS without fibroids (Group 3). Maternal outcomes included perioperative changes in hemoglobin, hematocrit, and platelet counts, transfusion requirement, and length of hospital stay. Neonatal outcomes included birth weight, birth length, and Apgar scores. Appropriate parametric and non-parametric statistical tests were used for group comparisons.</p><p><strong>Results: </strong>The study cohort numbered 682 with 252 (36.95%), 178 (26.1%) and 252 (36.95%) women in Groups 1, 2 and 3, respectively. Postoperative hemoglobin, hematocrit, and platelet levels differed significantly among the three groups (all p<0.05). However, hemoglobin deficit did not differ significantly between Group 1 and Group 2 (p=0.346), while both groups showed greater hemoglobin deficit than Group 3 (p<0.05). Transfusion rates and hospitalization duration differed significantly between groups (p<0.05), with longer hospital stay observed in transfused patients regardless of group. Maximum myoma volume was higher in Group 1, whereas myoma count was greater in Group 2 and total myoma volume was comparable between these groups (p=0.09). Neonatal birth weight was significantly lower in Group 2 compared with Groups 1 and 3 (p<0.05), while no difference was observed between Groups 1 and 3 (p=0.956). Other neonatal outcomes were similar.</p><p><strong>Conclusion: </strong>Cesarean myomectomy was associated with larger changes in hematologic parameters and transfusion rates; however, hemoglobin deficit appears related to fibroid presence rather than myomectomy itself. Neonatal outcomes were not adversely affected by cesarean myomectomy, whereas untreated fibroids appeared to be associated with lower birth weight.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"27 3","pages":"187-195"},"PeriodicalIF":1.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of hormonal intrauterine device and quarterly injection for contraception in adolescents with mental disorders.","authors":"Giani Silvana Schwengber Cezimbra, Edward Araujo Júnior, Maria Regina Torloni, Cristina Aparecida Falbo Guazzelli","doi":"10.4274/jtgga.galenos.2026.2026-2-7","DOIUrl":"10.4274/jtgga.galenos.2026.2026-2-7","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the continuity and satisfaction rate with contraceptive methods over 12 months in female adolescents with mental disorders (MD).</p><p><strong>Material and methods: </strong>Prospective cohort study carried out at a reference center for care for adolescents with MD. Adolescents with mild and moderate MD who opted for the hormonal intrauterine device (IUD) or a quarterly injectable contraceptive were included. Sociodemographic data were collected, such as age, education and gynecological data. Follow-up was quarterly for 12 months, with assessment of symptoms, desire to continue and satisfaction with the use of the quarterly injectable or hormonal IUD.</p><p><strong>Results: </strong>One-hundred and three adolescents participated in the study, 34 (33%) of whom chose to use the hormonal IUD and 69 (67%) the quarterly injectable with depot medroxy-progesterone acetate (DMPA). After 12 months, 26 adolescents (76.5%) continued to use the IUD and 34 (49.3%) maintained the use of DMPA. During IUD follow-up, one teenager (2.9%) wanted to have it removed after three months, three (8.8%) developed spontaneous expulsion of the IUD and four (11.7%) were lost to follow-up. Regarding satisfaction after 12 months of use, of the 30 who maintained the method, 29 (96.6%) adolescents were satisfied. Among the 69 adolescents who chose to use DMPA, after 12 months of follow-up, 34 (50.7%) said they were satisfied. Among the 30 (44.7%) who discontinued use, the most frequent causes were irregular bleeding and weight gain. When comparing the two methods, a significant difference was demonstrated for IUD users in terms of continuity (p=0.0001), and satisfaction (p=0.00002).</p><p><strong>Conclusion: </strong>Adolescents using the IUD exhibited significantly higher rate of continuity and reported greater satisfaction at 12 months compared to DMPA users. This result corroborates evidence of the preference for long-acting reversible methods for adolescents, especially for those who are most vulnerable.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"27 3","pages":"165-172"},"PeriodicalIF":1.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of angiopoietin-like protein 4 levels in patients with endometriosis.","authors":"Merve Didem Eşkin Tanrıverdi, Esin Merve Erol Koç","doi":"10.4274/jtgga.galenos.2026.2026-2-15","DOIUrl":"10.4274/jtgga.galenos.2026.2026-2-15","url":null,"abstract":"<p><strong>Objective: </strong>Endometriosis is a chronic inflammatory disorder lacking definitive laboratory diagnostic markers. Angiopoietin-like protein-4 (ANGPTL4) is a protein involved in the regulation of angiogenesis and inflammation. The aim of the present study was to evaluate serum and peritoneal fluid (PF) levels of ANGPTL4 to explore its potential role in the pathogenesis of endometriosis.</p><p><strong>Material and methods: </strong>This prospective study included women with surgically confirmed endometriosis and age-matched healthy controls with similar demographic characteristics. Clinical and laboratory parameters, including serum ANGPTL4, anti-Müllerian hormone (AMH), and cancer antigen-125 (CA125) levels were compared between groups. In addition, PF ANGPTL4 levels were assessed in the endometriosis group.</p><p><strong>Results: </strong>Serum ANGPTL4 (512.65±46.91 vs. 177.60±11.84 ng/mL, p<0.001) and CA125 (53.52±6.05 vs. 20.10±3.18 U/mL, p<0.001) levels were significantly higher in endometriosis group. Serum ANGPTL4 positively correlated with the severity of pelvic pain and dyspareunia, serum CA125 level and PF ANGPTL4, and negatively correlated with AMH (r=0.743, p<0.001; r=0.624, p<0.001; r=0.444, p<0.001; r=0.841, p<0.001; and r=-0.380, p<0.001, respectively). Receiver operating characteristic analysis identified an optimal serum ANGPTL4 cut-off value of 188.61 ng/mL (area under the curve =0.755, sensitivity 75% and specificity 62.5%, positive predictive value 66.7%, and negative predictive value 71.4%).</p><p><strong>Conclusion: </strong>Serum ANGPTL4 levels were significantly higher in women with endometriosis and were associated with clinical and laboratory parameters. It may serve as a supportive biomarker in the clinical assessment of endometriosis.</p>","PeriodicalId":17440,"journal":{"name":"Journal of the Turkish German Gynecological Association","volume":"27 3","pages":"203-210"},"PeriodicalIF":1.4,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}