Turkish Journal of Obstetrics and Gynecology最新文献

{"title":"Comprehensive analysis of selenoprotein gene expression and prognostic value in ovarian cancer.","authors":"Yingying Hou, Hongye Shen, Honghua Dong","doi":"10.4274/tjod.galenos.2024.66179","DOIUrl":"10.4274/tjod.galenos.2024.66179","url":null,"abstract":"<p><strong>Objective: </strong>To comprehensively analyze the expression and prognostic value of selenoprotein in ovarian cancer (OV).</p><p><strong>Materials and methods: </strong>GEPIA and cBioPortal were used to analyze selenoprotein expression and mutations and copy number variations. Kaplan-Meier plotter and the tumor immune estimation resource were used to evaluate the impact of these genes on clinical prognosis and their correlation with tumor immune infiltration.</p><p><strong>Results: </strong>Compared with normal tissues, the expression of iodothyronine deiodinase 3 (DIO3), glutathione peroxidase 4, SECISBP2, SELM, and SELP was decreased in the four gynecological malignancies. In OV, selenoprotein had the highest number of mutations (309) and mutation frequency (52.91%), whereas the lowest was observed in endometrial cancer (29.72%). DIO3, selenoprotein O (SELO), and selenoprotein T (SELT) are significantly related to the prognosis of OV. Immune infiltration analysis showed that DIO3 was associated with tumor-associated macrophages, SELO with CD4+ T-cells and monocytes, and SELT with T-cells. Enrichment analysis revealed that DIO3 is mainly involved in inflammatory immune responses and the Ras signaling pathway, SELO is primarily related to innate immune responses, and SELT is closely associated with mitochondrial oxidative phosphorylation.</p><p><strong>Conclusion: </strong>This study explored the expression characteristics of 25 selenoprotein in patients with gynecological malignancies and found that DIO3, SELO, and SELT were significantly associated with the prognosis and clinical features of OV, which are potential therapeutic targets.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"21 4","pages":"242-265"},"PeriodicalIF":1.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814555","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":"Retrospective analysis of the indications, methods, and complications of pregnancy termination.","authors":"Zahid Ağaoğlu, Atakan Tanacan, Murat Haksever, Hakan Coşkun, Göksun İpek, Ramazan Denizli, Özgür Kara, Dilek Şahin","doi":"10.4274/tjod.galenos.2024.88886","DOIUrl":"10.4274/tjod.galenos.2024.88886","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the indications and methods of termination of pregnancy (TOP) and to identify maternal complications that occur during TOP.</p><p><strong>Materials and methods: </strong>This retrospective study was conducted at a single tertiary center with a total of 231 patients who underwent TOP from April 2019 to March 2023. The patients were divided into two groups based on gestational age at the time of TOP and the presence of complications. Group 1 consisted of patients with a gestational age of 11-22+6 weeks (n=196), while Group 2 comprised patients with a gestational age of 23-30 weeks (n=35). Additionally, the patients were categorized based on complications into those with complications (n=63) and those without complications (n=168). The TOP protocol involves misoprostol, a uterine balloon, a combination of misoprostol and balloon, or oxytocin. Procedure-related complications included the following: Rehospitalization, rest placenta, infection, uterine rupture, blood transfusion, and repeated manual vacuum curettage.</p><p><strong>Results: </strong>The median gestational age at TOP was 18.0±3.3 weeks for women without complications and 19.5±5.1 weeks for those with complications, it was 19.5±5.1 weeks (p=0.037). In the group with complications, the combined misoprostol-balloon method was used significantly more frequently, and the rate of previous cesarean sections was higher (p<0.05). The induction time was longer in the oxytocin group (p<0.05). The misoprostol-balloon combination group had the highest rate of uterine rupture (p<0.05).</p><p><strong>Conclusion: </strong>TOP during advanced gestation is associated with increased rates of maternal complications, such as increased transfusion, uterine rupture, and hysterotomy. Higher gestational age and previous uterine surgery are the main causes of TOP-related maternal complications.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"21 4","pages":"273-279"},"PeriodicalIF":1.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813758","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 serum apelin-13 levels in early- and late-onset preeclampsia.","authors":"Rajeev Gandham, Dayanand C D, Sheela S R","doi":"10.4274/tjod.galenos.2024.37657","DOIUrl":"10.4274/tjod.galenos.2024.37657","url":null,"abstract":"<p><strong>Objective: </strong>To assess whether alterations in maternal serum apelin-13 levels differ between early-onset preeclampsia (EO-PE) and late-onset preeclampsia (LO-PE).</p><p><strong>Materials and methods: </strong>A prospective case-control study included 90 preeclamptic cases and 90 normotensive healthy pregnant women as controls. Preeclampsia cases were subclassified as EO-PE and LO-PE. Blood samples were collected, centrifuged, and the separated serum was stored at -80°C for further testing. Ethylenediamine tetraacetic acid blood was used for complete blood count. Serum sample was used for analysis of biochemical parameters. Maternal serum apelin-13 concentrations were measured using ELISA. Demographic details and fetal outcomes were recorded.</p><p><strong>Results: </strong>Results indicated significantly lower gestational age at sampling and delivery in preeclampsia cases. Blood pressure (systolic, diastolic, and mean arterial pressure) was elevated in preeclampsia. Maternal serum apelin-13 levels (261.7±110.6 pg/mL) were significantly reduced in preeclamptic cases compared to controls (575.3±164.7 pg/mL). Adverse fetal outcomes were more prevalent in preeclampsia. Regarding EO-PE and LO-PE, gestational age at sampling and delivery was lower in EO-PE compared to LO-PE. Maternal serum apelin-13 levels (371.3±116.0 pg/mL) were higher in EO-PE. A 40.9% reduction in apelin-13 levels was observed in LO-PE compared to EO-PE, indicating a gradual reduction in apelin-13 levels in preeclampsia. Adverse fetal outcomes, such as birth weight (1.8±0.5 kg), were lower, and other adverse outcomes were higher in EO-PE compared to LO-PE.</p><p><strong>Conclusion: </strong>Circulating serum apelin-13 concentration was reduced in preeclampsia and was higher in EO-PE than in LO-PE. Apelin-13 serves as a potential indicator for discriminating early-onset preeclampsia.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"21 4","pages":"235-241"},"PeriodicalIF":1.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813453","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":"Association between serum copeptin levels and non-obese normoglycemic polycystic ovary syndrome: A case control study.","authors":"Engin Yıldırım, Ümit Görkem","doi":"10.4274/tjod.galenos.2024.65703","DOIUrl":"10.4274/tjod.galenos.2024.65703","url":null,"abstract":"<p><strong>Objective: </strong>Copeptin is a glycopeptide that increases under stress and is present in polycystic ovary syndrome (PCOS) patients with metabolic system disorders. We examined the relationship between copeptin and reproductive function in patients with normoglycemic PCOS with anovulatory cycles and normal weight.</p><p><strong>Materials and methods: </strong>Women with unexplained infertility (n=52) and women with PCOS (n=57) were included in the study. PCOS was determined using the Rotterdam criteria. Biochemical tests including estradiol, follicle-stimulating hormone, luteinizing hormone, anti-Müllerian hormone (AMH), insulin, and copeptin were performed. Serum copeptin concentrations were measured using enzyme immunoassay.</p><p><strong>Results: </strong>There were no significant differences in demographic data, insulin levels, and insulin resistance between the PCOS and healthy volunteers. Copeptin levels were lower in the PCOS group (p<0.001). A significant negative correlation was observed between AMH and copeptin in the control group (r=-0.402, p= 0.013). In the PCOS group, a negative correlation was observed between antral follicle count and copeptin, as well as between AMH and copeptin (r=-0.544, p<0.01). Receiver operating characteristic (ROC) curve analysis was performed to determine the predictive value of copeptin levels. The estimated areas under the ROC curves for serum concentration were found to be statistically significant (p<0.001) with a cut-off value of 2.78 (95% confidence interval 0.701-0.896), sensitivity of 0.87, and specificity of 0.70.</p><p><strong>Conclusion: </strong>This study showed that copeptin levels are lower in patients with PCOS in the absence of insulin resistance and obesity than in healthy volunteers, and there is a negative correlation between copeptin and reproductive markers.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"21 4","pages":"280-285"},"PeriodicalIF":1.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814549","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":"Comparison of the effect of general anesthesia and combined epidural anesthesia on the anesthetic management of gynecological oncological surgery.","authors":"İrfan Mehmet, Berna Kaya Uğur, Furkan Çetin, İbrahim Taşkum, Mehmet Cesur, Süleyman Ganidağlı, Mete Gürol Uğur","doi":"10.4274/tjod.galenos.2024.22623","DOIUrl":"10.4274/tjod.galenos.2024.22623","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the potential advantages of combined general and epidural anesthesia for major gynecological oncological surgeries.</p><p><strong>Materials and methods: </strong>The data of 690 gynecological cancer were retrospectively examined, and 223 patients who met the inclusion criteria were included in the study. The patients were divided into two groups: Group G (123 patients who received general anesthesia only) and Group C (100 patients who received combined epidural and general anesthesia. The perioperative follow-up data were comparatively analyzed.</p><p><strong>Results: </strong>Operation times in Group G were significantly lower than those in Group C (p=0.018). The blood product replacement rate was higher in Group G (p<0.05). Additionally, intraoperative bleeding rates were lower in Group C (p<0.05). Postoperatively, the analgesic requirement time of Group C was significantly later than that of Group G (p=0.0001). The first mobilization time of Group C was substantially earlier (p=0.0001). Thrombosis and cardiac complications were considerably less frequent in group C, although allergic complications were more common (p<0.05). The length of hospital stay was shorter in Group C (p<0.05).</p><p><strong>Conclusion: </strong>Combined epidural and general anesthesia in gynecological oncological surgeries may improve postoperative outcomes, including reduced analgesic requirements, earlier patient mobilization, shorter hospitalization, and decreased rates of complications, particularly cardiovascular and thrombotic events.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"21 4","pages":"227-234"},"PeriodicalIF":1.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814553","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":"True empty follicle syndrome is a subtype of oocyte maturation abnormalities.","authors":"Şafak Hatırnaz, Ebru Hatırnaz, Justin Tan, Samettin Çelik, Canan Soyer Çalışkan, Alper Başbuğ, Gerçek Aydın, Ali Bahadırlı, Mehmet Bülbül, Handan Çelik, Aşkı Ellibeş Kaya, Nur Dokuzeylül Güngör, Seang Lin Tan, Mingju Cao, Michael H Dahan, Sebati Sinan Ürkmez","doi":"10.4274/tjod.galenos.2024.84031","DOIUrl":"10.4274/tjod.galenos.2024.84031","url":null,"abstract":"<p><strong>Objective: </strong>To review the outcomes of in vitro maturation (IVM) and in vitro fertilization (IVF) in women with empty follicle syndrome (EFS). The study evaluated the genetic underpinnings of EFS by analyzing mutations.</p><p><strong>Materials and methods: </strong>This retrospective case series involving 17 women with EFS over at least 2 IVF cycles was conducted. The study also employed whole-exome sequencing to analyze the genetic mutations. The treatment approaches included letrozole-primed IVM, follicle-stimulating hormone (FSH)-human chorionic gonadotrophin (hCG)-primed IVM, and conventional IVF.</p><p><strong>Results: </strong>The average female age was 31.5±4.6 years, and the duration of infertility was 7.3±3.5 years. Four patients underwent IVF. IVM oocyte collections yielded oocytes in 12 of 13 subjects. Of these, 75% (9/12) yielded MII oocytes after 48 h of IVM media incubation. Six subjects had fertilized embryos, resulting in a 40.9% intracytoplasmic sperm injection (ICSI) fertilization rate (9 embryos/22 MII oocytes). Genetic analysis revealed mutations in seven patients. This study demonstrated the partial efficacy of letrozole-primed IVM plus growth hormone and FSH-hCG primed IVM protocols. No pregnancies or live births were recorded after IVM. One ongoing pregnancy post-IVF and one spontaneous live birth were observed.</p><p><strong>Conclusion: </strong>Inter-cycle variabilities were observed in women with oocyte maturation abnormalities (OMAs). Almost all patients with EFS had oocytes collected during IVM following IVF. These oocytes have limited potential for maturation, fertilization, and live birth, as demonstrated by the low rates observed after IVM culture and ICSI. These conditions are observed in OMAs due to defects in the oocyte machinery. The proposed flowchart provides a comprehensive classification approach for various forms of EFS.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"21 3","pages":"142-152"},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126927","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":"Might retrigger with human chorionic gonadotropin be a solution for empty follicle syndrome after gonadotropin releasing hormone agonist trigger?","authors":"Zeynep Ece Utkan Korun, Ayşen Yücetürk, Özge Karaosmanoğlu, Yiğit Çakıroğlu, Bülent Tıraş","doi":"10.4274/tjod.galenos.2024.80439","DOIUrl":"10.4274/tjod.galenos.2024.80439","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to determine whether the use of human chorionic gonadotropin (hCG) as a trigger could offer a potential solution for addressing empty follicle syndrome following the administration of a trigger for gonadotropin-releasing hormone agonist.</p><p><strong>Materials and methods: </strong>A retrospective cohort analysis was conducted using data extracted from the hospital database pertaining to 415 patients who underwent in vitro fertilization (IVF) with an antagonist protocol triggered by a gonadotropin-releasing hormone (GnRH) agonist between December 2019 and January 2023 at the Acıbadem Maslak Hospital Assisted Reproductive Technologies Unit. All cases that failed to obtain oocytes and required rescue were analyzed.</p><p><strong>Results: </strong>This study analyzed 415 women who underwent IVF using GnRH agonist-triggered antagonist protocols. Among them, 6 (1.4%) had empty folicle syndrome (EFS). Patients with EFS had lower luteinizing hormone levels and fewer oocytes, embryos, and blastocysts, resulting in lower oocyte utilization rate. However, pregnancy rates were similar, with no biochemical or ectopic pregnancies observed in the EFS group.</p><p><strong>Conclusion: </strong>Use of an hCG retrigger in hyperresponders with no oocytes after GnRHa trigger may prevent cycle cancelation. Although the rates of egg utilization may decrease, oocyte maturity remains comparable. Frozen embryo transfer following hCG retrigger administration yields similar positive pregnancy test results and live birth rates.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"21 3","pages":"135-141"},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126924","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 placental bed uterine in L-NAME-induced early-onset preeclampsia (EO-PE) like the rat model.","authors":"Fitriana Fitriana, Soetrisno Soetrisno, Sri Sulistyowati, Dono Indarto","doi":"10.4274/tjod.galenos.2024.99132","DOIUrl":"10.4274/tjod.galenos.2024.99132","url":null,"abstract":"<p><strong>Objective: </strong>Preeclampsia (PE) is the leading cause of maternal death worldwide and is associated with long-term morbidity in both mothers and newborns. Animal modeling is considered a functional source for understanding PE pathogenesis, diagnostic standards, and therapeutic approaches.</p><p><strong>Materials and methods: </strong>This study aimed to demonstrate and evaluate the use of N-nitro-L-arginine methyl ester (L-NAME) in a Wistar rat model under conditions similar to PE. A total of 12 rats were divided into 4 groups, each consisting of 3 members, including the pregnant control group and treatment groups administered low-dose (PE 25 mg/kg L-NAME/day), medium-dose (PE 50 mg/kg L-NAME/day), and high-dose L-NAME (PE 75 mg/kg L-NAME/day) L-NAME from gestational day 4 to 19. Measurements included blood pressure, creatinine, and proteinuria levels, placental histological changes, and placental tissue hypoxia-inducible factor 1-alpha, and plasma endothelial nitric oxide synthase levels.</p><p><strong>Results: </strong>The results showed that intervention with L-NAME at 75 mg/kg body weight/day (PE3) induced PE earlier than that with 50 mg/kg body weight/day L-NAME.</p><p><strong>Conclusion: </strong>The model conditions also support further research into PE pathogenesis.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"21 3","pages":"180-189"},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126920","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":"Association between Mir-499, Mir-27a, and Mir-146a polymorphisms and their susceptibility to recurrent spontaneous abortion; <i>in silico</i> analysis.","authors":"Gholamreza Bahari, Mohsen Taheri, Mojgan Mokhtari, Mahdiyeh Moudi, Mahdi Majidpour, Hossein Shahraki Ghadimi","doi":"10.4274/tjod.galenos.2024.74419","DOIUrl":"10.4274/tjod.galenos.2024.74419","url":null,"abstract":"<p><strong>Objective: </strong>Recurrent spontaneous abortion (RSA) is defined as two or more pregnancy losses before 24 gestational weeks, accounting for 1-3% of fertile couples. A vast majority of single-nucleotide polymorphisms (SNPs) in some <i>microRNA</i> (<i>miRNA</i>) genes can change the miRNA-mRNA interaction and are associated with the risk of RSA. This study was designed to better elucidate the association between miR-27a, miR-499, and miR-146a polymorphisms and RSA risk.</p><p><strong>Materials and methods: </strong>SNP genotyping of miR-27a (rs895819), miR-499 (rs3746444), and miR-146a (rs2910164) was performed using polymerase chain reaction (PCR)-restriction fragment length polymorphism and tetra amplification-refractory mutation system PCR in 98 patients with RSA and 105 healthy subjects.</p><p><strong>Results: </strong>Our results showed that the miR-499 rs3746444 and miR-27a rs895819 polymorphisms were significantly associated with RSA risk, whereas no significant differences were observed between the rs2910164 polymorphism and RSA susceptibility.</p><p><strong>Conclusion: </strong>We proposed that the miR-499 rs3746444 and miR-27a rs895819 polymorphisms were correlated with RSA in our population, but the miR-146a rs2910164 variant was not associated with the risk of RSA.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"21 3","pages":"158-165"},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126918","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":"Lymph node evaluation and nodal metastasis prediction in epithelial ovarian cancers: A retrospective study.","authors":"Pallavi Verma, Anupama Bahadur, Shalini Rajaram, Rajkumar Kottayasamy Seenivasagam, Jaya Chaturvedi, Rajlaxmi Mundhra, Amrita Gaurav, Shalinee Rao, Ipshita Sahoo, Ayush Heda","doi":"10.4274/tjod.galenos.2024.50980","DOIUrl":"10.4274/tjod.galenos.2024.50980","url":null,"abstract":"<p><strong>Objective: </strong>To identify consensus regarding lymph node (LN) evaluation in epithelial ovarian cancer (EOC). The objective of the present study was to evaluate surgico-pathological findings, LN involvement, and the prediction of LN metastasis via preoperative imaging and intraoperative assessment in women with EOC.</p><p><strong>Materials and methods: </strong>Women with EOC who underwent cytoreductive surgery (CRS) between Jan 2019 to June 2022 were included. The distribution of histology, stage, and LN metastasis was studied. The predictive value of serum cancer antigen (CA)-125, instead of and radiologically and surgically enlarged LNs with final LN histopathology was studied.</p><p><strong>Results: </strong>A total of 96 women with EOCs underwent CRS. Fifty women (52%) underwent primary CRS and 46 women (48%) underwent interval CRS. Seventy-five women (78.13%) with EOC underwent pelvic and/or para-aortic lymphadenectomy, out of which 23 (30.67%) were histologically positive. High-grade serous carcinoma was the commonest (n=55, 73.33%) histology. The majority of women, 56 (74.67%) were stage III or IV at presentation. Complete cytoreduction was achieved in 59 (78.66%) patients. The receiver operating characteristics curve showed a cutoff for CA-125 of 1360 U/mL (area under the curve 0.702, p=0.002) for LN metastases. Both radiologically and surgically enlarged LNs significantly predicted LN metastasis on histopathology (p=0.02 and 0.006 respectively). The combined sensitivity, specificity, positive predictive value and negative predictive value of both contrast enhanced computed tomography (CECT) and surgically enlarged LNs were 78.26%, 57.69%, 45%, and 85.71%, respectively.</p><p><strong>Conclusion: </strong>Serous histology, high-grade tumors, highCA-125 levels, and suspicious LNs on CECT or during surgery were significantly associated with LN metastasis. However, considering the false-negative rate of 21.74%, the combination of radiologically and surgically enlarged LNs cannot be used as the sole surrogate marker for lymphadenectomy.</p>","PeriodicalId":45340,"journal":{"name":"Turkish Journal of Obstetrics and Gynecology","volume":"21 3","pages":"166-174"},"PeriodicalIF":1.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11589325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126923","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}