Przeglad Menopauzalny最新文献

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Estrogen receptor status low status in breast cancer: clinicopathological factors and prognostic value. 雌激素受体在乳腺癌中的低地位:临床病理因素和预后价值。
IF 2.2
Przeglad Menopauzalny Pub Date : 2026-03-01 Epub Date: 2026-05-06 DOI: 10.5114/pm.2026.161538
Joanna Huszno, Zofia Kołosza, Ewa Stobiecka, Dorota Ponikiewska, Bogna Szcześniak, Jakub Simek, Ewa Chmielik
{"title":"Estrogen receptor status low status in breast cancer: clinicopathological factors and prognostic value.","authors":"Joanna Huszno, Zofia Kołosza, Ewa Stobiecka, Dorota Ponikiewska, Bogna Szcześniak, Jakub Simek, Ewa Chmielik","doi":"10.5114/pm.2026.161538","DOIUrl":"10.5114/pm.2026.161538","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to investigate the prognostic significance of estrogen receptor status (ER)-low status in breast cancer (BC). Additionally, we compared the ER-low subgroup with ER-negative and ER-high BC according to clinical, histopathological and molecular factors.</p><p><strong>Material and methods: </strong>The analysis included medical records of BC patients treated at the National Institute of Oncology in Gliwice, Poland, between 2002 and 2018.</p><p><strong>Results: </strong>Of the 657 tumours, 14% were classified as ER-low, 52% as ER-high and 34% as ER-negative. Patients with ER-low tumours were more likely to present with T3-T4 disease compared with those with ER-high (19% vs. 12%, <i>p</i> = 0.089) and less frequently than ER-negative (19% vs. 29%, <i>p</i> = 0.092). Patients with ER-low tumours were less likely to be progesterone receptor status (PgR) negative (19% vs. 92%, <i>p</i> < 0.001) and G3 (22% vs. 49%, <i>p</i> < 0.001) compared with ER-negative. <i>BRCA</i> P/LP (pathogenic/likely pathogenic) variants were less frequent in ER-low than in ER-negative tumours (5% vs. 20%, <i>p</i> = 0.001). Overall survival (OS) was similar in both ER-high and ER-low groups (<i>p</i> = 0.333; 5-year OS: 93% vs. 92%, 7-year OS: 86% vs. 83%). Overall survival was non-significantly better for those with ER-low compared with ER-negative (<i>p</i> = 0.107).</p><p><strong>Conclusions: </strong>Estrogen receptor-low status appears to be associated with a higher T stage and PgR negativity compared with ER-high tumours, and with a lower grade and fewer <i>BRCA</i> P/LP variants compared with ER-negative tumours. A trend toward improved OS was observed in ER-low compared with ER-negative patients.</p>","PeriodicalId":55643,"journal":{"name":"Przeglad Menopauzalny","volume":"25 1","pages":"24-29"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457743","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}
引用次数: 0
Can machine learning predict endometrial cancer in patients with postmenopausal uterine bleeding? 机器学习能否预测绝经后子宫出血患者的子宫内膜癌?
IF 2.2
Przeglad Menopauzalny Pub Date : 2026-03-01 Epub Date: 2026-05-27 DOI: 10.5114/pm.2026.161939
Hadar Gluska, Nagam Gnaiem, Adi Ashkenazi Katz, Netanella Miller, Amit Tzidki, Alexandra Baron, Yael Hants, Mario Beiner, Aula Asali
{"title":"Can machine learning predict endometrial cancer in patients with postmenopausal uterine bleeding?","authors":"Hadar Gluska, Nagam Gnaiem, Adi Ashkenazi Katz, Netanella Miller, Amit Tzidki, Alexandra Baron, Yael Hants, Mario Beiner, Aula Asali","doi":"10.5114/pm.2026.161939","DOIUrl":"10.5114/pm.2026.161939","url":null,"abstract":"<p><strong>Introduction: </strong>Postmenopausal bleeding (PMB) is a common clinical symptom, with endometrial cancer (EC) accounting for about 10% of cases. This study aimed to develop machine-learning models to predict EC in women with PMB, supporting risk stratification and optimizing diagnostic pathways.</p><p><strong>Material and methods: </strong>We retrospectively analysed 617 women who underwent hysteroscopy for PMB at the Meir Medical Center between 2014 and 2023. Demographic, clinical, laboratory, and imaging data were collected. Three supervised machine-learning algorithms - Random Forest, eXtreme Gradient Boosting (XGBoost), and Light Gradient Boosting Machine (LightGBM) - were trained and evaluated. Synthetic minority oversampling technique addressed class imbalance. Model performance was assessed using accuracy, precision, recall, F1 score, and area under the receiver operating characteristic curve.</p><p><strong>Results: </strong>Seventy-two women (11.7%) were diagnosed with EC. eXtreme Gradient Boosting achieved the highest sensitivity (80%) for detecting EC, despite moderate accuracy (65%). Random Forest and LightGBM showed higher accuracy (85% and 84%, respectively) but much lower sensitivity. The most influential predictors in the XGBoost model were tamoxifen use, hormone therapy, age, hypertension, gravidity, parity, endometrial thickness, diabetes, and duration of bleeding.</p><p><strong>Conclusions: </strong>eXtreme Gradient Boosting provided the best clinical performance by minimizing missed diagnoses. Machine-learning models may enhance decision-making by identifying women at high risk for EC who require further evaluation. Larger datasets and additional clinical features are needed to improve specificity and reduce false positives.</p>","PeriodicalId":55643,"journal":{"name":"Przeglad Menopauzalny","volume":"25 1","pages":"30-35"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457745","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}
引用次数: 0
Clinical characteristics, surgical management, and outcomes of uterine smooth muscle tumours of uncertain malignant potential: a single-centre experience. 子宫平滑肌肿瘤的临床特征,手术治疗和预后不确定的恶性潜能:单中心经验。
IF 2.2
Przeglad Menopauzalny Pub Date : 2026-03-01 Epub Date: 2026-06-07 DOI: 10.5114/pm.2026.161236
Oliwia Maciejewska, Edyta Leśniak, Filip Jabłoński, Jan Bieńkiewicz, Hanna Romanowicz, Andrzej Malinowski, Milosz Wilczynski
{"title":"Clinical characteristics, surgical management, and outcomes of uterine smooth muscle tumours of uncertain malignant potential: a single-centre experience.","authors":"Oliwia Maciejewska, Edyta Leśniak, Filip Jabłoński, Jan Bieńkiewicz, Hanna Romanowicz, Andrzej Malinowski, Milosz Wilczynski","doi":"10.5114/pm.2026.161236","DOIUrl":"10.5114/pm.2026.161236","url":null,"abstract":"<p><strong>Introduction: </strong>Uterine smooth muscle tumours are primarily classified as benign leiomyomas or malignant leiomyosarcomas, with diagnosis based on cytologic atypia, mitotic activity, and tumour cell necrosis. Smooth muscle tumour of uncertain malignant potential (STUMP), a rare variant accounting for 2-5% of myomas, cannot be unequivocally classified as benign or malignant and most commonly affects women aged 45-55. The clinical presentation is similar to that of fibroids, and management is surgical, though standardized procedures are lacking due to the uncertain malignant potential. While prognosis is generally favourable, STUMP may recur, occasionally as leiomyosarcoma, highlighting the need for careful postoperative follow-up.</p><p><strong>Material and methods: </strong>This retrospective study included 12 patients with histopathologically confirmed STUMP treated between 2019 and 2024. Clinical data were analysed, and patients were followed until July 2025 to assess survival, recurrence, and outcomes.</p><p><strong>Results: </strong>Twelve patients with histopathologically confirmed STUMP were analysed, with a median age of 44.5 years and a median tumour size of 6.25 cm. Most patients presented with heavy menstrual bleeding (50%) or a pelvic mass (42%). Surgical treatment included hysterectomy in 50% of cases and myomectomy in 42%, performed via laparotomy, laparoscopy, or transvaginal approaches. After a median follow-up of 44 months, no recurrences were observed.</p><p><strong>Conclusions: </strong>Smooth muscle tumour of uncertain malignant potential remains a rare uterine neoplasm of uncertain malignant potential, requiring postoperative histopathological confirmation, individualized management, and long-term surveillance due to its risk of recurrence or metastasis.</p>","PeriodicalId":55643,"journal":{"name":"Przeglad Menopauzalny","volume":"25 1","pages":"19-23"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457761","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}
引用次数: 0
Primary transitional cell carcinoma of the endometrium: a case report and review of the literature. 原发性子宫内膜移行细胞癌1例报告及文献复习。
IF 2.2
Przeglad Menopauzalny Pub Date : 2026-03-01 Epub Date: 2026-05-06 DOI: 10.5114/pm.2026.161498
Vasilena Dimitrova Dimitrova, Milen Karaivanov, Stoyan Georgiev Kostov, Angel Danchev Yordanov
{"title":"Primary transitional cell carcinoma of the endometrium: a case report and review of the literature.","authors":"Vasilena Dimitrova Dimitrova, Milen Karaivanov, Stoyan Georgiev Kostov, Angel Danchev Yordanov","doi":"10.5114/pm.2026.161498","DOIUrl":"10.5114/pm.2026.161498","url":null,"abstract":"<p><p>Transitional cell carcinoma (TCC) of the endometrium is an extremely rare histologic subtype of endometrial carcinoma. While TCC is more frequently observed in the ovary, only a few cases have been documented in the cervix, fallopian tubes, adnexa, and endometrium. We describe the clinical presentation, diagnostic work-up, treatment, and histopathological features of a patient with pure high-grade endometrial TCC, followed by a focused review of previously published cases. A 70-year-old woman presented with an enlarging endometrial mass detected incidentally on imaging, despite two prior benign curettages. A total laparoscopic hysterectomy with bilateral salpingo-oophorectomy was performed. Histopathology revealed a pure high-grade TCC confined to the endometrium, without lymphovascular invasion or myometrial infiltration. The immunophenotype was CK7+, Vimentin+, CK HMW+, p16+, and CK20-, with a very high Ki-67 index (> 90%). Molecular classification (The Cancer Genome Atlas/ProMisE) could not be established due to unavailable p53 and mismatch repair testing. One-month follow-up showed no evidence of recurrence. Pure endometrial TCC is extremely rare. Although its morphology is high grade, early-stage disease without invasion may demonstrate favourable short-term outcomes. This case contributes a unique value because it shows a completely pure TCC pattern, absence of invasion, and early detection. Primary high-grade TCC of the endometrium represents a diagnostic and therapeutic challenge due to its rarity, aggressive histologic features, and lack of standardized treatment protocols. This unusual case underscores the importance of integrating histopathological and immunohistochemical findings for accurate diagnosis and guiding optimal patient management.</p>","PeriodicalId":55643,"journal":{"name":"Przeglad Menopauzalny","volume":"25 1","pages":"56-62"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457728","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}
引用次数: 0
Association between the triglyceride-glucose index and its correlation indices and stress urinary incontinence in American adult women: a population-based cross-sectional study. 甘油三酯-葡萄糖指数及其相关指数与美国成年女性应激性尿失禁之间的关系:一项基于人群的横断面研究
IF 2.2
Przeglad Menopauzalny Pub Date : 2026-03-01 Epub Date: 2026-05-06 DOI: 10.5114/pm.2026.161496
Yihong Pan, Li Ye, Xiuling Ren, Baojin Zeng
{"title":"Association between the triglyceride-glucose index and its correlation indices and stress urinary incontinence in American adult women: a population-based cross-sectional study.","authors":"Yihong Pan, Li Ye, Xiuling Ren, Baojin Zeng","doi":"10.5114/pm.2026.161496","DOIUrl":"10.5114/pm.2026.161496","url":null,"abstract":"<p><strong>Introduction: </strong>The relationship between the triglyceride-glucose (TyG) index - a reliable surrogate marker of insulin resistance - and stress urinary incontinence (SUI) in women remains insufficiently explored.</p><p><strong>Material and methods: </strong>We analysed cross-sectional data from 9,184 women aged 20 years and older, obtained from the National Health and Nutrition Examination Survey cycles spanning from 2001 to 2023. Stress urinary incontinence was defined based on self-reported urine leakage during physical exertion. The triglyceride-glucose index was calculated as ln[fasting triglycerides (mg/dl) × fasting glucose (mg/dl)/2], and its derivatives were computed by multiplying TyG with body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR), respectively. Multivariable logistic regression models, adjusted for sociodemographic, behavioural, and clinical covariates, were employed to assess independent associations. Dose-response relationships were examined using tertile analyses, and nonlinear associations were explored with restricted cubic splines.</p><p><strong>Results: </strong>The overall prevalence of SUI was 41.77% (n = 3,836). In fully adjusted models, all TyG-related indices demonstrated significant, dose-dependent positive associations with SUI risk. Compared to the lowest tertile (T1), the highest tertile (T3) exhibited markedly increased odds of SUI: TyG (odds ratio (OR) = 1.46, 95% CI: 1.29-1.66), TyG-BMI (OR = 2.50, 95% CI: 2.21-2.82), TyG-WC (OR = 2.29, 95% CI: 2.02-2.59), and TyG-WHtR (OR = 2.39, 95% CI: 2.10-2.71), with all <i>p</i>-values < 0.001. Nonlinear relationships were statistically significant (<i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>Elevated levels of TyG-derived indices, particularly TyG-BMI and TyG-WHtR, are independently associated with an increased prevalence of SUI among U.S. adult women.</p>","PeriodicalId":55643,"journal":{"name":"Przeglad Menopauzalny","volume":"25 1","pages":"1-9"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457722","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}
引用次数: 0
Identification of a novel missense mutation (L233Q) in the AMH gene in a polycystic ovary syndrome patient from Assam, India. 印度阿萨姆邦多囊卵巢综合征患者AMH基因新错义突变(L233Q)的鉴定
IF 2.2
Przeglad Menopauzalny Pub Date : 2026-03-01 Epub Date: 2026-05-15 DOI: 10.5114/pm.2026.161235
Adity Paul, Surya Prakash Goud Ponnam, Sumita Gogoi Hazarika, Juri Khanikar
{"title":"Identification of a novel missense mutation (L233Q) in the AMH gene in a polycystic ovary syndrome patient from Assam, India.","authors":"Adity Paul, Surya Prakash Goud Ponnam, Sumita Gogoi Hazarika, Juri Khanikar","doi":"10.5114/pm.2026.161235","DOIUrl":"10.5114/pm.2026.161235","url":null,"abstract":"<p><strong>Introduction: </strong>Polycystic ovary syndrome (PCOS) is a multifactorial, endocrinological, and reproductive condition among women of reproductive age worldwide, with a global prevalence between 6-13%. Multiple studies from different ethnicities have associated more than a dozen candidate genes with PCOS, including the anti-Mullerian hormone gene (<i>AMH</i>). To date, there have been no comprehensive reports on the molecular studies of PCOS patients from Assam, India.</p><p><strong>Material and methods: </strong>The current study is a prospective, case-control, tri-centric, hospital-based study. We recruited 100 PCOS patients, diagnosed based on Rotterdam classification, and 50 controls. Relevant clinical data was recorded and tabulated. A candidate gene screening approach was employed to identify novel and reported sequence variations in the <i>AMH</i> gene.</p><p><strong>Results: </strong>A novel pathogenic sequence variation, c.698T>A (homozygous), p.Leu233Gln substitution, was observed in a 31-year-old married female patient with no positive family history, with oligomenorrhea and multiple cysts in both ovaries. The observed sequence change variant was absent in 50 controls and was conserved across species. <i>In silico</i> tools such as SIFT, Polyphen2, Align GVGD, MutationTaster and I-Mutant2.0 had predicted the L233Q mutation to alter the structure and function of AMH protein.</p><p><strong>Conclusions: </strong>This is the first study to report L233Q pathogenic missense mutation in the <i>AMH</i> gene in PCOS patient from India. Our finding adds to the spectrum of reported mutations in the <i>AMH</i> gene and provides further evidence on the importance of AMH in the aetiopathogenesis of PCOS and also might aid in developing novel diagnostic markers.</p>","PeriodicalId":55643,"journal":{"name":"Przeglad Menopauzalny","volume":"25 1","pages":"10-18"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457769","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}
引用次数: 0
Menopause and mental health: clinical evidence and public discourse. 更年期和心理健康:临床证据和公众话语。
IF 2.2
Przeglad Menopauzalny Pub Date : 2026-03-01 Epub Date: 2026-06-05 DOI: 10.5114/pm.2026.162164
Panayoti Bachkangi
{"title":"Menopause and mental health: clinical evidence and public discourse.","authors":"Panayoti Bachkangi","doi":"10.5114/pm.2026.162164","DOIUrl":"10.5114/pm.2026.162164","url":null,"abstract":"<p><p>The global discourse surrounding menopause has undergone a seismic shift, transitioning from clinical silence to a hyper-visible cultural phenomenon. However, this \"menopausal turn\" has introduced a significant paradox: while visibility reduces stigma, it frequently replaces clinical nuance with market-driven, reductive narratives. This paper provides a comprehensive bio-psycho-social synthesis of the menopause transition, bridging the gap between emerging neurobiological evidence and contemporary public discourse. We examine the neuroendocrine basis of perimenopausal mood changes, illustrating how fluctuating ovarian steroids - specifically oestradiol and progesterone - modulate serotonergic, dopaminergic, and GABAergic systems to create a window of psychiatric vulnerability. Challenging the \"oestrogen deficiency\" monocausal model, we integrate epidemiological data from major longitudinal cohorts, such as the Study of Women's Health Across the Nation, to highlight the \"domino effect\" of vasomotor symptoms, sleep fragmentation, and pre-existing psychosocial stressors. A critical focus is placed on the diagnostic attribution bias prevalent across medical specialties. We argue that primary care and psychiatry often operate through divergent \"disciplinary lenses,\" leading to the misattribution of symptoms and fragmented care pathways. Furthermore, we critique the commercialisation of the \"wellness\" industry, which often leverages \"femvertising\" to promote non-clinical solutions that mask complex neurobiological realities. Ultimately, this paper advocates for a nuanced, interdisciplinary framework. By reconciling physiological evidence with the lived sociocultural experience, healthcare providers can move beyond superficial public narratives to deliver individualized, evidence-based care that addresses the holistic mental and physical wellbeing of women navigating this profound midlife transition.</p>","PeriodicalId":55643,"journal":{"name":"Przeglad Menopauzalny","volume":"25 1","pages":"36-44"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13371693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457779","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}
引用次数: 0
Association of C-reactive protein-triglyceride-glucose index with all-cause and cardiovascular mortality in postmenopausal women. c反应蛋白-甘油三酯-葡萄糖指数与绝经后妇女全因死亡率和心血管死亡率的关系
IF 1.7
Przeglad Menopauzalny Pub Date : 2025-12-01 Epub Date: 2026-02-04 DOI: 10.5114/pm.2025.158468
Jindong Wang, Aijin Li, Yaping Wang, Yanyun Liu
{"title":"Association of C-reactive protein-triglyceride-glucose index with all-cause and cardiovascular mortality in postmenopausal women.","authors":"Jindong Wang, Aijin Li, Yaping Wang, Yanyun Liu","doi":"10.5114/pm.2025.158468","DOIUrl":"10.5114/pm.2025.158468","url":null,"abstract":"<p><strong>Introduction: </strong>Although the C-reactive protein-triglyceride-glucose index (CTI) is associated with various adverse outcomes, its relationship with mortality in postmenopausal women remains unclear.</p><p><strong>Material and methods: </strong>We analysed data on 5,582 postmenopausal women from the National Health and Nutrition Examination Survey 2001-2010, with mortality follow-up continuing until the end of 2019. C-reactive protein-triglyceride-glucose index was calculated as 0.412 × ln [C-reactive protein (mg/l)] + ln [triglycerides (mg/dl) × fasting plasma glucose (mg/dl))/2]. The Cox proportional hazards model assessed the risk of mortality across CTI levels. We assessed potential nonlinearity with spline analyses and conducted sensitivity analyses.</p><p><strong>Results: </strong>The mean age of participants was 65.1 ±11.2 years and a mean CTI of 4.2 ±0.6 recorded at baseline. Over a median follow-up of 141 months (~ 11.8 years), 1,846 (33.1%) deaths occurred, including 582 (10.4%) cardiovascular disease (CVD) deaths. An association was observed between increasing CTI values and greater mortality risk in this population. Non-linear analysis identified a CTI threshold at 4.16. Below this value, no significant association with all-cause mortality was found (hazard ratio - HR 0.87, 95% CI: 0.74-1.03); above it, each 1-unit CTI increase raised all-cause mortality risk by 68% (HR 1.68, 95% CI: 1.47-1.92; <i>p</i> < 0.01). Tertile comparisons showed that the highest group/tertile group had significantly increased risks for all-cause (adjusted HR 1.34, 95% CI: 1.19-1.51) and cardiovascular mortality (HR 1.43, 95% CI: 1.16-1.76) compared to the middle tertile. A similar trend was observed for CVD mortality. These associations remained consistent in sensitivity analyses.</p><p><strong>Conclusions: </strong>Elevated CTI remains independently associated with an increased risk of both all-cause and CVD mortality in postmenopausal women.</p>","PeriodicalId":55643,"journal":{"name":"Przeglad Menopauzalny","volume":"24 4","pages":"259-267"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12895548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203893","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}
引用次数: 0
Regenerative capacity of mesenchymal stem cells in the management of Asherman syndrome - a systematic review and meta-analysis of clinical outcomes. 间充质干细胞的再生能力在阿什曼综合征的管理-临床结果的系统回顾和荟萃分析。
IF 1.7
Przeglad Menopauzalny Pub Date : 2025-12-01 Epub Date: 2025-12-19 DOI: 10.5114/pm.2025.157933
Sangam Jha, Vikas Chandra Jha, Pratap Patra, Sharda Jha, Shalini Singh
{"title":"Regenerative capacity of mesenchymal stem cells in the management of Asherman syndrome - a systematic review and meta-analysis of clinical outcomes.","authors":"Sangam Jha, Vikas Chandra Jha, Pratap Patra, Sharda Jha, Shalini Singh","doi":"10.5114/pm.2025.157933","DOIUrl":"10.5114/pm.2025.157933","url":null,"abstract":"<p><strong>Introduction: </strong>Asherman Syndrome is a refractory gynecological disorder resulting from injury to the endometrium due to various causes. The treatment of choice is hysteroscopic adhesiolysis; however, recurrence rates remain high. Stem cell therapy has emerged as a promising approach for regenerating damaged endometrium in refractory cases. So, this study aims to assess the efficacy of mesenchymal stem cell therapy in refractory Asherman syndrome unresponsive to conventional treatment.</p><p><strong>Material and methods: </strong>The study involved the literature searched in PubMed, Embase and Google Scholar databases from inception to June 2024. We included pre- and postintervention studies. We excluded case reports, conference abstracts, articles without full texts and studies with animal trials. Women with primary or secondary infertility of the reproductive age group (aged 20-50 years) with AS (Grade I-IV) not responding to standard treatment (hysteroscopic adhesiolysis and hormonal therapy) were included. Primary outcome included pregnancy outcome and change in the endometrial thickness whereas secondary outcome included improvement in menstrual pattern.</p><p><strong>Results: </strong>We identified 382 studies from our constructive search strategy. Finally, 12 studies with 137 women met the inclusion criteria. Stem cell therapy has been associated with an increase in endometrial thickness; the standardised mean difference was 2.09 (95% CI: 1.4-2.7). It has also been shown to improve pregnancy rate with risk ratio (RR) of 9.35 (95% CI: 4.2-24.9) and live birth rate (RR - 5.870, 95% CI: 2.071-16.633). All the patients reported improvement in menstrual function.</p><p><strong>Conclusions: </strong>Stem cell therapy is safe and effective in improving endometrial thickness, menstrual function and pregnancy rate in women with refractory AS. However, given the limitations of our study, further studies with a large sample size are needed to validate the findings.</p>","PeriodicalId":55643,"journal":{"name":"Przeglad Menopauzalny","volume":"24 4","pages":"282-292"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12895546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203915","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}
引用次数: 0
Adenosarcoma of the uterine cervix - a novel case report and review of the literature. 子宫颈腺肉瘤一例新病例报告及文献复习。
IF 1.7
Przeglad Menopauzalny Pub Date : 2025-12-01 Epub Date: 2025-12-20 DOI: 10.5114/pm.2025.158058
Oliwia Maciejewska, Milosz Wilczynski, Hanna Romanowicz, Andrzej Malinowski
{"title":"Adenosarcoma of the uterine cervix - a novel case report and review of the literature.","authors":"Oliwia Maciejewska, Milosz Wilczynski, Hanna Romanowicz, Andrzej Malinowski","doi":"10.5114/pm.2025.158058","DOIUrl":"10.5114/pm.2025.158058","url":null,"abstract":"<p><p>Adenosarcomas constitute approximately 1% of all malignancies affecting the female reproductive system. Their most common locations are the uterine corpus and ovaries. Cervical adenosarcomas are rare and poorly described in the literature. Therefore, there are still no treatment guidelines for such cases, and the proper scope of the surgical procedure has become questionable. The most popular options include total abdominal hysterectomy and/or bilateral salpingo-oophorectomy (BSO). Generally, the prognosis is relatively good, among other things, because it is detected in the earlier International Federation of Gynaecology and Obstetrics stage than other locations, with a 5-year overall survival rate of 63-84%. Here, the present paper describes the case of a 44-year-old female with adenosarcoma located in the cervix. The patient experienced abnormal vaginal bleeding occurring 7-10 days before proper menstruation and pelvic pain. Interestingly, despite a normal routine Pap smear test, the cervical mass was revealed in transvaginal ultrasonography. A subsequent biopsy of the lesion confirmed the presence of low-grade adenosarcoma. A radical hysterectomy (RH) with BSO and pelvic lymph node sampling was performed. The patient reports resolution of all symptoms. Our case study highlights the effectiveness of RH as the mainstay treatment for cervical adenosarcomas. Furthermore, we discuss these tumours' pathology and imaging features, as well as other therapeutic options. The present study has an exceptional value for practicing gynaecologists and oncologists.</p>","PeriodicalId":55643,"journal":{"name":"Przeglad Menopauzalny","volume":"24 4","pages":"299-304"},"PeriodicalIF":1.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12895551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146203799","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}
引用次数: 0
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