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Introduction: Endometrium cancer is the most common gynecological malignancy in developed countries. In this study, we aimed to investigate the effect of HER2 positivity on prognosis in endometrial cancer. Methods: In our study, patients admitted to our clinic with a diagnosis of endometrial cancer between September 2019 and December 2023 were retrospectively evaluated. Human epidermal growth factor receptor 2 (HER2) immunohistochemistry was performed in 121 patients. HER2-low group (HER2 score: 0 and 1) and HER2-high group (HER2 score: 2 and 3) were defined according to the HER2 immunohistochemistry score in the pathology, and patients were compared accordingly. Results: We observed that 97 (80.2%) of the patients were in the HER2-low group, while 24 (19.8%) were in the HER2-high group. In the OS analysis, age (p = 0.381), menopausal status (p = 0.511), ECOG performance status (p = 0.087), histological type of tumor (p = 0.727), pathological grade (p = 0.206), serum LDH (p = 0.091), and albumin (p = 0.315) levels did not affect the prognosis. Patients with lower FIGO stage (p = 0.003) and HER2-high patients (p = 0.040) had better survival outcomes. Multivariable analysis showed that FIGO stage (p = 0.004) and HER2 status (p = 0.040) were independent risk factors affecting survival in endometrial cancer. Conclusion: As a result of our study, it was observed that FIGO stage and HER2 status were independent risk factors affecting OS in endometrial cancer patients. HER2-high group had a better prognosis than HER2-low group. [ABSTRACT FROM AUTHOR]

Aim: In this study, we aimed to detect the MSI status and somatic mutations in MMR genes (MSH2, MSH6, MLH1, PMS2) of a total of 55 solid tumors diagnosed with colorectal, endometrium and ovarian cancer by NGS method and to reveal the relationship between them. Material and Method: DNA isolation was performed by taking 10-micron sections from paraffinembedded tissue samples of 55 patients diagnosed with kolorektal, endometrium ve ovarian solid tümörlerinin and Kapa NGS DNA extraction kit was used for sequence analysis. The purity and concentration of the DNA obtained was measured by Qubit fluoremeter, and NadPrep DNA Universal Library Preparation Kit was used for high quality library preparation. Bioinformatics analyses were performed on the Genomize Seq platform. The MSI value was analysed by Roche Navify Mutation Caller software and percentage MSI values were determined using the MSIsensor2 pipeline for secondary analysis of NGS. Results: All ovarian tumors were in the MSI-Stable category. The average MSI value was 2.01. One sample had an MSI of zero. In addition, no mutations in the MSH2 and MLH1 genes were detected in any of the ovarian tumors. 3 of 4 endometrial tumors were in the MSI-Stable category, and 1 tumor was in the MSI-low (MSI value: 13.2) category. No variants were detected in the MSH2 and PMS2 genes in endometrial tumors. 2 of the 41 colorectal tumors (Case4, Case16) were in the MSIHigh category. No variants were detected in the MMR genes in 19 tumors. Conclusion: Although frame-shift and stop-gain mutations were detected in 23 tumors that would cause protein deficiency in MMR genes, MSI-H was not detected, as expected, except for two colorectal tumors. Therefore, the results of our study emphasise the need to define new predictive biomarkers clinically within the framework of algorithms to predict response to immunotherapy and determine prognosis. [ABSTRACT FROM AUTHOR]

Aims: Sentinel lymph node dissection is performed in endometrial cancer surgery instead of staging surgery, particularly when the disease is advanced and confined to the uterus. The aim of this study is to share our sentinel lymph node detection rates via the vaginal natural orifice transluminal endoscopic surgery method with the literature and to demonstrate a safer and more comfortable surgical treatment process. Methods: The analysis includes the patients who underwent surgery sentinel lymph node dissection for endometrial cancer utilizing indociyanin green in our center between January 2022 and June 2024. Results: In all, of 24 endometrial cancer patients underwent surgery sentinel lymph node dissection, nonendometrioid (serous) pathology was observed in only 1 (4%) patient, our other patients (96%) had endometrioid adenocarcinoma pathology. The rates of our sentinel lymph node dissection bilateral and symmetric are 96% (23/24), 94% (22/24), and 79% (19/24), respectively. We would like to emphasize that we successfully used vaginal natural orifice transluminal endoscopic surgery approach on four of our patients who were unsuitable for laparoscopic and robotic surgery due to pain scores of 2 at the 12th hour after surgery and low lung capacity. Conclusions: Vaginal natural orifice transluminal endoscopic surgery and sentinel lymph node dissection will be considered as surgical options in other gynecological cancers due to the comfort it brings to the patient in endometrial cancer. [ABSTRACT FROM AUTHOR]

Copyright of Türk Radyoloji Seminerleri is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: In this experiment, we intend to investigate the relationship between ER-a36 expression and endometrial cancer. Materials and Method: A total of 172 healthy control and endometriosis patients were selected from our hospital. These included 43 cases of normal endometrium (NE group), 43 cases of endometrium without atypical hyperplasia (EH group), 43 cases of atypical hyperplasia (AH group) and 43 cases of endometrial cancer (EC group). The expression of ER-a36 in these tissues was detected by immunohistochemical methods. Results: The positive rate of estrogen receptor (ER-a36) in each group was 4.24%±5.02%, 5.74%±6.34%, 9.69%±9.42%, and 11.78%±10.39%, respectively. The expression of ER-a36 demonstrated a notably higher level in the AH and EC groups compared to the EH and NE groups. A statistically significant difference was observed between the NE group and the AH group (P=0.0112). The NE group was statistically different from the EC group (P=0.0001). There was a statistical difference between the EH group and the EC group (P=0.0040). Among endometrial cancers, the mean positive rate of ER-a36 expression was 11.67%±6.74% in highly differentiated endometrial cancers, 9.45%±11.38% in moderately differentiated, and 14.82%±11.35% in poorly differentiated. Comparison between the two groups showed that there was no statistically significant difference in the expression positivity rate of ER-a36 in endometrial cancer of different degrees of differentiation (P>0.05). Conclusion: ER-a36 has a certain diagnostic efficacy for endometrial cancer and can be used as an auxiliary judgment tool for pathological examination. [ABSTRACT FROM AUTHOR]

Purpose: To compare the dosimetric performance of vaginal intensity-modulated brachytherapy (IM-BRT) applicator and single-(SC-BRT) and multi-channel brachytherapy (MC-BRT) applicators for vaginal cuff brachytherapy (VC-BRT). Material and methods: Fifteen patients with uterine-confined endometrium cancer who received adjuvant VC-BRT were included in this study. IM-BRT, SC-BRT, and MC-BRT treatment plans were created for two different clinical target volume (CTV) definitions: 1. Standard CTV, called CTVs; and 2. Virtually defined CTV, called CTVv, with asymmetrical tumor extension > 5 mm in thickness. Plan comparison was performed using dose-volume histogram (DVH) and treatment planning parameters. Results: According to DVH analysis, D98 for CTVv and D2 for both CTVs and CTVv showed statistically significant differences between IM-BRT and SC-BRT plans, but there was no significant difference between IM-BRT and MC-BRT plans in terms of D98 and D2 for both CTVs and CTVv. Additionally, for CTVv plans, IM-BRT was found to be significantly superior to SC-BRT for the rectum (D2cc, V5Gy, and V7Gy), bladder (D2cc and V7Gy), and small bowel (D2cc, V5Gy, and V7Gy). On the other hand, DVH parameters of the sigmoid showed large difference between IM-BRT and SC-BRT plans, but it was not statistically significant. Similarly, the use of IM-BRT applicator demonstrated a noticeable dose reduction in all defined OARs when compared with MC-BRT applicator, but statistically significant for the rectum V7Gy (p = 0.03) only. Conclusions: While the IM-BRT applicator is still in pre-clinical phase, our investigation demonstrated the proofof-concept in real patient treatment plans with promising dosimetric results compared with SC-BRT and MC-BRT plans in selected patient group. [ABSTRACT FROM AUTHOR]

Endometrial cancer, which is the most common gynaecological cancer in women after breast, colorectal and lung cancer, can be diagnosed at an early stage. The first aim of this study is to classify age, tumor grade, myometrial invasion and tumor size, which play an important role in the diagnosis and prognosis of endometrial cancer, with machine learning methods combined with explainable artificial intelligence. 20 endometrial cancer patients proteomic data obtained from tumor biopsies taken from different regions of EC tissue were used. The data obtained were then classified according to age, tumor size, tumor grade and myometrial invasion. Then, by using three different machine learning methods, explainable artificial intelligence was applied to the model that best classifies these groups and possible protein biomarkers that can be used in endometrial prognosis were evaluated. The optimal model for age classification was XGBoost with AUC (98.8%), for tumor grade classification was XGBoost with AUC (98.6%), for myometrial invasion classification was LightGBM with AUC (95.1%), and finally for tumor size classification was XGBoost with AUC (94.8%). By combining the optimal models and the SHAP approach, possible protein biomarkers and their expressions were obtained for classification. Finally, EWRS1 protein was found to be common in three groups (age, myometrial invasion, tumor size). This article’s findings indicate that models have been developed that can accurately classify factors including age, tumor grade, and myometrial invasion all of which are critical for determining the prognosis of endometrial cancer as well as potential protein biomarkers associated with these factors. Furthermore, we were able to provide an analysis of how the quantities of the proteins suggested as biomarkers varied throughout the classes by combining the SHAP values with these ideal models.

OBJECTIVE: Endometrium cancer (EC) is the most prevalent cancer affecting women in developed countries. There is debate about the need to perform lymphadenectomy in cases with a tumor diameter >2 cm. The aim of our study is to research the prediction of lymph node metastasis using tumor size in stage 1A endometrioid endometrium cancer (EEC). PATIENTS AND METHODS: The study enrolled cases operated in the clinic due to stage 1A EEC (FIGO 2009) from December 2010-2021. The correlations of age, age interval, parity, type of operation, tumor diameter, myometrial invasion, histological grade, and lymph node metastasis were statistically analyzed. The cut-off point for tumor size was determined with the ROC curve and Youden index. RESULTS: The study analyzed a total of 292 cases, and the mean age of cases was 62.3±10.0 years. Of the cases, 79.5% had histological grade 1, and 20.5% had grade 2. Myometrial invasion =50% was detected in 69.5%, and no myometrial invasion was detected in 30.5%. The mean tumor diameter was 34.0±18.0. Lymph node metastasis was identified in 6 cases (2.1%). Based on the tumor diameter cut-off value of 35 mm, sensitivity was 100%, and specificity was 50.3%. 116 cases with tumor diameter >35 mm and 176 with diameter =35 mm, and grade 2 histology and lymph node positivity were found statistically significant between these groups (respectively, p=0.012 and p=0.038). The lymph node metastasis risk was 0% in cases with tumor diameter =35 mm, while it was 5.2% in cases with tumor diameter >35 mm. CONCLUSIONS: The general approach in stage 1A EEC is not to perform lymphadenectomy. However, when the tumor diameter is noted, lymphadenectomy may be considered as the lymph node metastasis risk increases in cases with a tumor diameter of 35 mm or more. There is a need for more clinical studies on this topic. [ABSTRACT FROM AUTHOR]

To dosimetrically compare applicator-guided intensity-modulated proton therapy (IMPT) and multichannel brachytherapy (MC-BRT) for vaginal vault irradiation (VVI) with special focus on dose to organs at risk (OARs) and normal tissues. Ten patients with uterine confined endometrial cancer who received adjuvant vaginal cuff brachytherapy were included in this study. For each patient an additional IMPT treatment plan was created using the same computed tomography dataset and contours segmented for MC-BRT plans. Clinical target volume (CTV) was defined as the proximal 3.5 cm of the vagina including the entire thickness of vaginal wall. Planning target volume for IMPT plans was generated from the CTV with an addition isotropic 3 mm margin. OARs included rectum, bladder, sigmoid, small bowel and femoral heads. The prescribed dose was 21 Gy in 3 fractions. For simplicity, all doses were expressed in Gy and a constant relative biological effectiveness of 1.1 was used for IMPT plans. Plan comparison was performed using dose-volume histogram and treatment planning parameters. A significant improvement of the D98% coverage for CTV was reached by the applicator-guided IMPT plans (p < 0.01). IMPT also provided a dose reduction in all OARs except for femoral heads due to the lateral beam direction, especially significant reduction of V5Gy, D2cc, D0.1 cc, Dmean, V95% values for the rectum and Dmean, D0.1 cc to bladder, sigmoid, small bowel. Additionally, IMPT plans showed a significant reduction of integral dose to normal tissue with respect to MC-BRT (221.5 cGy.L vs. 653.6 cGy.L, p < 0.01). Applicator-guided IMPT has the potential for improving plan quality in VVI while maintaining the high conformity afforded by the state-of-the-art intracavitary brachytherapy. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Academic Research in Nursing (JAREN) is the property of Hemsirelikte Egitim ve Arastirma Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background Circulating tumor cells represent an opportunity for the assessment of early recurrent disease or for real-time tracing of cancer. Glucose Regulated Protein 78 (GRP78) is known in the literature as a stress factor in endometrial cancer. We aimed to investigate the importance of the gene by targeting tumor traces circulating in the cell fluids of patients with Type 1 endometrial cancer, examining cell-free RNAs in patients’ samples and performing ROC analysis. Methodology In this study, 32 endometrial cancer patients and 20 controls were included. This in vitro study evaluated, the GRP78 cell-free mRNA expression levels in endometrial cancer patients, by quantitative real-time polymerase chain reaction qRT–PCR Light Cycler. Receiver operating characteristic (ROC) analysis is a tool used to identify the precision of a diagnostic test or prediction model. In our study, we investigated whether the expression levels of cell-free GRP78 mRNA could be used as a diagnostic criterion. Results The ROC curve results for endometrial cancer diagnostic criterion of cfRNA GRP78 mRNA indicated quite a significant value (p

OBJECTIVE: Sentinel lymph node biopsy refers to an innovative and minimalist surgical approach that has been introduced to reduce both complications and morbidity. A definitive answer to the question of whether lymphadenectomy is performed for staging or curative purposes in endometrial cancer has not yet been found. The aim of this study is to compare patients who underwent sentinel lymph node biopsy with indocyanine green and those who underwent laparoscopic complete surgical staging in terms of survival. PATIENTS AND METHODS: A total of 182 patients was included in the study. The patients were divided into two groups according to the lymph node sample type. The two groups were compared in terms of oncological outcomes. RESULTS: 92 patients underwent sentinel lymph node mapping (SLNM cohort) and 90 patients underwent extensive pelvic and paraaortic lymphadenectomy (SCL cohort). Considering only patients with negative lymph nodes, the Sentinel cohort was associated with a reduced DFS and OS (p=0.008 and p=0.005, respectively). This difference may be due to the longer follow-up times of patients with comprehensive lymph node sampling. On the other hand, There was no difference in survival in lymph node positive cases. CONCLUSIONS: Sentinel lymph node dissection has no negative effect on survival in lymph node positive patients. [ABSTRACT FROM AUTHOR]

Copyright of Ege Journal of Medicine is the property of Ege University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: We aimed to determine the possible clinicopathological factors that might affect recurrence and survival in synchronous malignancy of the endometrium and ovary without discriminating the presence of two independent primary tumors or metastasis. Methods: Patients who were admitted with the diagnosis of synchronous endometrial and ovarian cancer between 2000 and 2015 were reviewed retrospectively. Results: Recurrence occurred in 12 (48%) patients. The mean duration of recurrence was 23.7 months. There is a significant relationship between presence of lenfovascular invasion), involvement of lymph node, spread to non-ovarian, and non-endometrial pelvic organs or beyond and the increase recurrence risk in the synchronous endometrial and ovarian cancer. The conditions involving the increased diameter of tumor in the endometrium and bilateral ovarian involvement are related with decreased survival. Besides, presence of endometrioid type ovarian tumor and absence of endometrial myometrial invasion are related with increased survival. Discussion and Conclusion: Variables such as endometrial tumor diameter, myometrial invasion, endo/non endo type of ovarian tumor and presence of bilateral tumor were found to be effective on survival, variables such as lymphovascular invasion, lymph node involvement, and pelvic spread were effective on recurrence. [ABSTRACT FROM AUTHOR]

In this study, we investigated whether infusion of colorectal cancer cell line and PMSG could increase endometrial cancer. As a result, our study confirmed that the injection of colorectal cancer can cause inflammation and cancer in the uterus and increase the VEGF gene in the uterus. The study also found that endometrial cancer was associated with PMSG.

OBJECTIVE: This study was conducted to evaluate the relationship of p53 and Ki67 expression with prognostic factors in patients who underwent surgery due to a diagnosis of endometrial cancer, and to evaluate their use as molecular markers that can help with survival prediction. STUDY DESIGN: This retrospective cohort study included patients who underwent surgery for endometrial cancer indication at the Gynecologic Oncology Clinic of the University of Health Sciences Tepecik Training and Research Hospital between 2011 and 2019, and whose p53 and Ki67 from the dissected material were pathologically studied and who underwent pelvic/paraaortic lymph dissection between the relevant dates. RESULTS: The study included 140 patients who met the inclusion criteria, 60% (n=84) of whom had endometrioid type endometrial carcinoma and 40% (n=56) had non-endometrioid type endometrial carcinoma. Estrogen and progesterone receptor positivity was significantly higher in the endometrioid type endometrial carcinoma group (p<0.001 and p<0.001, respectively). The non-endometrioid type endometrial carcinoma group had a high degree of positive staining (+3 and +4 staining) with p53 was 51.8%, while this rate was 11.9% in the endometrioid type endometrial carcinoma group. The non-endometrioid group also had a high degree of positive staining of Ki67 at 51.8%, whereas the endometrioid group had 25%. The total staining rate with p53 and Ki67 was significantly higher in the non-endometrioid type group (p<0.001 and p=0.001, respectively). The mean survival duration was less than six months in cases with high degree positive p53 [57.4±2.7, (52.1-62.8) vs 51.9±5.9, (41.8-61.9)] and the mean survival duration was less than eight months in cases with high degree positive Ki67 [59.6±2.9, (53.8-65.4) vs 51.6±4.3, (43.2-60.1)]. CONCLUSION: p53 and Ki67 can be new markers for the prediction of prognosis and duration in endometrial cancer. The results of this study pave the way for new studies: however, randomized controlled prospective and multi-center studies are needed for immunohistochemical measures to be used as a parameter. [ABSTRACT FROM AUTHOR]

kanser hastalarının klinikopatolojik özelliklerini ve tedavi sonuçlarını değerlendirilmesi amaçlanmıştır.Gereç ve Yöntem: Bu çalışma hastane bazlı retrospektif gözlemsel bir vaka serileri çalışmasıdır. 2009-2015 yılları arasında Başkent Üniversitesi Tıbbi Onkoloji ve Jinekolojik Onkoloji Anabilim Dallarına başvuran 116 hasta dahil edildi. De-novo metastatik hastalar çalışmaya dahil edilmedi.Bulgular: Hastaların medyan yaşı 58 (dağılım 27-81) idi. Hastaların hepsinin ECOG performans puanı 0 (n: 116) idi. Endometrioid histoloji en sık görülen histopatolojik alt tipti (n: 103,% 88). Tüm hastalar lokal ve lokal ileri evrede idi. Hastaların önemli oranda bir kısmının grade 2 tümörü vardı (n: 55,% 47.4). Myometrial invazyon 78 hastada (% 67.2)% 50'den azdı. Ortanca takip süresi 61 ay idi ve 8 (% 6.9) hasta öldü. Tüm hastalara standart lenfadenektomi ile standart cerrahi evreleme yapıldı. Median genel sağkalım süresine (OS) ulaşılamadı. Sırasıyla 14 hasta (% 12.1) ve 34 hasta (% 29.3) adjuvan kemoterapi ve radyoterapi ile tedavi edildi.Sonuç: Endometrial kanser kadınlarda en sık görülen jinekolojik tümörler olmasına rağmen, tedavi oranı çok yüksektir. Nüks oranı % 6 (7 hasta) idi ve nüksün çoğu lokal,% 71.4 (5 hasta) idi.

ObjectiveTo investigate the correlation between sonographic, hysteroscopic, and pathological findings in postmenopausal asymptomatic patients with sonographically thickened endometrium.MethodsThe records of postmenopausal patients who attended the Menopause Outpatient Clinic of a tertiary women's hospital in Ankara, Turkey between January 1, 2012 and December 15, 2013 were retrieved. A total of 266 postmenopausal women without vaginal bleeding underwent hysteroscopic evaluation and endometrial sampling. Patients whose pathological records indicated an endometrial thickness equal to or greater than 6 mm (double layer) on transvaginal ultrasonography without any symptoms were included in the study.ResultsThe most frequently detected focal intrauterine lesions in asymptomatic women were endometrial polyps, which were diagnosed in 168 (63.1%) cases. Twenty-four (9%) patients were diagnosed as having simple hyperplasia, 4 (1%) atypical hyperplasia, and 8 (3%) endometrial adenocarcinoma. Two of the patients with adenocarcinoma were diagnosed based on endometrial polyps, and 6 cases showed endometrial hyperplasia on hysteroscopy, while histological examination showed endometrial carcinoma.ConclusionWe suggest 10.5 mm as the cutoff value for endometrial thickness and recommend hysteroscopy following dilatation and curettage to increase diagnostic efficacy and provide definitive treatment in asymptomatic postmenopausal women with thickened endometrium.

Cancer of the reproductive tract includes diseases with higher prevalence in the female population. This investigation examined whether an anthocyanin-enriched extract of Aristotelia chilensis, commonly known as "maqui," could affect some hallmarks of endometrial cancer. Cultures of the human endometrial cancer cell line Ishikawa were treated with a hydroethanolic maqui extract at 1, 3, 10, 30, 100, 300, or 1000 µg/mL to determine the effect on cell viability by MTT assay. Then, we used the 50% Effective Concentration (EC50) to evaluate whether the effect of the maqui extract is mediated via an arrest of the cell cycle or induction of apoptosis using flow cytometry or Annexin V -FITC assays, respectively. The effects of sublethal doses of the maqui extract on migration and invasiveness of Ishikawa cells were also evaluated by the wound healing and Boyden Chamber assay, respectively. Our results show that the hydroethanolic maqui extract inhibits the cell viability with an EC50 of 472.3 µg/mL via increased apoptosis, and that reduces the invasive capacity but not migration of Ishikawa cells. These findings suggest that the hydroethanolic maqui extract has antineoplastic properties for endometrial cancer and merits further studies to corroborate its efficiency as anticancer therapy in reproductive organs. [ABSTRACT FROM AUTHOR]

Introduction: Endometrial carcinoma is the most common gynaecological malignancy in developed countries and the sixth most common cancer among women worldwide. Cancer staging is vital in treatment decisions and the prediction of prognoses, and is based on imaging studies, histological results and surgery. Therefore, a simple and fast preoperative tool to predict the precise cancer stage of patients is needed. CA 125, a cancer antigen, is used in assessing therapeutic response and cancer surveillance in endometrial carcinoma. However, this tumour marker is not routinely performed in the mentioned circumstances. Studies have shown that preoperative CA 125 was significantly high in patients in a higher stage of endometrial cancer. Thus, this study aims to assess the primary role of CA 125 in predicting the stage of endometrial carcinoma, by correlating preoperative serum CA 125 with clinicopathological parameters. Method: The retrospective data of endometrial carcinoma cases consisting of demographic and clinicopathological parameters as well as preoperative serum CA 125 levels were retrieved from Laboratories Information System (LIS) at Hospital Selayang, Selangor, Malaysia, from January 2000 until June 2016. Only 20 cases fulfilled the inclusion and exclusion criteria. Preoperative serum CA 125 was correlated with demographic and clinicopathological parameters, and was analysed using a Kruskal-Wallis test. Results: There was a significant association between elevated serum CA 125 with myometrial and cervical stroma invasion in endometrial carcinoma (p<0.05). Conclusion: Preoperative serum CA 125 is a useful marker in predicting early stages of endometrial carcinoma, and plays a role in pre-operative cancer staging in endometrial carcinoma. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the relationship between KRAS LCS6 mutation and endometrial cancer (EC). The study included 105 patients who had hysterectomy for benign reasons and 99 EC patients. The patients with Type 1 EC were classified according to histological properties, cancer stage, grade, tumour dimension, myometrial invasion (MMI), lymphovascular invasion (LVI), cytology, and number of positive lymph nodes. KRAS LCS6 mutation was examined in blood samples taken from all patients in both groups. No statistically significant difference was determined between the EC patients and the control group in demographic features. Weight and the Body Mass Index (BMI) values were higher in EC group (p < .001). While the incidence of this polymorphism is 5.8% throughout the world, the polymorphism rate was found to be 16.2% in the EC group and 12.4% in the control group, with no statistically significant difference determined (p > .05). Despite the higher rate of LCS6 polymorphism incidence in EC patients in this study conducted on a relatively large sample, there was not found to be a statistically significant difference in comparison with the control group. In addition, the presence of LCS6 polymorphism was not determined to have an effect on EC histopathological characteristics.Impact statementWhat is already known on this subject? Endometrial cancer (EC) is a genital system cancer which is one of the most widespread gynecological cancers seen in the USA and other developed countries, In EC, the most frequently seen gene mutations are PTEN tumour suppressor gene, KRAS, β1 catenin, BCL-2, CTNNB and P53 mutations. KRAS LCS6(let-7 miRNA binding region polymorphism) polymorphism has a worldwide incidence of 5.8% (Chin et al. 2008).There are studies shown that KRAS LCS6 polymorphism has an effect on developing EC (Lee et al. 2014), ovarian cancer(Ratner et al. 2010)and endometriosis in women (Grechukhina et al. 2012).What do the results of this study add? In our study, LCS6 located on KRAS 3'-UTR was found at the rate of 16.2% in Type 1 EC patients. This increase is noticeable when it is considered that the incidence of this polymorphism is 5.8% in the general population. The results of the current study supports the preliminary findings of Lee et al.What are the implications of these findings for clinical practice and/or further research? These new genetic markers could help to develop gene-targeted therapies, identify genetic basis of the disease and the factors that could affect the EC prognosis. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was o compare the diagnostic value of sonohysterobiopsy to a method involving saline infusion sonography followed by dilatation and curettage in detecting endometrial pathologies in postmenopausal asymptomatic women with an endometrial thickness greater than 5 mm. Materials and Methods: Asymptomatic postmenopausal women who were diagnosed by means of transvaginal ultrasonography with endometrial thickness greater than 5 mm were assigned to two diagnostic groups prior to hysteroscopy. The study group included patients who underwent sonohysterobiopsy (SHB) during saline infusion sonohysterography (SIS). The control group included patients who underwent SIS followed by dilatation and curettage (D&C). Results: In 35 patients (35%), at least one of the risk factors for endometrial malignancy was present. The histopathological evaluation of the specimens showed presence of a polyp in 40 (60%) patients who underwent SIS and D&C. SHB results were more concordant with the hysteroscopic findings compared to those of SIS and D&C. The cut-off value for the accurate diagnosis of an endometrial polyp with SHB was 10 mm, with a sensitivity of 96% and a specificity of 100%. Conclusion: Sonohysterobiopsy is an efficient and safe procedure with a high sensitivity and specificity for the diagnosis of endometrial pathologies. [ABSTRACT FROM AUTHOR]

Aim: Endometriosis and endometrial cancer are described as typical estrogen-dependent gynaecological diseases. The question arises if estrogens, working through their receptors, could influence the immunological activity of lymphocytes in these disorders. Here, we evaluated transcriptional expression of the estrogen receptors alpha and beta (ERα and ERβ) in T lymphocytes isolated from the peripheral blood in endometrial cancer and endometriosis patients. Methods: Peripheral blood was collected from ten patients with endometrial cancer, nine with endometriosis, and ten disease-free controls. After isolation of the T lymphocytes, purity was confirmed by flow cytometry and the relative level of ERα and ERβ mRNA was determined using RT-qPCR analysis. Results: Both ERα and ERβ were significantly decreased in T lymphocytes isolated from patients with either endometrial cancer or endometriosis when compared to the healthy controls. We measured no difference in the mRNA levels of ERα between endometrial cancer patients and endometriosis group, but ERβ expression in endometrial cancer women was twice as high than in the endometriosis group. Conclusion: Decreased transcription of nuclear estrogen receptor isoforms characterizes T lymphocytes from women with endometrial cancer and endometriosis. [ABSTRACT FROM AUTHOR]

We performed this dosimetric study to compare a nonstandard volumetric modulated arc therapy (VMAT) and helical tomotherapy (HT) techniques with high-dose rate (HDR) brachytherapy (BRT) plan of vaginal vault in patients with postoperative endometrial cancer (EC). Twelve postoperative patients with early stage EC were included in this study. Three plans were performed for each patient; dosimetric and radiobiological comparisons were made using dose-volume histograms and equivalent dose for determining the planning target volume (PTV) coverages in brachytherapy and external beam radiotherapy, and organs-at-risk (OARs) doses between three different delivery techniques. All the plans achieved adequate dose coverage for PTV; however, the VMAT plan yielded better dose conformity, and the HT plan showed better homogeneity for target volume. With respect to the OARs, the bladder D 2cc was significantly lower in the BRT plan than in the VMAT and HT plans, with the highest bladder D 2cc value being observed in the HT plan. However, no difference was observed in the rectum D 2cc of the three plans. Other major advantages of the BRT plan over the VMAT and HT plans were the relatively lower body integral doses and femoral head doses as well as the fact that the integral doses were significantly lower in the BRT plan than in the VMAT and HT plans. This is the first dosimetric comparison of vaginal vault treatment for EC with BRT, VMAT, and HT plans. Our analyses showed the feasibility of stereotactic body radiotherapy technique as an alternative to HDR-BRT for postoperative management of EC patients. [ABSTRACT FROM AUTHOR]

Copyright of Cukurova Medical Journal / Çukurova Üniversitesi Tip Fakültesi Dergisi is the property of Cukurova University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: The aim of this study was to compare the survival durations of patients with uterine carcinosarcoma with the survival of patients with serous endometrial cancer. Method: Patients who were operated for endometrial cancer between 2002 and 2014 were screened from clinic archive. Patients with histological tumor type carcinosarcoma or serous type were included in the study. Results: Total number of patients was 99; 53 of them had carcinosarcoma and 46 had serous histology. Median disease-free survival was 20 (2-27) months in carcinosarcoma and 36 (3-180) months in serous type (Log-Rank test p=0.156). Median overall survival duration was 28 (4-170) months for carcinosarcoma and 46 (3-180) months for serous (p=0.105). The 5-year overall survival rate was 41.2% in carcinosarcoma histology and 55.4% in serous histology. After recurrence, patients with carcinosarcoma histology survived for an average of 8 (1-19) months, while those with serous histology survived for an average of 14 (2-43) months (p=0.090). Conclusion: According to the results of Log-Rank test analysis, no statistically significant survival difference between the patients with uterin carcinosarcoma and with serous endometrial cancer was found. However, disease-free survival, overall survival, and survival duration after recurrence are longer in serous histology than in carcinosarcoma. [ABSTRACT FROM AUTHOR]

The high morbidity, often latent, asymptomatic disease development is not optimal therapy in the first line, causes the development of the frequent recurrence of tumors, requiring second and thirds lines of chemotherapy. The use of topotecan in standard mode is limited by myelosuppression, therefore the new regimes are studied. To reduce the hematologic toxicity is recommended weekly injection of 4 mg/m2 in 1, 8, 15 days of a 28-day cycle of therapy, as its effectiveness is comparable to the effectiveness of the standard 5-day regime. We determined the toxicity and efficacy of combined weekly topotecan and bevacizumab in patients with secondary platinumresistant ovarian, peritoneal, fallopian tube, endometrium and cervix cancer. Patients were treated topotecan 3,5–4 mg/m2 and bevacizumab 7 mg/kg on days 1, 8, and 15 of a 28-day cycle until progressive disease or excessive toxicity. The primary end point was efficacy and toxicity.Combination on weekly topotecan and bevacizumab showed acceptable toxicity and encouraging efficacy in patients with platinum-resistant tumors.

Aim: Endometrium cancer is the most commonly seen gynecologic cancer. As in all the cancer processes, chronic inflammation plays an etiological role. Material and Method: The study included a total of 105 patients. Three groups each consisting 35 patients are formed. Based on the results of endometrial sampling, the patients are groped as benign, hyperplasia and malignant. Differences of hematologic parameters between the groups were investigated. Results: There was no statistically significant difference between the groups in terms of neutrophil, lymphocyte, and platelet count, neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) (p>0,05). Hemoglobin, mean platelet volume (MPV) and platelet distribution width (PDW) values were found statistically significantly higher in the malignant group (p<0.05). Conclusion: As a result; inflammation may increase platelet activity and provide a basis for endometrial cancer. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate whether the tumor free distance (TFD), which is the distance in millimeters between the deepest point of invasion and the serosal surface, and absolute depth of invasion (DMI), the distance in millimeters between the endomyometrial junction and the deepest point of myometrial invasion, are useful in surgical staging and in predicting prognosis. The present study retrospectively analyzed 62 cases of endometrial carcinoma with complete surgical staging, carried out over a 4 and half-year period (January 2003 to June 2007). All surgicopathological findings including surgical stages, histological type and grade, myometrial invasion, lymphovascular space invasion, cervical and adnexal involvement, and lymph node metastasis were abstracted from medical records and pathological reports. Univariate and multivariate analyses were performed comparing TFD, DMI and the percentage of mypmetrial invasion (MI) with established prognostic factors. A total of 62 patients were included in the study. A total of 52 (84%) had endometrioid carcinomas and 31 patients (60%) had grade 1 cancer. The deepest MI was <50% in 32 patients (52%). Median DMI was 2.7 mm (range 0–15 mm). Median TFD was 3 mm (range 0–19 mm). There was lymphovascular space invasion (LVSI) in 11 patients (17.5%), cervical involvement in 11 patients (17.5%), extra-uterine extension in 9 cases (14%) and lymph node metastasis in 12 patients (22%). It was demonstrated that 50% MI was significantly associated with prognostic factors (cervical involvement, type 2 carcinomas and LVSI, and was a significant predictor of the 5-year overall survival rate and recurrence-free survival (P=0.05, P=0.01). No significant association was observed between DMI and TFD with clinicopathological parameters and survival rates. The importance of DMI in predicting recurrence of disease was observed to be highest in terms of sensitivity and specificity. The cut-off value with the highest sensitivity and specificity crossing the receive operating characteristic curve was calculated to be 3 mm for DMI and 2.5 mm for TFD. The results indicate that DMI is a superior predictive factor of recurrence of the disease compared with TFD. However, further studies are required in order to prove the prognostic usefulness of these parameters and then to improve management of endometrial cancer. [ABSTRACT FROM AUTHOR]

Surgery is the primary choice of treatment for this disorder. Radiotherapy is an important step of treatment in this cancer after surgery due to the stage of the disease. Lack of prospective randomised data for survival limits the use of adjuvant radiotherapy. Hovewer adjuvant radiotherapy is suggested for high risk patients to reduce locoregional recurrence. The aim of this study is to define the statistical difference of hemogram, transaminases, kidney function tests and electrolyte changes in patients before starting radiotherapy, the end of radiotherapy, with the onset of acute side effects, and three months after finishing radiotherapy with the onset of chronic side effects. 18 patients with early stage endometrial malignancy attending to Adana Numune Training and Research Hospital have been included. This study has assessed the changes in hemogram, blood transaminases, urea, creatinin and electrolyte values of patients before radiotherapy, at the last week of radiotherapy and three months after radiotherapy. The values were statistically significant for AST, Ca, LDH, urea, Hb and HTC values before treatment, at the end of the treatment and three months after treatment (p<0.05). The effect of radiotheraphy seen as lower values of hemoglobin and hematocrite in endometrial malignancy patients resolved and become normal after three months of the radiotherapy. [ABSTRACT FROM AUTHOR]

Endometrial carcinoma (EC) is the most common malignant gynecologic tumor in women. EC is thought to be caused by increasing estrogen levels relative to progesterone in the body. Hesperidin (Hsd), a biologically active flavonoid, could be extracted from Citrus species. It has been recently shown that Hsd could exert anticarcinogenic properties in different cancer types. However, the effects of Hsd and its molecular mechanisms on EC remain unclear. In this study, the antiproliferative, apoptotic and genomic effects of Hsd in EC and its underlying mechanisms were identified. We found that Hsd significantly suppressed the proliferation of EC cells in dose and time dependent manner. Mechanistic studies showed that Hsd could contribute apoptosis by inducing externalization of phosphatidyl serine (PS), caspase-3 activity and loss of mitochondrial membrane (MMP). Furthermore, we examined that Hsd could also significantly upregulate the expression of proapoptotic Bax subgroup genes (Bax and Bik) while downregulating the anti-apoptotic protein Bcl-2 in EC cell lines. According to GO enrichment and KEGG pathway analysis of differentially expressed genes in Hsd treated EC cells, we identified that Hsd could promote cell death via downregulation of estrogen receptor I (ESRI) that was directly related to ERK/MAPK pathway. Taken together, our study first showed that Hsd could be an antiestrogenic compound that could modulate nongenomic estrogen receptor signaling through inhibition of EC cell growth. Our findings may provide us a novel growth inhibitory agent for EC treatment after verifying its molecular mechanism with in vivo studies. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the association between ratios of inflammatory markers and survival in endometrium cancer (EC). Material and Methods: Four hundred ninety-seven patients with epithelial EC were included. The evaluated ratios were neutrophil (N)/ lymphocyte (L), neutrophil count divided by the lymphocyte count; platelet (P)/lymphocyte, platelets divided by the lymphocyte count; lymphocyte/monocyte (M), lymphocytes divided by the monocyte count; NM/L, neutrophil plus monocyte divided by the lymphocyte count; PNM/L, the sum total counts of platelets, neutrophils and monocytes divided by the lymphocyte count. Results: The median follow-up time was 24 months (1-129). Recurrence and exitus occurred in 34 (7%) and 18 (3.7%) patients, respectively. Metastasis in pelvic or para-aortic lymph nodes were significantly related only with low L/M. None of the inflammatory ratios were associated with disease-free survival. In multi-variant analysis, only high P/L (>168) and high PNM/L (>171) were related with a statistically significant hazard ratio for death of 2.91 (p=0.024) and 2.93 (p=0.023), respectively. Conclusion: The P/L and PNM/L were in relation with worse overall survival and also independent prognostic factors for OS. [ABSTRACT FROM AUTHOR]

Objective: To compare endometrial biopsy results in patients with postmenopausal bleeding or menometrorrhagia. Material and Methods: A retrospective analysis of endometrial biopsies conducted by a single physician for diagnostic purposes in symptomatic patients at Yozgat Sorgun State Hospital between January 2015 and June 2016 was performed. Results: The results of 128 patients were evaluated. The mean age of 14 menopausal patients and 114 premenopausal women were 56.6±9.3 and 44.0±6.7, respectively. The endometrial thickness was statistically significantly thicker in premenopausal than postmenopausal patients. The most common pathologies in symptomatic premenopausal women were endometrial polyp and endometrial atrophy. In postmenopausal patients, normal pathologic result, endometrial polyp, cervical polyp was observed equally. Endometrium cancer has not been detected in any case. Conclusions: The menstrual cycle normally lasts for 28±7 days. Vaginal bleeding occurs approximately 2-6 days. The amount of bleeding is circa 20-60 ml. Any deviation from these values is called menstrual disorders. Menometrorrhagia defines intermenstrual bleeding together with bleeding more than 80 ml per day and longer than six days with irregular intermittent characteristics. Menometrorrhagia can be a symptom of many different spectrum of diseases. These diseases may also change with aging. In particular, endometrium cancer may occur with this symptom. Menorrhagia can also be seen in cases such as endometrial polyps, endometrial hyperplasia, endometrial atrophy, endometritis, submucous myomas, adenomyosis, ovarian cysts andhemostasis diseases. Postmenopausal vaginal bleeding occurs after the ceasing of menstruation for one year. Endometrial atrophy, endometrial polyp, endometrium cancer, hormone replacement therapy, endometrial hyperplasia, other genital cancers may be the causes of postmenopausal bleeding. It is interesting that no case of cancer has been detected in our study. However, pathologies such as endometrial polyps, endometrial hyperplasia, and cervical polyps were detected and treated at the same time. Endometrial biopsy in symptomatic pre- and postmenopausal patients is effective not only in cancer diagnosis but also in the diagnosis and treatment of benign conditions. [ABSTRACT FROM AUTHOR]

Objective: To review the clinicopathologic and survival outcomes of patients with serous endometrial cancer (EC) and to investigate subgroup analysis based on pure serous and mixed serous EC subtypes. Material and Methods: Patients who underwent EC surgery between 2002 and 2014 and who were reported as serous EC were enrolled in the study. All patients were diagnosed as having serous EC or mixed serous EC with serous component higher than 10% based on the postoperative pathology report. Results: A total of 93 patients were analyzed. The median disease-free and overall survival (OS) durations were 49.6 and 32.2 months, respectively. Forty-three patients (46.2%) relapsed and 35 patients (37.6%) died. The histologic type was pure serous EC in 52 (55.9%) and mixed EC in 41 (44.9%) patients. There was no statistical difference between the pure serous and mixed serous groups in terms of age, International Federation of Gynecology and Obstetrics stage, lymphadenectomy, lymph node metastasis or adjuvant therapy combinations. Twenty-nine (55.8%) patients in the pure serous group and 14 (34.1%) in the mixed serous group hade recurrence (p=0.038). Twenty-five (48.1%) patients in the pure serous group and 10 (24.4%) in the mixed serous group died (p=0.034). In the pure serous group, the mean disease-free and OS durations were shorter than in the mixed serous group (59 vs. 81 months and 73 vs. 95 months, log-rank p=0.055 and 0.041, respectively). Histologic type was a significant prognostic factor on recurrence and OS in the univariate analysis (Hazard ratio: 2.404, 95% Confidence interval: 1.01-5.71; 2.027, respectively), but not in the multivariate analysis, which included disease stage and age of the patients. Conclusion: Compared with pure serous and mixed serous endometrium cancer groups, primary surgical treatments, clinicopathologic features and adjuvant treatments were similar, but there was a survival difference. Patients with pure serous cancer had a worse prognosis. However histology was not an independent factor for survival. [ABSTRACT FROM AUTHOR]

Objectives: To estimate the incidence of ovarian cancer (OC) and endometrial cancer (EC) separately, as well as double cancers diagnosed in the same calendar year, and to relate the occurrences to histological subtype.Study Design: All cases of epithelial OC and EC diagnosed in the Netherlands in 1989-2009 were related to population data. Histologically specific associations were made using the ratio of observed and expected incidence numbers, calculated with age-specific incidence rates.Results: 25,489 OC and 32,729 EC were analyzed, and 649 OC/EC. Life-time risks for OC and EC were 1.8% and 2.4%. Among OC, adenocarcinoma (18%) and serous cancers (33%) were the most prevalent subtypes. In EC, adenocarcinoma (39%) and endometrioid cancer (37%) were highest, with hardly any serous cancers. The observed incidence of OC/EC was 50-fold higher than expected (95% CI, 46-54). For patients aged <55years, the O/E ratio was 274, for the elderly 32, both findings are significant. Of the 2345 OC endometrioid subtype, 294 had EC (12.5%), whereas 1.1 was expected. In EC patients, no particular histological subtype was distinguished with a highly elevated occurrence of OC. The 680 serous EC patients had 11 double cancers (1.6%), of which 8 with the ovarian serous subtype.Conclusion: Strong relationships exist between malignancies in the ovary and a second primary malignancy in the endometrium, especially for the endometrioid subtype of ovarian cancer. Viewed from the endometrial site, no special subtype was noted, and the influence of endometrial serous adenocarcinoma in developing serous OC is not plausible. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the relationship between histopathologic results and sonographic data in cases of endometrial sampling. Methods: The results of patients who underwent endometrial sampling between January 2015 and January 2017 at the Düzce University Medical Faculty Hospital were examined retrospectively from the hospital computer system and patient files. Patients were classified as premenopausal and postmenopausal groups according to the results of the patient groups were compared statistically. Results: Based on clasified, 231 of patients were premenopausal and 202 were postmenopausal. The mean endometrial thickness of premenopausal patients was 10.42 ± 6.75 (mm, mean ± SD), whereas the mean endometrial thickness of postmenopausal patients was 10.01 ± 7.26 (mm, mean ± SD). Premalign lesions were observed in similar proportions in both groups (p=0.87, p=0.54). Ten patients detected with malignancy, all of them were postmenopause and had bledding. Endometrial thickness cut-off value for malignancy was found 8.5 mm by ROC analysis. In premenopausal group, endometrial polyp was observed in 22.1% (n = 51) and 16.3% (n = 33) in postmenopausal period (p = 0.014). The histopathology results of 8 patients using tamoxifen were 75% (n = 6) benign, 12.5% (n = 1) premalign and 12.5% (n = 1) malignant. Conclusion: Endometrial sampling in postmenopausal symptomatic patients is crutial in terms of malignancy exclusion. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Obstetrics & Gynecology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: The aim of this study was to evaluate the treatment options and post–brain involvement survival (PBIS) of patients with isolated brain involvement from endometrial cancer (EC). Materials and Methods: The literature electronic search was conducted from 1972 to May 2016 to identify articles about isolated (without extracranial metastases) brain involvement from EC at recurrence and the initial diagnosis. Forty-eight articles were found. After comprehensive evaluation of case series and case reports, the study included 49 cases. Results: The median age of the patients at initial diagnosis was 57 years (range, 40–77 years). Poor differentiation was determined in 36 (73.5%) patients. Thirty-five (71.4%) patients had a single brain lesion. Lesion was found in the supratentorial part of the brain in 33 (67.3%) patients. Median PBIS for all cohorts was 13 months (range, 0.25–118 months) with 2-year PBIS of 52% and 5-year PBIS of 37%. Age, tumor type, grade, disease-free interval, diagnosis time of brain lesion, localization, and number of brain lesion were not predictive of PBIS. Two-year PBIS was 77% in patients who underwent surgical resection and radiotherapy, whereas it was 19% in the surgical resection–only group, and 20% in the primary radiotherapy–only group (P s = 0.003 and 0.001, respectively). Chemotherapy was not associated with improved PBIS. Conclusions: Although neuroinvasion from EC appears mostly with a disseminated disease, there is a considerable amount of patients with isolated brain involvement who would have a higher chance of curability. Surgery with radiotherapy is the rational current management option, and this improves the survival for isolated brain involvement from EC. [ABSTRACT FROM AUTHOR]

Objective: The purpose of the study was to assess the reliability of transvaginal ultrasound (TVUSG) in endometrial pathologies by comparing the ultrasonographic and histopathologic findings in symptomatic and asymptomatic postmenopausal women. Materials and Methods: In this retrospective study the data of 129 postmenopausal women that underwent dilatation and curettage was reviewed by dividing them two groups as symptomatic and asymptomatic. Symptomatic group was divided into subgroups according to the value of endometrial thickness obtained by TVUSG. Results: Among all subjects the cancer rate was found statistically 3.043 times higher in patients with the endometrial thickness of 15 mm and greater and atrophic endometrium rate was 75% in patients with the endometrial thickness of less than five mm. Endometrial thickness was found significantly higher in cancer patients than the others (p < 0.05). Among the patients with endometrial thickness of 15 mm and greater, the cancer rate was found higher in symptomatic group than in the asymptomatic group. The cancer rate was found statistically higher in patients with bleeding compared to asymptomatic ones with the endometrial thickness between 5-14.99 mm (p < 0.05). Cancer was not detected in any of the symptomatic patients with the endometrial thickness of less than five mm. Conclusion: Postmenopausal patients with the symptom of bleeding should undergo detailed gynecological and ultrasonographic examination. The authors believe that this study may be a strong support to the success of TVUSG as a screening method in both symptomatic and asymptomatic postmenopausal women. Furthermore if the patient is symptomatic with a thick endometrium, to exclude the malignancy, endometrial biopsy must be performed. [ABSTRACT FROM AUTHOR]

Objective: We aimed to analyze the reasons for postmenopausal bleeding that originated from the uterus in cases who consulted our menopausal clinic. Methods: Sixty-eight patients who visited the Gaziosmanpaşa Taksim Training and Research Hospital meopausal clinic with the complaint of postmeopausal bleeding were included in this prospective study. Systematic and gynecological examinations were conducted on these patients when they first visited. The age of the patients, last menstruation dates, characteristics of the vaginal bleeding, whether the patients had undergone hormone replacement treatment or not, number of pregnancies, whether they had a systematic disease or not, and alcohol consumption and smoking were investigated and recorded. Patients who had uterine bleeding that originated from the vagina and that was related to a systematic disease were excluded. The patients' vagina and vulva were examined, with the patient in the dorsolithotomy position on the gynecological table. Each patient underwent a smear test, followed by a transvaginal ultrasound. Results: The average age of the 68 patients who were included was 57 years, with the youngest aged 45 years and the oldest aged 83 years. As a result of the sampling done with these 68 patients, endometrium cancer was observed in six of them, with three of them aged over 65 years. In our study, 8.8% patients were detected with endometrium cancer. There are six nullipara patients according to the number of births and four of them were diagnosed with endometrium cancer. The menopause period of five of these six patients who were diagnosed with endometrium cancer was over 10 years. For the other reasons of postmenopausal bleeding, it was detected that atrophy in our series was 41.2%, hyperplasia was 7.4%, polyp was 35.3%, submucous myoma was 2.9%, cervical cancer was 2.9%, and cervical intraepithelial neoplasia-2 was 1.5%. In one of the cases who was diagnosed with endometrium cancer, the thickness of the endometrium was detected as 11 mm, and in the rest of the cases, this thickness was 20 mm. Conclusion: Beside obviously seeing the benefit of getting a prior knowledge for the patients about the endometrium by detecting the thickness of the endometrium by conducting transvaginal ultrasonography on the patients who have postmenopausal bleeding, in the postmenopausal bleeding, endometrial curettage is the golden standard. [ABSTRACT FROM AUTHOR]

Endometrial cancer is one of the most common cancer types among women in the world. In our study, it was aimed to investigate the potential anticancer effect of α-chaconine, which is one of the major glycoalkaloids found in Solanum tuberosum (potato), on estrogen receptor (ER) positive endometrial cancer cell line RL95-2. The effect of α-chaconine on RL95-2 cell viability was determined by the method of sulforhodamine B. Effect of α-chaconine on cell growth curve was assessed with the real-time cell analyzer system (xcelligence). The ERα inhibitor methyl-piperidino-pyrazole (MPP) dihydrochloride was used as a positive control to evaluate the association of α-chaconine with ERα. Expressions of ERα and p-ERα protein level were investigated by western blot. ERα mRNA expressions were performed by the real-time PCR method. The IC50 values ​​ of MPP dihydrochloride and α-chaconine were calculated as 20.01 μM and 4.72 μM, respectively. At MPP dihydrochloride 20 μM (p < 0.001), α-chaconine; 2.5 (p < 0.001); 5 (p < 0.001) and 10 μM (p < 0.001) concentrations, p-ERα/ERα ratio was decreased in the same significance compared to control. α-Chaconine decreased the level of ERα mRNA expression, after 24 h, but this decrease was not significant. This study showed for the first time the effect of α-chaconine on cell proliferation, ERα activity and expression in RL95-2 cells.

Aim: Adropin is a recently identified protein in liver, brain and many peripheral tissues, which is important in energy homeostasis. The purpose of this study is to determine adropin levels in patients with endometrium cancer (EC). Material and methods: A total of 74 patients (47 EC patients and 27 healthy controls) were included in the study. Fasting venous blood samples were collected from all patients. Serum adropin levels were measured by an enzyme-linked immunosorbent assay (ELISA). The correlations between serum adropin levels and clinicopathologic variables were determined. Results: In body mass index and age-matched groups of patients, adropin levels were determined lower in patients with EC than control group (p < 0.01). Adropin levels were negatively correlated with age (r = −0.265,p = 0.023), homeostasis model-resistance index (HOMA-IR) (r = −0.294,p = 0.005) and fasting insulin levels (r = −0.292,p = 0.001). It was shown that in receiver operator characteristic (ROC) analysis, at cut-off value ≤ 1.055 (ng/ml), adropin had 92.7% sensitivity, 91.5% specificity and had AUC = 0.948, CI; 0.894–1.000 for diagnosis of EC (p < 0.001). Conclusion: Adropin seems to be an important protein in pathogenesis of EC. Clearly, there are largely unknown aspects of adropin in EC pathophysiology and require further multi-centered, molecular and genetic studies including high number of cases. 目的：能量相关蛋白是新近在肝，脑和许多外周组织中被发现的对能量平衡具有重要作用的蛋白质。研究的目的在于确定子宫内膜癌（EC）患者的能量相关蛋白水平。 材料与方法：总计74名患者（47例EC患者和27例对照）被纳入了此项研究。提取所有受试患者的空腹静脉血样本。使用酶联免疫吸附试验（ELISA）测量血清能量相关蛋白水平。评估血清能量相关蛋白水平与临床病理变化之间的联系。 结果：在体质指数和年龄相当的患者组中，EC患者的能量相关蛋白水平较对照组低(p<0.01)。能量相关蛋白水平与年龄(r=－0.265,p=0.023)，稳态模型-抵抗指数(r=－0.294,p=0.005)和空腹胰岛素水平呈负相关(r=－0.292,p=0.001)。受试者工作特征分析表现，在截断值≤1.055 (ng/ml)时，能量相关蛋白在诊断EC时具有92.7% 的灵敏度， 91.5% 的特异性，且 AUC=0.948, CI; 0.894–1.000。 结论：能量相关蛋白是一个对EC的发病机理起重要作用的蛋白质。很明显，能量相关蛋白在EC发病机制中的作用有许多未知的方面，需要进一步的纳入大量患者的多中心的，分子与遗传方面的研究。 [ABSTRACT FROM PUBLISHER]

In this study, we aimed to assess the relation between indications and histopathological diagnosis of the endometrial sampling procedures performed for various indications in the light of the current literature. The data obtained from the records of 799 patients who had undergone endometrial biopsy due to various causes between January 2012 and May 2015 were evaluated in this retrospective study. The most frequent indication of endometrial biopsy was found as menometrorrhagia in 56. 6 % of the patients. Endometrial cancer was found in 1.9% of all patient population. Patients complaining of postmenopausal bleeding (8.1%) showed the highest risk for endometrial cancer. Any histopathological abnormality was not found in endometrial biopsy materials performed preoperatively in patients who were scheduled to undergo hysterectomy for myoma uteri or benign causes. In conclusion, particularly patients complaining of postmenopausal bleeding have the highest risk for endometrial cancer which requires histopathological assessment of the endometrium. In consideration of the risk factors, preoperative endometrial assessment can be performed in patients who will undergo underwent hysterectomy with indications of myoma uteri or benign reasons based on the potential development of premalign or malign lesions. [ABSTRACT FROM AUTHOR]

The cell fate determinant Numb orchestrates numerous cell physiological and pathological processes and previous evidence has indicated that Numb expression is associated with tumorigenesis. The present study investigated the potential role of Numb in endometrial cancer (EC). Numb expression was compared between the normal endometrium and EC tissue by immunohistochemistry, and the protein levels were assessed by western blotting and confocal microscopy in the human endometrial HEC-1B cancer cell line and normal epithelial cells. The intracellular localization of Numb in HEC-1B cells was examined by immunofluorescence. Numb was found to be expressed at higher levels in endometrial cancer compared with the normal endometrium. Although Numb localizes to the cytoplasm and plasma membrane in the normal epithelium, the present study found that Numb accumulated in the nucleus of HEC-1B cells. The present data reveals the upregulation of Numb expression in EC tissues and indicates that Numb plays a role in the occurrence of EC, which may be mediated by its translocation into the nucleus. The role of Numb in cancer development requires additional investigation. [ABSTRACT FROM AUTHOR]

Introduction and Purpose: In this study, we aim to investigate the effects of the prognostic factors related to tumour, treatment, local and regional controls, overall survival, and disease free survival in postoperative radiotherapy patients. Materials and Methods: Sixty-one patients admitted to suffering from adenocarcinom of endometrium were analyzed retrospectively following surgical operation, adjuvant radiotherapy, and brachytherapy. We evaluated the patients in trems of age, tumour differentiations, tumour stage, lymphovascular invasion, serosal invasion, myometrial invasion, endocervical invasion, adnex involvement, lymph node involvement, menopausal age, hypertension, diabetes mellitus, smoking history, parity, hormone replacement therapy, chemotherapy process, vaginal brachitherapy, the type and doses of radiotherapy and local relapses. Throughout our research, we studied how overall survival and disease-free survival are influenced by factors like age, stage, tumour differentiation, histological type, lymph node involvement, lymphovascular invasion (LVI), endocervical invasion, serosal invasion, menopausal age, hypertension, diabetes mellitus, smoking history, parity, hormone replacement therapy (HRT), operation type, depth of myometrial invasion, and adnexal involvement. Results: Fifty three patiens (87%) were exposed to total abdominal hysterectomy+bilateral saphingo oohporectomy+bilateral pelvic lymp node dissection (TAH+BSO+BPLND), while 8 patients (13%) were exposed to TAH-BSO. Thirty patients were treated by conventional methods, 23 patients were treated by conformal methods. Eight patients were treated only by brachytherapy. The five-year overall survival rate was 80.3% and disease-free survival rate was found to be 77%. Two year overall survival rate was 93.4% and disease-free survival rate was 85.2%. It was noticed that serosal invasion (p=0.034) affect overall survival. Conclusion: Postoperative radiation therapy is an effective and safe treatment option in endometrium cancer. [ABSTRACT FROM AUTHOR]

INTRODUCTON: The aim of this study was to evaluate the clinical characteristics, post-surgery adjuvant treatment approach and posttreatment disease course in patients with intermediate risk stage I endometrium cancer and also to assess the effects of known prognostic factors on this group of patients. PATIENTS AND METHODS: A total of 148 patients followed up postoperatively or after adjuvant treatment between 1996 and 2007 were evaluated retrospectively. Median follow-up duration was 67 months (range: 7-166). Among the study population 14.9% had Ib and 83.1% had stage Ic disease. 72 were treated by external beam radiotherapy (EBRT), 7 by intracavitary radiotherapy (ICRT), 65 by external + intracavitary radiotherapy (EBRT + ICRT), and one by chemoradiotherapy (CRT). RESULTS: Vaginal vault is found to be the most common site of recurrences. Five and 10-year local control (LC) rates were 96.6% and 95.9%, respectively, while 5 and 10-year distant control (DC) rates were 94.6% and 91.9%, respectively. One, 5 and 10-year overall survival rates (OS) were 99.3%, 87.6% and 71.2%, respectively, while 1, 5 and 10-year progression-free survival rates (PFS) were 97.3%, 87.6% and 71.2%, respectively. Univariate analysis has revealed that prognostic factors as age (P = 0.0001), menopausal status (P = 0.049) and EBRT duration (P = 0.003) statistically significantly affected OS; while age (P = 0.0001) and EBRT duration (P = 0.006) affected PFS. Multivariate analysis has revealed that only age (P = 0.001) (P = 0.0001) and ERT duration (P = 0.021) (P = 0.027) affected both OS and PFS. CONCLUSION: LC and OS rates are high in the intermediate risk group. Age over 60 years and EBRT duration of 35 days and over both have negative effects on outcome in this group. [ABSTRACT FROM AUTHOR]