Mehmet Emre Peker, Ufuk Atlıhan, Duygu Uçar Kartal, Can Ata, Murat Özşahin
Objective
This study aimed to evaluate the role of systemic inflammatory indices—including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII)—in predicting the response to medical treatment in patients diagnosed with tubo-ovarian abscess (TOA).
Methods
This retrospective cross-sectional study included 100 female patients aged ≥ 18 years diagnosed with TOA between January 2020 and April 2025 at İzmir Buca Seyfi Demirsoy Training and Research Hospital and Manisa City Hospital. Patients were divided into two groups: those who responded to medical treatment (n = 50) and those who required surgical intervention after treatment failure (n = 50). Demographic, clinical, laboratory (NLR, PLR, SII, CRP), and radiological data (abscess diameter) were analyzed. Statistical analyses were conducted using SPSS version 27.0, with p < 0.05 considered significant.
Results
There were no significant differences between the groups regarding NLR (4.92 ± 2.80 vs. 4.87 ± 4.53; p = 0.947), PLR (163.7 ± 93.2 vs. 160.5 ± 139.2; p = 0.893), and SII (1570 ± 1096 vs. 1657 ± 1647; p = 0.756). However, CRP levels (89.8 ± 51.1 vs. 125.9 ± 67.1; p = 0.003) and abscess diameter (41.4 ± 19.1 mm vs. 68.9 ± 18.7 mm; p < 0.001) were significantly higher in the surgical group.
Conclusion
NLR, PLR, and SII showed limited value in predicting treatment response in TOA patients. Elevated CRP levels and larger abscess diameter were significant predictors of surgical need. Considering these factors may guide more individualized treatment strategies.
{"title":"The Role of Systemic Inflammatory Indices (NLR, PLR, SII) in Predicting the Response to Medical Treatment in Patients With Tubo-Ovarian Abscess: A Retrospective Evaluation","authors":"Mehmet Emre Peker, Ufuk Atlıhan, Duygu Uçar Kartal, Can Ata, Murat Özşahin","doi":"10.1111/jog.70128","DOIUrl":"https://doi.org/10.1111/jog.70128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to evaluate the role of systemic inflammatory indices—including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII)—in predicting the response to medical treatment in patients diagnosed with tubo-ovarian abscess (TOA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cross-sectional study included 100 female patients aged ≥ 18 years diagnosed with TOA between January 2020 and April 2025 at İzmir Buca Seyfi Demirsoy Training and Research Hospital and Manisa City Hospital. Patients were divided into two groups: those who responded to medical treatment (<i>n</i> = 50) and those who required surgical intervention after treatment failure (<i>n</i> = 50). Demographic, clinical, laboratory (NLR, PLR, SII, CRP), and radiological data (abscess diameter) were analyzed. Statistical analyses were conducted using SPSS version 27.0, with <i>p</i> < 0.05 considered significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were no significant differences between the groups regarding NLR (4.92 ± 2.80 vs. 4.87 ± 4.53; <i>p</i> = 0.947), PLR (163.7 ± 93.2 vs. 160.5 ± 139.2; <i>p</i> = 0.893), and SII (1570 ± 1096 vs. 1657 ± 1647; <i>p</i> = 0.756). However, CRP levels (89.8 ± 51.1 vs. 125.9 ± 67.1; <i>p</i> = 0.003) and abscess diameter (41.4 ± 19.1 mm vs. 68.9 ± 18.7 mm; <i>p</i> < 0.001) were significantly higher in the surgical group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>NLR, PLR, and SII showed limited value in predicting treatment response in TOA patients. Elevated CRP levels and larger abscess diameter were significant predictors of surgical need. Considering these factors may guide more individualized treatment strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 11","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145385035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Feifei Song, Xiaojing Chen, Tao Zhang, Xuedong Tang, Xiaodong Cheng
Aim
Low-grade serous ovarian cancer (LGSOC) is a rare subtype of ovarian cancer with distinct biological behavior. This study aimed to identify new biomarkers with potential diagnostic and prognostic value for LGSOC.
Methods
Gene-expression data were downloaded from the Gene Expression Omnibus (GEO). Differentially expressed genes (DEGs) were identified using R. Functional enrichment analyses were conducted to determine the biological functions and signaling pathways associated with DEGs. The mitogen-activated protein kinase (MAPK) pathway-related gene, chromosome 1 open reading frame 106 (C1orf106), was selected as the target gene. Immunohistochemistry and quantitative real-time polymerase chain reaction (qRT-PCR) were performed to verify its expression. Associations between C1orf106 expression and the clinical features of patients were analyzed using the chi-square (χ2) test. Prognostic significance was evaluated with survival analyses.
Results
A total of 3099 upregulated and 4968 downregulated genes were identified in LGSOC. Gene set enrichment analysis (GSEA) demonstrated significant alterations in KRAS signaling and metabolic pathways between LGSOC and healthy controls. Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) analyses revealed enrichment in immune response and MAPK pathway alterations. Immunohistochemistry and qRT-PCR confirmed that C1orf106 expression in LGSOC tissues was significantly higher than in normal ovarian tissues. Clinically, high C1orf106 expression was associated with lower BMI (< 25 kg/m2), the absence of visible residual disease, and improved progression-free survival (PFS) and overall survival (OS) in univariate Cox and Kaplan–Meier analyses.
Conclusions
C1orf106 may serve as a promising marker for the diagnosis and prognosis of LGSOC.
目的：低级别浆液性卵巢癌（LGSOC）是一种罕见的卵巢癌亚型，具有独特的生物学行为。本研究旨在寻找对LGSOC具有潜在诊断和预后价值的新生物标志物。方法：从Gene Expression Omnibus （GEO）下载基因表达数据。差异表达基因（differential expressed genes, deg）通过功能富集分析确定了与deg相关的生物学功能和信号通路。选择丝裂原活化蛋白激酶（MAPK）通路相关基因1号染色体开放阅读框106 （C1orf106）作为靶基因。免疫组织化学和定量实时聚合酶链反应（qRT-PCR）验证其表达。采用χ2检验分析C1orf106表达与患者临床特征的相关性。通过生存分析评估预后意义。结果：在LGSOC中共鉴定出3099个上调基因和4968个下调基因。基因集富集分析（GSEA）表明，在LGSOC和健康对照之间，KRAS信号和代谢途径发生了显著变化。京都基因和基因组百科全书（KEGG）和基因本体（GO）分析显示免疫反应和MAPK通路改变富集。免疫组织化学和qRT-PCR证实，C1orf106在LGSOC组织中的表达明显高于正常卵巢组织。在临床上，在单变量Cox和Kaplan-Meier分析中，高C1orf106表达与较低的BMI(2)、没有可见的残留疾病、改善的无进展生存期（PFS）和总生存期（OS）相关。结论：C1orf106可作为LGSOC的诊断和预后指标。
{"title":"The Expression and Clinical Significance of C1orf106 in Low-Grade Serous Ovarian Cancer","authors":"Feifei Song, Xiaojing Chen, Tao Zhang, Xuedong Tang, Xiaodong Cheng","doi":"10.1111/jog.70118","DOIUrl":"10.1111/jog.70118","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Low-grade serous ovarian cancer (LGSOC) is a rare subtype of ovarian cancer with distinct biological behavior. This study aimed to identify new biomarkers with potential diagnostic and prognostic value for LGSOC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Gene-expression data were downloaded from the Gene Expression Omnibus (GEO). Differentially expressed genes (DEGs) were identified using R. Functional enrichment analyses were conducted to determine the biological functions and signaling pathways associated with DEGs. The mitogen-activated protein kinase (MAPK) pathway-related gene, chromosome 1 open reading frame 106 (<i>C1orf106</i>), was selected as the target gene. Immunohistochemistry and quantitative real-time polymerase chain reaction (qRT-PCR) were performed to verify its expression. Associations between <i>C1orf106</i> expression and the clinical features of patients were analyzed using the chi-square (<i>χ</i><sup>2</sup>) test. Prognostic significance was evaluated with survival analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 3099 upregulated and 4968 downregulated genes were identified in LGSOC. Gene set enrichment analysis (GSEA) demonstrated significant alterations in KRAS signaling and metabolic pathways between LGSOC and healthy controls. Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) analyses revealed enrichment in immune response and MAPK pathway alterations. Immunohistochemistry and qRT-PCR confirmed that <i>C1orf106</i> expression in LGSOC tissues was significantly higher than in normal ovarian tissues. Clinically, high <i>C1orf106</i> expression was associated with lower BMI (< 25 kg/m<sup>2</sup>), the absence of visible residual disease, and improved progression-free survival (PFS) and overall survival (OS) in univariate Cox and Kaplan–Meier analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p><i>C1orf106</i> may serve as a promising marker for the diagnosis and prognosis of LGSOC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://obgyn.onlinelibrary.wiley.com/doi/epdf/10.1111/jog.70118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Letter to “Etiologies and clinical characteristics of primary amenorrhea: A study from a quaternary care hospital in southern Thailand”","authors":"Lianyi Bao, Guangbin Yu","doi":"10.1111/jog.70086","DOIUrl":"10.1111/jog.70086","url":null,"abstract":"","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. M. Ashika, D. Jayalakshmi, P. Veena, H. Nandeesha
Objective
To evaluate the performance of the risk of endometrial malignancy (REM) scoring system using its existing cut-off value (0.3185) in stratifying risk for endometrial malignancy and to determine an optimal cut-off value in a tertiary care setting in South India.
Methods
This cross-sectional diagnostic accuracy study enrolled 220 women aged 40–80 years who underwent surgical interventions for abnormal uterine bleeding (AUB), postmenopausal bleeding (PMB), or ultrasonographic abnormalities. Data on clinical, ultrasonographic, and biochemical parameters (including HE4 levels) were collected, and REM scores were calculated. Histopathological outcomes served as the gold standard for assessing performance.
Results
The median REM score was significantly higher in women with malignancy (0.5581, IQR: 0.3442–0.7489) compared to those without (0.1709, IQR: 0.0993–0.3628, p < 0.001). At the existing cut-off value (0.3185), the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 79.6%, 72.67%, 51.65%, and 90.7%, respectively. An optimal cut-off value of 0.3348 demonstrated improved sensitivity and specificity in the study population.
Conclusion
The REM scoring system effectively stratifies patients at high risk for endometrial malignancy. Adjusting the cut-off value for this population may further enhance its diagnostic utility.
{"title":"Clinical Utility of the REM Score in Stratifying Endometrial Malignancy Risk: Insights From a Tertiary Care Centre in South India","authors":"K. M. Ashika, D. Jayalakshmi, P. Veena, H. Nandeesha","doi":"10.1111/jog.70108","DOIUrl":"10.1111/jog.70108","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the performance of the risk of endometrial malignancy (REM) scoring system using its existing cut-off value (0.3185) in stratifying risk for endometrial malignancy and to determine an optimal cut-off value in a tertiary care setting in South India.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional diagnostic accuracy study enrolled 220 women aged 40–80 years who underwent surgical interventions for abnormal uterine bleeding (AUB), postmenopausal bleeding (PMB), or ultrasonographic abnormalities. Data on clinical, ultrasonographic, and biochemical parameters (including HE4 levels) were collected, and REM scores were calculated. Histopathological outcomes served as the gold standard for assessing performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median REM score was significantly higher in women with malignancy (0.5581, IQR: 0.3442–0.7489) compared to those without (0.1709, IQR: 0.0993–0.3628, <i>p</i> < 0.001). At the existing cut-off value (0.3185), the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 79.6%, 72.67%, 51.65%, and 90.7%, respectively. An optimal cut-off value of 0.3348 demonstrated improved sensitivity and specificity in the study population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The REM scoring system effectively stratifies patients at high risk for endometrial malignancy. Adjusting the cut-off value for this population may further enhance its diagnostic utility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We present a rare case of small bowel metastasis of ovarian clear cell carcinoma, successfully diagnosed preoperatively using capsule and double-balloon endoscopy. The patient was a 62-year-old woman who underwent primary surgery for stage IIB ovarian clear cell carcinoma followed by six cycles of adjuvant chemotherapy. Six years later, she developed iron-deficiency anemia with melena, but conventional upper and lower endoscopy failed to identify the source of bleeding. Subsequent capsule endoscopy revealed a tumor in the distal ileum, and a biopsy was taken using double-balloon endoscopy. Pathological and immunohistochemical findings supported a diagnosis of recurrent ovarian clear cell carcinoma. Surgical resection was performed, followed by chemotherapy, and the patient remains recurrence-free. This is the first case of small bowel metastasis of ovarian clear cell carcinoma diagnosed preoperatively with endoscopic biopsy. It highlights the criticality of advanced endoscopic modalities for evaluating unexplained anemia in patients with a history of ovarian cancer.
{"title":"Preoperative Diagnosis of Small Bowel Metastasis of Ovarian Clear Cell Carcinoma Using Capsule and Double-Balloon Endoscopy: A Case Report","authors":"Miku Takadera, Yoshifumi Takahashi, Miki Shinohara, Kohei Tamura, Yuji Takei, Hiroyuki Fujiwara","doi":"10.1111/jog.70116","DOIUrl":"10.1111/jog.70116","url":null,"abstract":"<div>\u0000 \u0000 <p>We present a rare case of small bowel metastasis of ovarian clear cell carcinoma, successfully diagnosed preoperatively using capsule and double-balloon endoscopy. The patient was a 62-year-old woman who underwent primary surgery for stage IIB ovarian clear cell carcinoma followed by six cycles of adjuvant chemotherapy. Six years later, she developed iron-deficiency anemia with melena, but conventional upper and lower endoscopy failed to identify the source of bleeding. Subsequent capsule endoscopy revealed a tumor in the distal ileum, and a biopsy was taken using double-balloon endoscopy. Pathological and immunohistochemical findings supported a diagnosis of recurrent ovarian clear cell carcinoma. Surgical resection was performed, followed by chemotherapy, and the patient remains recurrence-free. This is the first case of small bowel metastasis of ovarian clear cell carcinoma diagnosed preoperatively with endoscopic biopsy. It highlights the criticality of advanced endoscopic modalities for evaluating unexplained anemia in patients with a history of ovarian cancer.</p>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Menopausal symptoms affect work performance and the occurrence of presenteeism and absenteeism. However, how well these women cope with menopausal symptoms and whether they receive appropriate treatment remains unclear. In this study, we examined Japanese working women with respect to menopausal symptoms, whether they used medical facilities and which departments they visited, and their satisfaction with the treatment they received.
Methods
An online survey was conducted in Japan. A total of 1031 working women with menopausal symptoms, aged between 40 and 59 years, were recruited. We used an original questionnaire that included items on the participants' demographic characteristics, coping behaviors for menopausal symptoms, the clinical department they visited, and their satisfaction. Menopausal symptoms were assessed using the Menopausal Rating Scale.
Results
The proportion of women with moderate-to-severe menopausal symptoms was 58.4%; 46.8% had somatic symptoms, 61.0% had psychological symptoms, and 28.4% had urogenital symptoms. The proportion of women with moderate-to-severe hot flashes was 16.5%. Among the study population, 45.5% could not cope with their menopausal symptoms. Among women who were coping well with menopausal symptoms, 44.1% visited medical facilities, and 63.6% visited a gynecologist. The respondents' satisfaction rate with their gynecologist was 68.8%.
Conclusions
Among working women with menopausal symptoms, more than 50% had moderate or severe symptoms, and ~50% were coping well with menopausal symptoms. Many working women were likely to visit gynecologists. These results highlight the importance of supporting middle-aged women.
{"title":"Treatment-Seeking Behaviors Among Japanese Working Women With Menopausal Symptoms","authors":"Riyo Kinouchi, Takeshi Iwasa, Hiroshi Ishikawa, Hirokazu Uemura, Toshifumi Takahashi, Yoshiko Mochizuki, Kaori Koga, Seiichiro Tateishi, Yoshihisa Fujino, Shigeo Horie, Toshiyuki Yasui","doi":"10.1111/jog.70120","DOIUrl":"10.1111/jog.70120","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Menopausal symptoms affect work performance and the occurrence of presenteeism and absenteeism. However, how well these women cope with menopausal symptoms and whether they receive appropriate treatment remains unclear. In this study, we examined Japanese working women with respect to menopausal symptoms, whether they used medical facilities and which departments they visited, and their satisfaction with the treatment they received.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An online survey was conducted in Japan. A total of 1031 working women with menopausal symptoms, aged between 40 and 59 years, were recruited. We used an original questionnaire that included items on the participants' demographic characteristics, coping behaviors for menopausal symptoms, the clinical department they visited, and their satisfaction. Menopausal symptoms were assessed using the Menopausal Rating Scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The proportion of women with moderate-to-severe menopausal symptoms was 58.4%; 46.8% had somatic symptoms, 61.0% had psychological symptoms, and 28.4% had urogenital symptoms. The proportion of women with moderate-to-severe hot flashes was 16.5%. Among the study population, 45.5% could not cope with their menopausal symptoms. Among women who were coping well with menopausal symptoms, 44.1% visited medical facilities, and 63.6% visited a gynecologist. The respondents' satisfaction rate with their gynecologist was 68.8%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among working women with menopausal symptoms, more than 50% had moderate or severe symptoms, and ~50% were coping well with menopausal symptoms. Many working women were likely to visit gynecologists. These results highlight the importance of supporting middle-aged women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yufeng Wang, Zhiruo Qiu, Yuan Yao, Jie Tan, Xuan Che
Aim
This study aimed to compare clinical characteristics and evaluate diagnostic biomarkers in ovarian endometriosis, with a focus on thyroid autoimmunity associations.
Methods
A retrospective analysis of 885 patients (441 ovarian endometriosis cases; 444 benign ovarian tumor controls) was conducted. Clinical parameters, thyroid function markers (FT3, FT4, TSH), thyroid autoantibodies (TPOAb, TGAb), and CA125 levels were analyzed. Multivariate regression and ROC curves assessed diagnostic utility.
Results
Ovarian endometriosis patients exhibited higher dysmenorrhea prevalence (49.7% vs. 15.3%, p < 0.001), bilateral cysts (26.1% vs. 8.8%, p < 0.001), endometrial polyps (21.9% vs. 15.9%, p = 0.015), and uterine fibroids (35.6% vs. 26.2%, p = 0.003) versus controls. Elevated CA125 (75.3% vs. 10.8%), TPOAb (56.9% vs. 6.5%), and TGAb (68.5% vs. 12.4%) incidences were observed in endometriosis (p < 0.001). Autoimmune thyroid disease co-occurrence was significantly higher in cases (51% vs. 15%, p < 0.001). Multivariate analysis identified CA125 (OR = 18.4, 95% CI: 12.5–27.6), TPOAb (OR = 2.63, 95% CI: 1.46–4.77), and TGAb (OR = 4.03, 95% CI: 2.48–6.60) as independent risk factors (p ≤ 0.001). ROC analysis revealed AUCs of 0.895 (CA125), 0.793 (TGAb), and 0.736 (TPOAb); their combination achieved superior diagnostic accuracy (AUC = 0.924, sensitivity 88.9%, specificity 84.5%).
Conclusion
This large-scale retrospective analysis demonstrates that the integration of serum CA125 with thyroid autoantibodies (TPOAb/TGAb) generates a synergistic diagnostic signature for ovarian endometriosis, achieving unprecedented discriminative accuracy (AUC 0.924) that significantly surpasses individual biomarker testing. The > 3-fold elevated co-occurrence of autoimmune thyroid dysfunction in cases reinforces an underrecognized immune-endocrine interplay in disease pathogenesis. These findings support incorporating thyroid autoimmunity screening into standard diagnostic workups to optimize risk stratification and personalized management pathways for symptomatic patients.
This study aimed to investigate whether optimizing the timing of vaginal administration of carboprost methylate (CM), a prostaglandin F2α analogue, could ensure surgical safety and effectiveness while minimizing its side effects.
Methods
This randomized controlled trial included 120 patients undergoing surgical abortion who were equally divided into two groups in a tertiary hospital. Group A received CM about 2 h before surgery, while group B received the medication just before anesthesia. The primary outcome was the cervical dilation time and the secondary outcomes included parameters of surgery completeness (surgery time, blood loss, and first-pass success rate of 7.5 Hegar dilator) and adverse events (abdominal pain, vomiting, nausea, diarrhea, defecation urgency, and fever).
Results
The cervical dilation time and parameters of surgery completeness were similar between the two groups, and the concentration of cervical matrix metalloproteinase was no different. However, adverse events related to CM were significantly lower in group B than in group A (93.4% vs. 28.8%, p < 0.01) before anesthesia. The abdominal pain numerical rating scale (NRS) score before anesthesia was 10 times higher in group A (2.84 ± 2.11 vs. 0.27 ± 0.53, p < 0.01). Postoperative vomiting and nausea (PONV) percentage were significantly lower in group B (6.7% vs. 19.0%, p = 0.04).
Conclusion
Delayed administration of CM until before anesthesia is effective in cervical priming for surgical abortion in early pregnancy and significantly reduces adverse symptoms, including PONV, diarrhea, and abdominal pain.
{"title":"Delayed Administration of Carboprost Methylate Reduces Perioperative Complications Without Affecting Cervical Ripening Effect in Surgical Abortion: A Randomized Controlled Trial","authors":"Yifei Zhao, Wei Xue, Weilin Chen, Duoduo Zhang","doi":"10.1111/jog.70107","DOIUrl":"10.1111/jog.70107","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to investigate whether optimizing the timing of vaginal administration of carboprost methylate (CM), a prostaglandin F2α analogue, could ensure surgical safety and effectiveness while minimizing its side effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This randomized controlled trial included 120 patients undergoing surgical abortion who were equally divided into two groups in a tertiary hospital. Group A received CM about 2 h before surgery, while group B received the medication just before anesthesia. The primary outcome was the cervical dilation time and the secondary outcomes included parameters of surgery completeness (surgery time, blood loss, and first-pass success rate of 7.5 Hegar dilator) and adverse events (abdominal pain, vomiting, nausea, diarrhea, defecation urgency, and fever).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cervical dilation time and parameters of surgery completeness were similar between the two groups, and the concentration of cervical matrix metalloproteinase was no different. However, adverse events related to CM were significantly lower in group B than in group A (93.4% vs. 28.8%, <i>p</i> < 0.01) before anesthesia. The abdominal pain numerical rating scale (NRS) score before anesthesia was 10 times higher in group A (2.84 ± 2.11 vs. 0.27 ± 0.53, <i>p</i> < 0.01). Postoperative vomiting and nausea (PONV) percentage were significantly lower in group B (6.7% vs. 19.0%, <i>p</i> = 0.04).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Delayed administration of CM until before anesthesia is effective in cervical priming for surgical abortion in early pregnancy and significantly reduces adverse symptoms, including PONV, diarrhea, and abdominal pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ClinicalTrials.gov: NCT05834361</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brain metastases from endometrial carcinoma are extremely rare and associated with poor prognosis. We present a 43-year-old woman with mismatch repair deficient endometrial cancer who developed multiple brain metastases refractory to cytotoxic chemotherapy and without extracranial involvement. After stereotactic radiotherapy, combination therapy with lenvatinib and pembrolizumab resulted in sustained partial remission for 16 months, with no evidence of brain hemorrhage. This case demonstrates that lenvatinib plus pembrolizumab may offer an effective and safe therapeutic option for brain metastases from endometrial cancer, even in patients resistant to conventional therapy. Remarkably, this outcome challenges the traditionally poor prognosis of such cases and underscores the potential for novel targeted and immunotherapeutic strategies to redefine the standard of care for this rare and devastating complication.
{"title":"Long Term Disease Control of Brain Metastases From Chemotherapy-Resistant Endometrial Cancer With Lenvatinib and Pembrolizumab: A Case Report","authors":"Ayaka Fujioka, Akimasa Takahashi, Tsukuru Amano, Yuji Tanaka, Yutaka Yoneoka, Shunichiro Tsuji","doi":"10.1111/jog.70102","DOIUrl":"10.1111/jog.70102","url":null,"abstract":"<p>Brain metastases from endometrial carcinoma are extremely rare and associated with poor prognosis. We present a 43-year-old woman with mismatch repair deficient endometrial cancer who developed multiple brain metastases refractory to cytotoxic chemotherapy and without extracranial involvement. After stereotactic radiotherapy, combination therapy with lenvatinib and pembrolizumab resulted in sustained partial remission for 16 months, with no evidence of brain hemorrhage. This case demonstrates that lenvatinib plus pembrolizumab may offer an effective and safe therapeutic option for brain metastases from endometrial cancer, even in patients resistant to conventional therapy. Remarkably, this outcome challenges the traditionally poor prognosis of such cases and underscores the potential for novel targeted and immunotherapeutic strategies to redefine the standard of care for this rare and devastating complication.</p>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To clarify the causes of maternal death due to complications related to labor analgesia.
Methods
A nationwide retrospective study was conducted to investigate intrapartum maternal deaths in Japan between 2010 and 2022. The obstetric and anesthetic characteristics of women with (cases) and without (controls) labor analgesia were compared.
Results
Of the 558 maternal deaths in Japan during the study period, 161 occurred intrapartum. Among these, 24 (15%) patients received labor analgesia (cases), 117 did not receive labor analgesia (controls), and 20 underwent elective cesarean section. Regarding the causes of maternal death, the incidence of amniotic fluid embolism was 71% among the cases and 56% among the controls. The incidence of uterine rupture/laceration was 13% among the cases and 9% among the controls (nonsignificant difference). Moreover, among the patients who received labor analgesia, there were two cases of maternal deaths directly related to neuraxial labor analgesia (due to high spinal anesthesia and local anesthetic toxicity). Induction of labor was attempted in 96% of the cases with labor analgesia compared to 55% of the controls (p < 0.01).
Conclusion
Among the cases of maternal deaths, amniotic fluid embolism, uterine rupture/laceration, and complications of the labor analgesia itself were likely causes in patients who had received labor analgesia. These results may be related to the higher frequency of induction of labor in labor analgesia.
{"title":"Maternal Death due to Complications Related to Labor Analgesia: Report From Maternal Death Exploratory Committee in Japan","authors":"Junichi Hasegawa, Hiroaki Tanaka, Kayo Tanaka, Tatsuya Arakaki, Masamitsu Nakamura, Rie Kato, Toshiyuki Okutomi, Hiroyuki Sumikura, Masahiko Nakata, Takeshi Murakoshi, Akihiko Sekizawa, Akihito Nakai, Isamu Ishiwata, Tomoaki Ikeda","doi":"10.1111/jog.70103","DOIUrl":"10.1111/jog.70103","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To clarify the causes of maternal death due to complications related to labor analgesia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A nationwide retrospective study was conducted to investigate intrapartum maternal deaths in Japan between 2010 and 2022. The obstetric and anesthetic characteristics of women with (cases) and without (controls) labor analgesia were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 558 maternal deaths in Japan during the study period, 161 occurred intrapartum. Among these, 24 (15%) patients received labor analgesia (cases), 117 did not receive labor analgesia (controls), and 20 underwent elective cesarean section. Regarding the causes of maternal death, the incidence of amniotic fluid embolism was 71% among the cases and 56% among the controls. The incidence of uterine rupture/laceration was 13% among the cases and 9% among the controls (nonsignificant difference). Moreover, among the patients who received labor analgesia, there were two cases of maternal deaths directly related to neuraxial labor analgesia (due to high spinal anesthesia and local anesthetic toxicity). Induction of labor was attempted in 96% of the cases with labor analgesia compared to 55% of the controls (<i>p</i> < 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Among the cases of maternal deaths, amniotic fluid embolism, uterine rupture/laceration, and complications of the labor analgesia itself were likely causes in patients who had received labor analgesia. These results may be related to the higher frequency of induction of labor in labor analgesia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 10","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号