Gynecology Oncology
Hedyeh Mansoori; Mahmoud Shirazi
Articles in Press, Accepted Manuscript, Available Online from 13 March 2024
Abstract
Background & Objective: This research aimed to study the role of the meaning of life in death anxiety and suicidal thoughts in women with cancer.Materials & Methods: The method of this research is correlation. The statistical population of the study included all women with cancer referred to ...
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Background & Objective: This research aimed to study the role of the meaning of life in death anxiety and suicidal thoughts in women with cancer.Materials & Methods: The method of this research is correlation. The statistical population of the study included all women with cancer referred to Tawheed Hospital in Sanandaj City in 1400-1401. The sample size consists of one hundred people selected by purposive sampling. To collect data, Steger's Meaning in Life (MLQ), Templer's Death (DAS), and Beck's Suicidal Thoughts (BSSI) questionnaires were used. SPSS software was used in this research.Results: The information was analized using correlation tests and regression analysis. The regression conclusions showed that the meaning of life has an inverse relationship with suicidal thoughts, and death anxiety has a direct relationship with suicidal thoughts. The Pearson correlation results showed that the meaning of life predicts death anxiety and suicidal thoughts.Conclusion: In general, it can be concluded that the meaning of life plays an instrumental role in the death anxiety and suicidal thoughts of women with cancer.
Gynecology Oncology
Zahra Shiravani; Fatemehsadat Najib; Mahvash Alirahimi; Elham Askary; Tahereh Poordast; Nader Tanideh; Shohreh Roozmeh; Golsa Shekarkhar; Sana Atbaei; danilo porro; Soudabeh Sabetian; Claudia Cava
Articles in Press, Accepted Manuscript, Available Online from 03 September 2023
Abstract
The endometriosis treatment was critical issue due to complications associated with current drug delivery system. Present investigation compared the curative effect of Vitamin D3 (VTD3) and Omega–3 (OG3) with Diphereline during the treatment of endometriosis. Endometriosis was induced in different ...
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The endometriosis treatment was critical issue due to complications associated with current drug delivery system. Present investigation compared the curative effect of Vitamin D3 (VTD3) and Omega–3 (OG3) with Diphereline during the treatment of endometriosis. Endometriosis was induced in different groups containing 60 adult female rats. The rat model is categorized into 6 groups untreated and treated (Olive Oil (solvent), VTD3 (42 mcg/kg/day), OG3 (450 mg/kg/day), VTD3+OG3, Diphereline (3 mg/kg/day)). The suspension containing combination of Diphereline and supplements was injected and treated for 4 weeks to analyses the effect of supplements. The interleukin -6 (IL-6) and Tumor necrosis factor – alpha (TNFα) inflammatory responses were measured from the serum samples while endometrial implants was dissected and histopathological investigation was done. At the end of four weeks pathologic score was decreases significantly with simultaneous measurement of inflammation score of endometriotic lesion, size of implant area, IL-6, TNFα response and compared with untreated female rat. No significant different was observed in groups undergoing treatment of VTD3, OG3 and Diphereline. The combined effect of VTD3+OG3 has similar responses with Diphereline treated endometrial implants. In conclusion, treatment of VTD3 deficiency and making a change in dietary habits of high-risk population for endometriosis from adolescence may also play a preventative role in adulthood.
Gynecology Oncology
Ahmad Shuib Yahaya; Mohd Norazam Mohd Abas; Jamil Omar
Articles in Press, Accepted Manuscript, Available Online from 18 November 2023
Abstract
Objective:
This study aims to analyze the survival outcomes and prognostic factors of patients with uterine sarcoma in the Department of Gynae-Oncology, between June 2015 and December 2022.
Methods:
The study population consists of patients with histopathologically confirmed uterine sarcoma. Oncological ...
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Objective:
This study aims to analyze the survival outcomes and prognostic factors of patients with uterine sarcoma in the Department of Gynae-Oncology, between June 2015 and December 2022.
Methods:
The study population consists of patients with histopathologically confirmed uterine sarcoma. Oncological data collected includes stage, pathological report and type of surgery, adjuvant therapy, recurrence, and mortality. Kaplan-Meier analysis used to estimate survival.
Results:
We identified 58 eligible uterine sarcoma patients: 13 leiomyosarcoma (22.4%), 9 endometrial stromal sarcoma (15.5%), 32 carcinosarcoma (55.2%), 2 adenosarcoma (3.4%) and another 2 were undifferentiated sarcoma (3.4%). Mean age was 56.1 (SD=12.03) and 56% patients were postmenopausal. Majority of patients presented in stage III and IV (53.4%) and only 22 patients (37.9%) in stage I. Adjuvant radiotherapy was given to 21 patients (36.2%); 8 patients (13.8%) received chemotherapy and 9 patients (15.5%) received both radiotherapy and chemotherapy. Median follow up period was 13.5 months (range: 73 months) and total of 35 patients (60.3%) had recurrence with median time to recurrence of 6.0 months (range: 35). Death occurred in 21 patients (36.2%) with median time to death 5.0 months (range: 36 months). Progression free survival (PFS) among all patients was 26.64 (range: 4.32) months with significant correlation with stage of disease. Overall survival (OS) in patients received surgery only, radiotherapy and combine radiotherapy and chemotherapy were 23.3, 54.8 and 62.4 months respectively (p value 0.03).
Conclusion:
Uterine sarcoma is a relatively rare tumor type with worse survival. Multimodality adjuvant treatments showed to improve prognosis in those patients.
Gynecology Oncology
farahnaz farzaneh; Shahla Mirgaloybayat; Abbas Ali Niazi; Marziyeh Ajdary; Javid Dehghan Haghighi; Neda Eslahi; Mohammad Raisi
Articles in Press, Accepted Manuscript, Available Online from 20 November 2023
Abstract
Background & Objective: Endometrial hyperplasia is the primary precursor of endometrial cancer in the female reproductive system, with abnormal uterine bleeding (AUB) being the predominant manifestation of this condition. The purpose of this study was to determine the prevalence of endometrial hyperplasia ...
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Background & Objective: Endometrial hyperplasia is the primary precursor of endometrial cancer in the female reproductive system, with abnormal uterine bleeding (AUB) being the predominant manifestation of this condition. The purpose of this study was to determine the prevalence of endometrial hyperplasia and its correlation with various factors among patients presenting with abnormal uterine bleeding.Materials & Methods: This cross-sectional descriptive-analytical study reviewed the hospital records of all patients with abnormal uterine bleeding admitted to Ali Ebn-e Abi Taleb Hospital in Zahedan from April 2015 to April 2018. Data were analyzed using the SPSS. Results: The prevalence of endometrial hyperplasia was estimated to be 20.3%. The average age of the study subjects was about 45 years. The highest number of patients (37, 52.9%) belonged to the age group of 36-50 years. Among the different types of endometrial hyperplasia observed, the most common was "simple non-atypical hyperplasia" found in 45 patients (64.3%), while the least common was "simple atypical hyperplasia" observed in three patients (4.3%). Overall, "non-atypical hyperplasia" (including both simple and complex types) was present in 58 patients (82.85%). The prevalence of infertility, obesity, hypertension, diabetes, premature menarche, late menopause, family history, oligomenorrhea, and polycystic ovary syndrome (PCOS) was reported in 7.1%, 32.9%, 24.3%, 22.9%, 8.5%, 13.6%, 7.1%, 5.7%, and 3.4% of cases, respectively.Conclusion: women with a history of diabetes, hypertension, and obesity are at an increased risk of developing endometrial hyperplasia. Therefore, it is crucial to evaluate these patients for the presence of endometrial hyperplasia.
Gynecology Oncology
Zahraa Al-Tamimi; Mahmood A. Al Ani
Articles in Press, Accepted Manuscript, Available Online from 11 January 2024
Abstract
Background: Asymptomatic bacteruria is a form of lower urinary tract infections (UTIs) that is significant during pregnancy for its high prevalence, high tendendency for persistence and progression to the other symptomatic forms, besides posing adverse effects on pregnancy through effects on both maternal ...
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Background: Asymptomatic bacteruria is a form of lower urinary tract infections (UTIs) that is significant during pregnancy for its high prevalence, high tendendency for persistence and progression to the other symptomatic forms, besides posing adverse effects on pregnancy through effects on both maternal and fetal morbidity. In this respect, Cranberry has been suggested in the prevention and sometimes treatment with a big conflict in results and recommendations.
Materials & Methods: In our study we tried to search its role in treatment and prevention using capsules rather than juices (the most common form in previous studies) and comparing results of its use alone versus combined with antibiotics on the outcome.
Results: Results showed that it is less effective than antibiotics in the treatment ( 56% versus 88% cure rate) (X2: 6.3492; df=l; P value =0.01174), closely effective to them in prevention (26.7% recurrence on cranberry versus 12.5% on antibiotic) (X2:0.9954;P value=0.3184), but reducing the cure rate when used in combination with antibiotics in treatment versus antibiotics alone ( 28.6% versus 57.1% response) (X2=1.1667; P value = 0.2801). Regarding the most commonly reported side effects: headache was supervening consistent with reports in previous studies, whereas gastrointestinal upset commonly experienced in cranberry juice was reported in only (8%) of study cases.
Conclusion: In view of results we recommend using cranberry especially in what seems to be less harmful formulation (capsules) in the prevention of asymptomatic bacteruria in pregnant population and discourage using it in the treatment whether alone or in combination with antibiotics.
Gynecology Oncology
Aida Uzaya; Syahrul Rauf; Trika Irianta; Firdaus Hamid; John Rambulangi; Abdul Rahman
Articles in Press, Accepted Manuscript, Available Online from 12 February 2024
Abstract
Background and Aim: Ovarian cancer affects women worldwide. Immunoregulatory cytokines, particularly interleukin (IL)-6, can enhance tumorigenicity and are persistently secreted by ovarian cancer cells. This study aims to examine IL-6 as a marker of preoperative epithelial ovarian malignancy.
Methods: ...
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Background and Aim: Ovarian cancer affects women worldwide. Immunoregulatory cytokines, particularly interleukin (IL)-6, can enhance tumorigenicity and are persistently secreted by ovarian cancer cells. This study aims to examine IL-6 as a marker of preoperative epithelial ovarian malignancy.
Methods: This study used a cross-sectional design on 81 eligible patients with ovarian neoplasms who were undergoing surgery at the Dr. Wahidin Sudirohusodo Hospital and its networking hospital from October 2021 to June 2022. The ELISA technique was used to measure serum IL-6 from the peripheral vein. In addition, the CA-125 levels, risk of malignancy (RMI) index, and proportion of blood cells were analyzed. Chi-square analysis of the data had been used.
Results: Most of the subjects were presented as malignant ovarian neoplasms (66.7%), followed by benign ovarian neoplasms (33.3%). IL-6 level ≥ 3.75 pg/mL was found in 72.8% of patients. In individuals with epithelial ovarian neoplasms, IL-6 levels did not significantly differ between malignant and benign types (p > 0.05). CA-125 levels, RMI, ascites, and tumor size differed significantly in patients with ovarian epithelial neoplasms between malignant and benign types (p <0.05). Leukocyte levels, hemoglobin levels, platelet levels, age, parity, and age of menarche were not significantly different in epithelial ovarian neoplasm patients between malignant and benign types (p > 0.05).
Conclusion: The preoperative serum IL-6 level cannot be used as a marker of ovarian malignancy. However, this study confirms the relationship between the CA-125 level, RMI, ascites, and tumor size with the malignancy of ovarian tumors.
Gynecology Oncology
Fatemeh Sedaghat; zahra Shiravani; Ali Mohammad Karimi; Mohammad Reza Haghshenas; Abbas Ghaderi; Mohammad Javad Fattahi
Articles in Press, Accepted Manuscript, Available Online from 02 March 2024
Abstract
Objective: Endometrial cancer (EC) is the most prevalent gynecological malignancy in more developed countries. Multiple researches have been done about the role of IL-27 in different cancers that suggest a dual role for this cytokine. In the present study, we evaluated the serum level of IL-27 in endometrial ...
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Objective: Endometrial cancer (EC) is the most prevalent gynecological malignancy in more developed countries. Multiple researches have been done about the role of IL-27 in different cancers that suggest a dual role for this cytokine. In the present study, we evaluated the serum level of IL-27 in endometrial cancer patients. We also investigated the correlations between serum levels of IL-27 and the demographic and clinicopathologic features of the patients.
Material and Method: In this case-control study 65 endometrial cancer patients and 58 sex-age-match healthy controls were investigated. Serum levels of IL-27 in both cases and the control group were assessed by a reliable and specific sandwich enzyme-linked immunosorbent assay (ELISA) kit and results were analyzed with SPSS.
Results: We observed that the serum level of IL-27 in EC patients was dramatically higher than in the control group (P=0.003). Additionally, Higher grades of EC (grade II and III) showed higher IL-27 serum levels compared to the control (P=0.006 and P=0.01 respectively). No significant correlations between serum levels of IL-27 and lymph node involvement, tumor stage, tumor size, and demographic features of the patients were detected.
Conclusion: Our results showed that there is a statistically significant difference between serum levels of IL-27 in EC patients and controls. Therefore, the serum level of IL-27 may exert a role in the pathogenesis of endometrial carcinoma although further studies are needed.
Gynecology Oncology
Maha Saad Maki; Mohammed S. Ali; Hala Rawi
Articles in Press, Accepted Manuscript, Available Online from 03 March 2024
Abstract
Background: assess the level of serum Macrophage inhibitory cytokine-1 and high sensitive C - reactive protein level in the first trimester threatened miscarriage.Method: We conducted a case-control study on 91 pregnant women who were in their first trimester and had a positive fetal heart confirmed ...
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Background: assess the level of serum Macrophage inhibitory cytokine-1 and high sensitive C - reactive protein level in the first trimester threatened miscarriage.Method: We conducted a case-control study on 91 pregnant women who were in their first trimester and had a positive fetal heart confirmed by ultrasound. On the same day, a serum sample was taken to measure the levels of macrophage inhibitory cytokine-1 and high-sensitivity C-reactive protein using an enzyme-linked immunosorbent assay and particle-enhanced immunoturbidimetric assay, respectively. The study grouped the participants into two categories: control and patient.Result: We conducted a study with 91 pregnant women, out of which 30 had symptoms of threatened miscarriage such as vaginal spotting or bleeding, while the remaining 61 were healthy. In our study, we found that the concentration levels of serum Macrophage inhibitory cytokine-1 varied significantly between the two groups (control and patient groups) with a P-value of 0.005. The mean concentration for the control group was 622.77 ± 15.10, while for the patient group, it was 1860.13 ± 33.60. Additionally, we observed that high-sensitivity c-reactive protein (HS CRP) had a significant correlation with threatened miscarriage, with a P-value of 0.001. The mean concentration for the control group was 7.49 ± 0.89, while for the patient group, it was 16.02 ± 2.11.Conclusion: The results of this study provide valuable insights into the pathophysiology of miscarriage and may pave the way for the development of novel therapeutic interventions to prevent this adverse pregnancy outcome.
Gynecology Oncology
elham sharafkhani
Articles in Press, Accepted Manuscript, Available Online from 13 March 2024
Abstract
Ovarian Low-grade serous carcinoma (LGSC), a type of epithelial ovarian tumor, is often diagnosed in the advanced stage, arising from fallopian tube cells or borderline tumors that cause symptoms like abdominal or pelvic pain, bloating, and unexplained weight loss. Treatment involves surgery and chemotherapy. ...
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Ovarian Low-grade serous carcinoma (LGSC), a type of epithelial ovarian tumor, is often diagnosed in the advanced stage, arising from fallopian tube cells or borderline tumors that cause symptoms like abdominal or pelvic pain, bloating, and unexplained weight loss. Treatment involves surgery and chemotherapy. Fertility may be affected depending on the cancer stage. In advanced stages (3 and 4), removing all tumoral implants with both the uterus and ovaries (debulking surgery) may be the first surgical goal, and it can be anticipated that the possibility of pregnancy will be diminished. We presented a case of a 38-year-old woman who became pregnant three years after being diagnosed with LGSOC at stage 3c. Although the standard surgery at a higher stage is debulking surgery and we resected all tumoral implants, the decision was made to preserve the uterus for her since there were no signs of tumor metastasis to the uterus, and the patient wanted to be pregnant. The patient underwent surgery then followed by a standard chemotherapy regimen with carboplatin (AUC 6) and paclitaxel (175 mg/m2) every three weeks for four cycles. During the three years of follow-up, there were no signs of tumor return; she decided to get pregnant by egg donation through an in vitro fertilization (IVF) procedure. She received routine supplements during her pregnancy with the incidence of gestational diabetes and HTN. A cesarean section was done in the week 35th, and the twin infants were born in good condition and with good APGAR scores.
Gynecology Oncology
Kavitha Nagandla; Khine Khine Lwin; Phyu Synn Oo; Thin Thin Win; Afshan Sumera
Articles in Press, Accepted Manuscript, Available Online from 13 March 2024
Abstract
Background and Objective: The management of cervical cancer during pregnancy is significantly challenging. This systematic review summarises the current data on chemotherapy agents (platinum and taxanes) in the management of cervical cancer during pregnancy.
Methods: Two independent investigators searched ...
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Background and Objective: The management of cervical cancer during pregnancy is significantly challenging. This systematic review summarises the current data on chemotherapy agents (platinum and taxanes) in the management of cervical cancer during pregnancy.
Methods: Two independent investigators searched the literature and extracted data from all studies that examined the efficacy and safety of platinum and taxanes in managing cervical cancer during pregnancy. A quantitative synthesis of the published articles was performed and Kaplan–Meier survival curves were estimated to determine the overall and progression-free survival.
Results: Overall, 43 studies with 114 patients were included in this systematic review. All patients received neoadjuvant chemotherapy during pregnancy; the majority received platinum-based chemotherapy. Cisplatin was the main platinum-based chemotherapy agent in 49% (n = 56) of patients, followed by combined platinum and paclitaxel therapy in 36% (n = 41) of patients. A few and two patients were treated with single-agent vincristine and platinum with external beam radiation therapy, respectively. Bleomycin and 5-fluorouracil were administered to two patients. The most frequent complications were grade 2 thrombocytopenia and grade 3 hepatotoxicity in 32 (28%) and 18(20.5%) cases, respectively. The common fetal complications were low birth weight and growth restriction. Chemotherapy was well tolerated by most women in the case group. The progression-free survival was 35% (n = 22).
Conclusion: Platinum and taxane neoadjuvant chemotherapy has proven to be safe and effective in preventing cervical cancer disease progression until definitive surgical treatment.
Gynecology Oncology
Ganesalingam Murali; CheeMeng Yong; Nagandla Kavitha; Chew Hua Yeoh
Articles in Press, Accepted Manuscript, Available Online from 26 March 2024
Abstract
Pelvic exenteration (PE) is a surgical procedure that requires an en-bloc excision of lower abdominopelvic structures. Despite its high morbidity, PE is most indicated for treatment of advanced primary or locally recurrent pelvic cancers. We aim to evaluate our experience with PE for patients with gynaecological ...
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Pelvic exenteration (PE) is a surgical procedure that requires an en-bloc excision of lower abdominopelvic structures. Despite its high morbidity, PE is most indicated for treatment of advanced primary or locally recurrent pelvic cancers. We aim to evaluate our experience with PE for patients with gynaecological cancers over 8 years from January 2011 to 31 December 2019 that were identified through hospital databases. Patient demographic characteristics, indications, surgical characteristics and outcomes were retrospectively assessed. Overall survival (OS) was analysed with Kaplan-Meier method and log rank test. Cox proportional hazards regression was used to model survival outcomes. Twenty- one patients were identified with recurrent cervical, endometrial, ovarian and, or vaginal cancer underwent PE. Local disease recurrence was the most common indication in 80.9%. The primary tumor origin was the cervix in 80.9%, followed by endometrial origin 9.5%. PE was performed as curative intent in 62% and in 38% as palliative intent. The most common early complication was wound infections and late complications included deep vein thrombosis, lymphocyst and recurrent urinary tract infections. The median survival at 6 months is 85.7% and 12 months is 57.1 %. Our five-year OS was 54.3 % (95% CI 34.2, 74.6). Our case series illustrates pelvic exenteration provides about 54.3% of 5-year survival chance in a selected group of patients. The early-and late complications rate are similar to those described historically. Pelvic exenteration results in sustained survival in selected patients and continued efforts must focus on identifying those patients who could potentially benefit most from PE.
Gynecology Oncology
Mervet B. Jasim; Asmaa B. Al-Obaidi; Enas Adnan Abdulrasul
Articles in Press, Accepted Manuscript, Available Online from 12 April 2024
Abstract
Background: The infection can present in newborns in different ways, ranging from no noticeable symptoms to more serious conditions like meningoencephalitis, myocarditis, and disseminated sepsis.Methods: A cross-sectional study was conducted from November 2022 to June 2023. The study included 100 pregnant ...
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Background: The infection can present in newborns in different ways, ranging from no noticeable symptoms to more serious conditions like meningoencephalitis, myocarditis, and disseminated sepsis.Methods: A cross-sectional study was conducted from November 2022 to June 2023. The study included 100 pregnant women with gestational ages ranging from 0 to 16 weeks, aged between 15 and 40 years. Each participant completed a standardized questionnaire. Afterward, placental tissue samples were collected from women who underwent elective termination of pregnancy. These samples were then analyzed for the presence of Coxsackievirus B (CVB) genome using a molecular biology approach. The detection process involved RNA extraction, cDNA, and qRT-PCR.Results: A total of 100 women who had abortions were included in this study. Out of these, 88 had missed abortions, 10 had incomplete abortions, and 2 had spontaneous abortions. The mean ages of the women were as follows: 28±2.8 years for missed abortions, 29±1.5 years for incomplete abortions, and 32±0.5 years for spontaneous abortions. The mean gestational ages were 10±1.1 weeks for missed abortions, 10±1.5 weeks for incomplete abortions, and 14 weeks for spontaneous abortions. Our investigation found no presence of Coxsackie B virus nucleic acid in the placental tissues obtained from the women who had abortions. The internal control (quality control) and positive control both yielded positive results.Conclusion: Despite the assay's high sensitivity for accurate detection, the study produced only null findings. These negative results are likely to be true negatives, indicating the absence of the target analyte.
Gynecology Oncology
Ali D. Marhash; Mohammed S. Abdul-Razaq; Milal Muhammad AL-Jeborry; Wisam Jasim; Safa Khaleel khalaf
Articles in Press, Accepted Manuscript, Available Online from 13 April 2024
Abstract
Background and objective: Worldwide, cervical cancer stands as the leading cause of cancer-related fatalities. Cervical cancer is unequivocally attributed to the human papillomavirus (HPV) infection, which is both essential and adequate for its development. The particular prevalence of HPV in the population ...
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Background and objective: Worldwide, cervical cancer stands as the leading cause of cancer-related fatalities. Cervical cancer is unequivocally attributed to the human papillomavirus (HPV) infection, which is both essential and adequate for its development. The particular prevalence of HPV in the population of Iraq is currently unclear. The objective of this study is to determine the frequency of HPV and identify the most common genotypes present in a sample of the Iraqi population. Materials and Methods: From November 2022 to December 2023, a total of 300 women with cervical anomalies, who were referred to the Gynecological Oncology Departments in multiple hospitals in Babylon and Baghdad, had cervical swabs collected. Real-time polymerase chain reaction was utilized to conduct HPV DNA testing on all specimens.Result: A total of 300 women between the ages of 20 and 60 were screened during the collecting period. The average age was 30 years. The prevalence of High-risk HPV was 16.7% overall. The age group of women between 30 and 40 years exhibited the highest overall prevalence of HPV. Our population survey indicates a higher prevalence of genotyping for HPV 16, 18, and 31.Conclusion: In this work, we used multiplex real-time pcr. This approach has numerous advantages, including HPV detection and genotyping to known prevalent genotypes as well as cost effective and no time consuming.
Gynecology Oncology
Pegah Sasanpour; Marzieh Ghasemi; Maryam Nazemian; Narjes Noori; Hossein Ansari
Volume 9, Issue 2 , March and April 2024, , Pages 150-153
Abstract
Background & Objective: Endometrial cancer is the most prevalent type of genital system cancers. It is needed to assess discrimination power of CEA, CA 15-3, CA 125 tumor markers in endometrial cancer patients and moreover in cases with abnormal uterine bleeding. We examined tumor markers (CA 15-3, ...
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Background & Objective: Endometrial cancer is the most prevalent type of genital system cancers. It is needed to assess discrimination power of CEA, CA 15-3, CA 125 tumor markers in endometrial cancer patients and moreover in cases with abnormal uterine bleeding. We examined tumor markers (CA 15-3, CA 125, CEA) in differentiating endometrial cancer and unusual uterine bleeding.
Materials & Methods: The present case-control study was conducted on 60 women with endometrial cancer and evidence of abnormal uterine bleeding who referred to Ali Ibn Abitaleb Hospital in Zahedan in 2021. The sampling method was easy and accessible and was used to collect observation information, examination, and data form data. For data analysis, SPSS software version 26, statistical graphs and independent t-test were used.
Results: The difference in serum levels of CEA marker tumor in patients of case (endometrial cancer patients) and control (abnormal uterine bleeding patients) was statistically significant. Differences in serum levels of CA 15-3 tumor marker in patients between case group (endometrial cancer patients) and control (patients with abnormal uterine bleeding) and difference in serum levels of CA 125 tumor marker in patients between case (endometrial cancer patients) and control groups (bleeding patients) uterine abnormalities were not statistically significant.
Conclusion: Serum level of CEA tumor marker has a statistically significant relationship with endometrial cancer patients and abnormal bleeding patients, but serum tumor marker level CA 15-3 and serum tumor marker CA 125 and with endometrial cancer patients and abnormal bleeding patients do not have.
Gynecology Oncology
Jorge Cea García; Francisco Márquez Maraver; Inmaculada Rodríguez Jiménez; Laura Ríos-Pena; M. Carmen Rubio Rodríguez
Volume 9, Issue 2 , March and April 2024, , Pages 185-200
Abstract
Background & Objective: We aimed to compare sexual function and body image among cervical cancer survivors.Materials & Methods: Between August 1, 2016 and January 31, 2019, we conducted a prospective study with 104 participants. The FSFI and the FACT-Cx v.4.0 (B4 and C7) were the measurement ...
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Background & Objective: We aimed to compare sexual function and body image among cervical cancer survivors.Materials & Methods: Between August 1, 2016 and January 31, 2019, we conducted a prospective study with 104 participants. The FSFI and the FACT-Cx v.4.0 (B4 and C7) were the measurement tools.Results: Forty–seven and twelve hundredths percent reported sexual activity, with the surgical group considerably less sexually active than the non-surgical group (63% vs. 100%, P=0.0003). Throughout the follow-up, we found no significant changes in sexual function (P>0.05). A diagnosis of sexual dysfunction was made in 60.58% of cervical cancer survivors, 80.65% following surgery alone, and in 100% after radiotherapy and chemotherapy. In comparison with survivors who did not receive radiotherapy, irradiated survivors had lower FSFI total scores (1.2 vs. 21.4, P T1=0.0001; 2.1 vs. 21.75, P T2=0.0002). In comparison with the non–chemotherapy group, the chemotherapy group's scores were considerably lower (1.2 vs. 21.15, P T1 <0.0001; 2.4 vs. 18.95, P T2=0.004). We detected no significant changes in body image scores (P=0.184). Except for T1 time assessment (2 vs. 3, P T1=0.016), no differences in body image between the surgical and non-surgical groups were found throughout the follow-up (P T2=0.992; P T3=0.207; P T4=0.139).Conclusion: The rate of female sexual dysfunction was 60.58%, prevailing after therapeutic multimodality, radiotherapy, and chemotherapy. Throughout the follow–up, we discovered no significant changes in sexual activity and function, or in body image. In terms of body image, there were no significant differences between the surgical and non–surgical groups.
Gynecology Oncology
Jorge Cea García; M. Carmen Rubio Rodríguez; Francisco Márquez Maraver; Laura Ríos-Pena; Inmaculada Rodríguez Jiménez
Volume 9, Issue 2 , March and April 2024, , Pages 201-211
Abstract
Background & Objective: Sexual dysfunction is the symptom with the greatest negative impact on the quality of life of cervical cancer survivors. However, the evaluation of sexual function is challenging, and there is ongoing debate concerning its determinants. We aimed to identify predictive variables ...
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Background & Objective: Sexual dysfunction is the symptom with the greatest negative impact on the quality of life of cervical cancer survivors. However, the evaluation of sexual function is challenging, and there is ongoing debate concerning its determinants. We aimed to identify predictive variables for sexual function after cervical cancer treatment.Materials & Methods: One hundred and four cervical cancer survivors participated in a prospective cohort study that we carried out employing FACT–Cx v.4.0 and FSFI questionnaires.Results: We developed a beta generalized linear model with a predictive accuracy of 78% (C–index=0.78) and based on vaginal shortening (Cx4) (P=0.077), age (P=0.0002), and ovarian preservation (P=0.01) as risk factors, and functional well–being (P<0.0001) and follow–up duration (P=0.015) as protective factors.Conclusion: To the best of our knowledge, we may have created the first reliable and internally validated prediction model for cervical cancer survivors based on predictors like vaginal shortening, age, ovarian preservation, functional well–being, and follow–up duration that significantly affect female sexual function as targets for potential intervention.
Gynecology Oncology
Farah Farzaneh; Shaghayegh Hooshmand Chayijan; Hanieh Najafi Arab; Farima Rahimi Mansour; Amirreza Keyvanfar; Zahra Bakhtiyari
Volume 9, Issue 1 , January and February 2024, , Pages 45-52
Abstract
Background & Objective: Uterine fibroids (UFs) are the most common pelvic tumors among women at reproductive age, affecting women’s quality of life even their confidence with its symptoms. We designed a study to investigate the clinical, laboratory, and imaging characteristics of Iranian ...
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Background & Objective: Uterine fibroids (UFs) are the most common pelvic tumors among women at reproductive age, affecting women’s quality of life even their confidence with its symptoms. We designed a study to investigate the clinical, laboratory, and imaging characteristics of Iranian women with UF.Materials & Methods: This cross-sectional study was performed from April 2016 to September 2022 at Imam Hossein hospital (Tehran, Iran). We included all women with UF referring to the Obstetrics and Gynecology Clinic of Imam Hossein Hospital. Based on a checklist, a research team interviewed the patients to investigate clinical characteristics. Also, we explored laboratory and transvaginal sonography (TVS) findings of all patients.Results: The mean age of 439 studied patients was 44.47±8.80 years (range: 23-81). The most prevalent underlying disease was hypertension (17.1%), followed by thyroid diseases (15.7%) and diabetes mellitus (13.7%). The patients mainly complained of AUB (abnormal menstrual bleeding) (60.0%) and abdominal pain (23.7%). The mean NLR (neutrophil to lymphocyte ratio) and the mean PLR (platelet to lymphocyte ratio) were significantly higher than the normal upper limit (P<0.001). The largest diameter of UF was 49.89±47.92 mm. Most fibroids were located anteriorly (43.1%). The multivariate linear regression model revealed that age (β=-0.931, 95%CI= (-1.657, -0.204), P=0.012) and number of fibroid (β=22.418, 95%CI= (16.360, 28.476), P<0.001) could predict the size of fibroid.Conclusion: Our results showed that NLR and PLR were increased in UF patients. It seems that patient’s age and number of fibroids may be the predictive factors for UF's size.
Gynecology Oncology
Forozan Milani; Seyedeh Hajar Sharami; Negar Gholamalipour; Ehsan Kazemnezhad Leyli; Seyedeh Fatemeh Dalil Heirati; Yalda Donyaei-Mobarrez
Volume 9, Issue 1 , January and February 2024, , Pages 53-62
Abstract
Background & Objective: Evaluation of the alpha-fetoprotein is one of the screening tests during pregnancy. The purpose of this study was to determine the relationship between the level of alpha-fetoprotein in amniotic fluid (AF-AFP) and adverse pregnancy outcomes.Materials & Methods: This ...
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Background & Objective: Evaluation of the alpha-fetoprotein is one of the screening tests during pregnancy. The purpose of this study was to determine the relationship between the level of alpha-fetoprotein in amniotic fluid (AF-AFP) and adverse pregnancy outcomes.Materials & Methods: This comparative analytical study was performed on 244 pregnant women who referred to a private prenatal clinic in Rasht (Iran). Amniocentesis was performed on pregnant women with maternal serum alpha-fetoprotein (MS-AFP) was higher than 2.5MoM in the second trimester and based on this finding, participants were divided into four groups of 61 patients. The first group (control group) included pregnant women with normal MS-AFP, the second group included pregnant women with high MS-AFP and normal AF-AFP, the third group included pregnant women with high MS-AFP and low AF-AFP and the fourth group included pregnant women with high MS-AFP and high AF-AFP.Results: Adverse outcomes include abortion (6.6%), stillbirth (6.6%), IUGR (18%), LBW (29.5%), PTL (21.3%), fetal abnormalities (4.9%), preeclampsia (14.8%), gestational diabetes (8.2%), in the fourth group (high AF-AFP) was higher than other groups. The incidence of adverse pregnancy outcomes in the fourth group was 1.2 times higher than the control group, and this relationship was borderline statistically significant (P=0.056).Conclusion: Considering that adverse pregnancy outcomes are important causes of mortality and morbidity, early diagnosis of high-risk pregnancies and efforts for preventive interventions can be associated with reducing mortality and morbidity. Therefore, evaluation of the level AF-AFP can be helpful in determining adverse pregnancy outcomes.
Gynecology Oncology
Farah Farzaneh; Elnaz Ghaffari; Maryam Sadat Hosseini; Tahereh Ashraf Ghanjouee; Afsaneh Hosseini
Volume 8, Issue 6 , November and December 2023, , Pages 571-578
Abstract
Background & Objective: High-risk (HR) HPV infection is the major cause of cervical cancer, which is still one of the most common cancers among women. Based on some not-published results, it seems that some of the other HR HPVs might be as important as HPV 16, and 18 in developing high-grade ...
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Background & Objective: High-risk (HR) HPV infection is the major cause of cervical cancer, which is still one of the most common cancers among women. Based on some not-published results, it seems that some of the other HR HPVs might be as important as HPV 16, and 18 in developing high-grade CIN. This study was conducted to determine the relationship between Other HPV and high-grade CIN.Materials & Methods: In this prospective study from 2019 to 2022 (approved by the ethics committee), all women with positive HPV based on the COBAS method were invited to participate in the study (N=646). For all the patients, colposcopy was done, and then the liquid-based samples of women with Other HPV positives were reanalyzed by HPV typing.Results: All the patients who were infected with HPV18 were involved in CIN1. On the other hand, 50% of patients who were infected with HPV18 were involved in CIN2. 50% of patients with HPV45 were involved in CIN2. There is also a significant relationship between HPV31 and CIN3.Conclusion: Because in our study there was a significant relationship between CIN3 and HPV31; and CIN2 with HPV45, and in the COBAS method, HPV31 and HPV45 are only reported under the general title of Other HPV, because of the possibility of the importance of other HPV with high-grade neoplasias, it is recommended to analyze the other HPV with HPV typing. Further studies are needed to confirm our findings.
Gynecology Oncology
May Kassim Khalaf; Fadia J Alizzi; Ammar Mohammed Qassim
Volume 8, Issue 6 , November and December 2023, , Pages 599-606
Abstract
Background & Objective: Gonadotropin-releasing hormone acts on the anterior pituitary and promotes the release of both follicle-stimulating hormone (FSH) and luteinizing hormone (LH), both of great importance in the ovarian cycle.Materials & Methods: In a prospective cross-sectional ...
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Background & Objective: Gonadotropin-releasing hormone acts on the anterior pituitary and promotes the release of both follicle-stimulating hormone (FSH) and luteinizing hormone (LH), both of great importance in the ovarian cycle.Materials & Methods: In a prospective cross-sectional study conducted at the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies / Al-Nahrain University and Kamal Al-Sameraie Hospital for Infertility and In Vitro Fertilization, Baghdad, Iraq during the period from April 2022 to April 2023, women received rFSH in a single daily dose of (150-300 IU) for ovarian stimulation. Women in groups B and C received ovarian stimulation antagonists, while those in group A did not.Results: Both clinical and ongoing pregnancy rates were measured for each group. A positive hCG test was found in 27 (79.4%) in Group A while it was positive in 19 (55.9%) in Group B with a significant difference (P=0.03), clinical pregnancy was 25 (73.5%) in Group A while it was positive in 17 (50.0%) in Group B with a significant difference (P=0.04), and ongoing pregnancy was found in 24 (70.6%) in Group A while it was positive in 15 (44.1%) in Group B with significant difference (P=0.01).Conclusion: Women with LH <4 IU presented with a significantly higher pregnancy rate than those with ≥4 IU, and do not need GnRH antagonist addition as co-treatment.
Gynecology Oncology
Isha Nandal; Roopa Malik; Krishna Dahiya
Volume 8, Issue 6 , November and December 2023, , Pages 633-636
Abstract
Primary fallopian tube carcinoma is a very rare gynecological malignancy and poses a challenge in diagnosis preoperatively. We are reporting a rare case of bilateral primary fallopian tube carcinoma in a 48-year-old lady with classical symptoms. These symptoms are seen in less than 15% of cases. The ...
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Primary fallopian tube carcinoma is a very rare gynecological malignancy and poses a challenge in diagnosis preoperatively. We are reporting a rare case of bilateral primary fallopian tube carcinoma in a 48-year-old lady with classical symptoms. These symptoms are seen in less than 15% of cases. The differential diagnosis for bilateral fallopian tube cancer includes secondary malignancies arising from endometrial, ovarian and gastrointestinal cancers. Although the prognosis is poor. Early diagnosis, optimum cytoreduction and adjuvant chemotherapy are important to improve survival in such patients.
Gynecology Oncology
Mastaneh Sanei; Hamidreza Dehghan; Nadereh Behtash
Volume 8, Issue 6 , November and December 2023, , Pages 645-649
Abstract
Non-Hodgkin lymphomas are a heterogeneous group of lymphoproliferative disorders with various behaviors and responses to treatment. As a primary extranodal NHL, the disease must be confined to one location, and bone marrow should not be involved. Primary uterine cervix lymphoma is a rare malignancy as ...
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Non-Hodgkin lymphomas are a heterogeneous group of lymphoproliferative disorders with various behaviors and responses to treatment. As a primary extranodal NHL, the disease must be confined to one location, and bone marrow should not be involved. Primary uterine cervix lymphoma is a rare malignancy as well as a rare site of extranodal lymphoma. Because of the rarity of the disease, there is no standard treatment guideline for women with primary uterine cervix lymphoma. Patients mostly present with abnormal uterine bleeding, vaginal discharge or pelvic pain. Typically, a pap smear may not show the malignant cells in the specimen. When the diagnosis is made, management may be debated due to its rarity and lack of standard treatment. Surgery, chemotherapy, chemo-immunotherapy and radiotherapy, either alone or in combination, are the treatment options. Most patients respond well to chemotherapy and radiation therapy. The prognosis is usually favorable. Here, we report a case of primary cervical lymphoma in a 50-year-old woman who presented with abnormal vaginal bleeding. She was treated with radiotherapy and chemo-immunotherapy and remained disease-free after nine months of treatment.
Gynecology Oncology
Roya Dolatkhah; Mehrnaz Hosseinalifam; Zohreh Sanaat; Neda Dolatkhah; Saeed Dastgiri
Volume 8, Issue 5 , September and October 2023, , Pages 422-430
Abstract
Breast cancer (BC) was the most common cancer in Iran, accounting for 12.9% of all incident cancer, and was the 5th leading cause of cancer death in 2020. The latest age standardized incidence rate (ASIR) of breast cancer was 35.8 in Iran and is expected to increase to more than 70 per 100,000 by the ...
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Breast cancer (BC) was the most common cancer in Iran, accounting for 12.9% of all incident cancer, and was the 5th leading cause of cancer death in 2020. The latest age standardized incidence rate (ASIR) of breast cancer was 35.8 in Iran and is expected to increase to more than 70 per 100,000 by the end of 2030. Incidence of breast cancer had a clustering pattern in Iran, while central provinces had the highest ASIR (72 per 100,000 population), and South East provinces had the lowest ASIR (5-11 per 100,000 population). Numerous studies have shown that the peak incidence of breast cancer was occurred in the age group of 40-49 years in Iran. There has also been reported a rapid increase in the incidence in young women from different regions of the country. Known molecular and cellular processes involved in the development of breast cancer in Iranian BCs have been reported from various studies in recent decades, and the most well-known and prominent genes susceptible to breast cancer were BRCA1 and BRCA2. They acted as tumor suppressor genes and inherited mutations leading to chromosomal instability. However, non-coding RNAs, epigenetic alterations, signaling pathways, immune responses, and antioxidant-related genes are the main molecular processes associated with the progression of breast cancer among Iranian patients. While we are facing a significant increase in the incidence of breast cancer, with a lower survival rate, breast cancer is currently considered as one of the major health problems in Iran, which emphasizes the importance of providing and designing prevention and early detection program of breast cancer.
Gynecology Oncology
Batool Hossein Rashidi; Marjan Ghaemi; Ensieh Shahrokh Tehrani; Marzieh Mohebbi; Marzieh Savari
Volume 8, Issue 5 , September and October 2023, , Pages 446-456
Abstract
Background & Objective: Preserving fertility in women with cancer before therapeutic interventions is very important. This study was evaluating the 8 years’ experience of an onco-fertility center from 2013 to 2020 on fertility preservation and its outcomes in female cancer survivors.Materials ...
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Background & Objective: Preserving fertility in women with cancer before therapeutic interventions is very important. This study was evaluating the 8 years’ experience of an onco-fertility center from 2013 to 2020 on fertility preservation and its outcomes in female cancer survivors.Materials & Methods: Participants were females with an approved cancer diagnosis of reproductive ages that were referred for fertility preservation. After proper counseling by an expert team, the final decision on the fertility preservation method was made based on the patient's condition and survival expectation. The primary goal was to collect data about the fertility, clinical and survival outcomes of these women and pregnancy rate as a secondary objective that were compared between cancer types.Results: Totally 337 participants were recruited with a mean±SD age of 30.7±6.6 years. Gynecological cancers accounted for 166 (49.3%) of all cases followed by breast (107 (31.8%)) and other cancers (64 (19.0%)) respectively. Of those, 144 (42.7%) cases entered into the ovulation induction cycle and the others did not continue due to lack of correct information and late referral, and inability to postpone treatment as the major reasons. Comparing between 3 groups (gynecological, breast and other cancers), a higher rate of pregnancy otherwise not statistically different was detected in gynecological cancer survivors. In the breast cancer survivors, the chance of oocyte retrieval and fertility was not lower than in other cancers.Conclusion: Many patients and even their therapists are unfamiliar with the methods of fertility preservation, and when they consider it, the golden time is usually passed. Therefore, having a good consultation with the survivors and patient education may be the most important issue that led to a timely referral for preserving fertility in cancer patients.
Gynecology Oncology
Behnaz Nouri; Malihe Arab; Nazli Najeddin Choukan
Volume 8, Issue 5 , September and October 2023, , Pages 494-500
Abstract
Background & Objective: Endometriosis is a common and benign disease of the female genital system, which is often seen in reproductive age and leads to infertility, dysmenorrhea, and dyspareunia. The aim of this study is to investigate the anatomical location and characteristics of endometriosis ...
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Background & Objective: Endometriosis is a common and benign disease of the female genital system, which is often seen in reproductive age and leads to infertility, dysmenorrhea, and dyspareunia. The aim of this study is to investigate the anatomical location and characteristics of endometriosis lesions in laparoscopic surgery.Materials & Methods: In this cross-sectional study, 557 endometriosis patients who referred to the gynecology department of Shohadaye-Tajrish Hospital and underwent laparoscopic surgery during 2016-2021 were evaluated. Statistical analysis of data was done using SPSS software version 24.P-value less than 0.05 was considered statistically significant level.Results: The results of this study show that the highest anatomical distribution of endometriosis lesions was ovarian endometriosis, and the lowest was vagina. Also, the highest rate of surface lesions is uterus and bladder, and the lowest is superficial lesions of the cul-de-sac cyst.Conclusion: Our results demonstrate that the distribution of endometriosis lesions is asymmetric.
