CYFRA 21-1 Protein - a Potential Marker of Endometriosis

Endometrioza je kronična upalna bolest karakterizirana pojavom i rastom endometrija izvan maternice. Etiopatogeneza nije razjašnjena, a postoji više teorija nastanka endometrioze. Patološki procesi prisutni u endometriozi jesu adhezija, invazija, proliferacija, angiogeneza i promijenjena imunost. Moguće je da procesi invazije i proliferacije uzrokuju povećanu sintezu određenih proteina koji se zatim izlučuju urinom. Protein citokeratin 19-9 (CYFRA 21-1) pojačano se izlučuje u urinu pacijentica s endometriozom te je potencijalni marker u ranim stadijima ove bolesti kada nije moguće slikovnim metodama postaviti sumnju na bolest ili ciljanu dijagnozu.Endometriosis is a chronic gynaecological inflammatory disease characterized by the appearance and flourishing of endometrium outside the uterine cavity. The etiopathogenesis is not yet clearly understood. The ongoing pathologic processes are invasion, adhesion, proliferation, angiogenesis, and immune dysfunction. There is a possibility of increased production of proteins caused by proliferation and invasion, that are excreted in the urine. The protein CYFRA 21-1 shows increased production in endometriosis and is a potential marker in the early stages of this disease when it is not possible to suspect the disease or diagnose it with imaging techniques

Complete restoration of fertility in a patient treated for androgen-secreting granulosa cell tumor- Case report

Case report: A 35-yr-old patient suffering from secondary amenorrhea for two years before she was diagnosed. Secondary amenorrhea occurred after the first normal vaginal delivery, and it was initially associated with breastfeeding and a formerly diagnosed thyroid disease. Transvaginal ultrasound confirmed a tumorous mass of the right ovary. Blood hormone tests detected high serum inhibin B and Anti-Müllerian hormone levels and high androgen level with no signs of virilization. Surgical treatment was indicated for a definitive diagnosis of suspected sex cord-stromal tumor. Right-sided laparoscopic salpingo-oophorectomy was performed, and the histopathological analysis confirmed the diagnosis of granulosa cell tumor adult type. The oncological team recommended adjuvant chemotherapy after the operation, but the patient did not give an informed consent. One month after surgical treatment, spontaneous menstrual bleeding occurred with normalization of sex hormone levels and the menstrual cycle. Nine months after surgical treatment, the patient was examined again due to secondary amenorrhea. Ultrasound confirmed a vital intrauterine pregnancy. The pregnancy course was normal, and the patient had a full-term spontaneous vaginal delivery of her second child. Conclusion: Restoration of fertility after a temporary loss due to hormone-secreting granulosa cell tumor is possible after sparing surgical treatment. The role of adjuvant chemotherapy is controversial, particularly in patients with stage I-II disease because of the rarity of this tumor and the absence of prospective randomized studies

Proteins in urine – Possible biomarkers of endometriosis

In the pathogenesis of endometriosis, a number of pathological reactions occur. Proteins secreted in the urine are thought to interact with each other and stimulate the pathological processes in endometriosis. Identifying one or more proteins that are specific enough and could serve as biomarkers for endometriosis is both a challenge and a necessity that would facilitate diagnosis. The urine of patients treated in a tertiary university hospital between July 1, 2020 and June 30, 2021 was analyzed. The studied group consists of patients who were treated surgically for endometriosis and in whom the diagnosis was confirmed by pathohistological analysis. The control group consists of patients who were operated for functional ovarian cysts. Urinary proteins were analyzed by chromatography and mass spectrometry (LC-MS/MS). We identified 17 proteins in urine whose concentrations were statistically significantly different in the group with endometriosis (N = 16) compared with the control groups (N = 16). The detected proteins were classified into groups according to their function in invasion, migration and proliferation, proteolysis, immune system, cell adhesion and vascular system. For all mentioned proteins the difference in concentration is statistically significant p < 0.005. Proteins are secreted in the urine of patients with endometriosis that may be involved in the pathogenesis of the disease and are possible biomarkers for endometriosis