Clinicopathological and survival characteristics of mismatch repair status and PD-1 expression in serous ovarian cancer

Objective: To evaluate the clinicopathological characteristics of mismatch repair (MMR) deficiency and its clinical outcomes by performing immunohistochemistry (IHC) for MMR genes in the serous ovarian cancer (SOC) tumour sections.Study Design: A retrospective case-control study. Place and Duration of the Study: Gynecology Department of Kanuni Sultan Suleyman Training and Research Hospital, and Department of Medical Oncology of Medipol University, between March 2001 and January 2020. Methodology: IHC was carried out for MLH1, MSH2, MSH6, and PMS2 on full-section slides from 127 SOCs to evaluate the MMR status. MMR-negative and MMR-low groups together were defined as MMR deficient and called microsatellite instability-high (MSI-H). The MSI status and expression of programmed cell death-1 (PD-1) were compared in SOCs with different MMR statuses. Results: A significantly higher frequency of MMR-deficient SOCs was diagnosed at early stages compared with the patients in the MSS group (38.6% and 20.6%, respectively, p=0.022). The frequency of cases with PD-1 expression was significantly higher in the MSI-H group (76.2%) than in the MSS counterparts (58.8%, p=0.028). Patients in the MSI-H group had significantly longer DFS (25.6 months) and OS (not reached) than those in the MSS group (16 months and 48.9 months, p=0.039 and p=0.026, respectively).Conclusion: MSI-H SOCs were diagnosed at an earlier stage as compared to MMR proficient cases. The presence of PD-1 expres-sion was significantly higher in cases presenting MMR deficiency compared with MMR-proficient cases. MSI status was significantly associated with DFS and OS

The Relationship between First Trimester Serum Progesterone Levels and Spiral Artery Doppler Findings with Adverse Perinatal Outcomes

Background: Progesterone is essential for maintaining pregnancy. Spiral arteries, providing blood flow to the placenta, undergo changes in early pregnancy, reducing uteroplacental resistance. Our study was aimed at investigating the relationship between the first trimester serum progesterone levels, spiral artery Doppler findings and pregnancy outcome. Methods: This observational retrospective cohort study included 126 pregnant women at 11–14 weeks of gestation, confirmed by last menstrual period and ultrasonography. Between 11–14 weeks, serum progesterone levels were measured and spiral artery pulsatility index (PI), resistive index (RI), peak systolic velocity (PSV) and systolic/diastolic ratio (S/D) values were recorded. Pregnant women were followed up until delivery, and serum progesterone levels and spiral artery Doppler findings were compared between patients with poor perinatal outcomes and others. Results: This study included 126 pregnancies, of which 13 patients were lost to follow-up. Miscarriage occurred in 2 of the pregnant women, stillbirth in 1, intrauterine growth retardation in 10 and preeclampsia in 5 of them. 6 infants developed respiratory problems and 3 infants developed jaundice. Seventeen of the infants were hospitalized in the neonatal intensive care unit. There was no statistically significant difference between serum progesterone, spiral artery PI, RI and S/D values of 86 uncomplicated and 27 complicated pregnant women. Conclusions: It is known that there is a strong relationship between the first trimester serum levels of progesterone, which is an important hormone for the healthy continuation of pregnancy, and the risk of miscarriage. The quantity and quality of placental and fetal circulation is determined by the changes that occur in the spiral arteries with pregnancy. Although a close relationship is known between both variables and pregnancy outcomes, no correlation could be established between them in terms of early detection of poor perinatal outcomes

Comparison of elasticity values in normal and gestational diabetic pregnancies in the third trimester

Placental elasticity was compared by using Shear wave elastography (SWE) in patients with gestational diabetes mellitus (GDM) with and without insulin to non-diabetic controls. Three groups were created as follows: Group 1 (n = 79, GDM with insulin therapy), Group 2 (n = 90, GDM with only diet) and Group 3 (n = 150, healthy controls) All patients were above 36 gestational weeks with anterior placenta. Clinical trial number was also received (NCT04455880). Group 1 had higher BMI while group 3 had lowest rate of C/S. Birthweight in GDM groups was statistically significantly higher than controls (p = .001). Although there was no significant difference between APGAR scores, Group 1 had higher rates of neonatal intensive care unit (NICU) admission. SWE values were significantly higher in GDM patients treated with insulin or diet than controls. SWE may be an alternatively supplementary management modality in GDM.IMPACT STATEMENT What is already known on this subject? Shear wave elastography (SWE), is one of the types of sono elastography methods that are used to measure the stiffness and elasticity of soft tissues. Recently, it became popular for screening the stiffness and elasticity of the placenta in high-risk pregnancies like preeclampsia, intrauterine growth restriction (IUGR), and placental dysfunction. What the results of this study add? All SWE velocities on the maternal side were statistically significantly different between groups. Regarding foetal side velocities, GDM groups had statistically significantly higher values (stiffer tissue) compared to controls. What the implications are of these findings for clinical practice and/or further research? SWE may be a Supplementary method in the diagnosis and management of GDM. Placental SWE should be measured at 24–28 weeks of gestation in patients with GDM and diagnosis confirmation and their responses to the treatment should be examined

Remission of Endometriosis by Hyperbaric Oxygen Treatment in Rats

We designed this prospective, randomized controlled animal study to determine the effects of hyperbaric oxygen (HBO) on experimentally induced endometriosis in a rat model. Surgical induction of endometriosis was performed in 40, nonpregnant, female, Wistar-Albino rats at the Experimental Medicine Research Center of Istanbul University (DETAE). Four weeks later, the first and second laparotomies for volume measurement and peritoneal fluid (PF) collection were performed, and the rats were divided randomly into the study and control groups. The study group was exposed to HBO treatment for 6 weeks. Then, a third laparotomy was performed on all of the rats. The volume, histopathologic scores, Ki-67 labeling of the endometriotic implants, and the levels of tumor necrosis factor-alpha (TNF-alpha) in the PF were measured. The mean volume of the endometriotic implants in the study group was significantly lower than that of the control group at the end of the study (57.4 +/- 12.5 vs 94.6 +/- 17.2 mm(3)). The mean histopathological scores (1.60 +/- 0.50 vs 2.42 +/- 0.51), Ki-67 immunohistochemical scores (1.50 +/- 0.51 vs 2.37 +/- 0.49) of the endometriotic implants, and the TNF-alpha levels (5.33 +/- 1.02 vs 8.16 +/- 1.76 pg/mL) were significantly lower in the study group than in the control group. Hyperbaric oxygen treatment for 2 hours a day for 6 weeks resulted in significant remission of endometriosis in rats