An evaluation of special AT-rich sequence-binding protein 2 expression in primary epithelial tumors and metastatic tumors of the ovary

Background: Ovarian cancer is the second most common gynecologic cancer in women. Differential diagnosis between primary and metastatic neoplasms can be problematic in some cases. The special AT-rich sequence-binding protein 2 (SATB2) is a nuclear matrix-associated protein that is important for growth and development. SATB2 has been shown to be a sensitive and highly specific marker for colorectal carcinomas (CRCs). SATB2 expression has also been reported in lung, breast, pancreas, renal, laryngeal, esophageal carcinomas and bone cancers. In this study, we aimed to evaluate SATB2 expression in primary epithelial and metastatic ovarian tumors and determine its significance in differentiating between subtypes. Material and Methods: The study group comprised 148 cases of primary epithelial tumor and 29 cases of metastatic ovarian tumor. Immunohistochemical analysis was performed by applying SATB2 on paraffin blocks. Results: SATB2 expression was identified in 54.5% of mucinous carcinomas, 51.7% of endometrioid carcinomas, 18.2% of high-grade serous carcinomas, 17.9% of borderline mucinous tumors, 6.7% of borderline serous tumors, and 51.7% of metastatic ovarian tumors. SATB2 expression did not show specificity for any of the subgroups. Metastatic ovarian tumors originating from the colon, breast, upper gastrointestinal tract, and appendix also showed SATB2 expression at different rates. All of the metastatic CRCs showed SATB2 positivity. Conclusion: It must be considered that primary carcinomas and metastatic carcinomas may manifest varying levels of SATB2 expression with different intensity and extensiveness. Extensive and strong SATB2 expression indicates metastatic colon carcinoma, consistent with the literature. Further comprehensive studies are needed in order to investigate SATB2 specificity for different subtypes

Is there a role of prophylactic bilateral internal iliac artery ligation on reducing the bleeding during cesarean hysterectomy in patients with placenta percreta? A retrospective cohort study

Objectives: Our study aims to evaluate the effect of bilateral prophylactic internal iliac artery ligation (IIAL) on bleeding in patients with placenta percreta who undergo cesarean hysterectomy (CH) with the use of blunt dissection technique.Material and methods: This retrospective cohort study included 96 patients with placenta percreta who underwent planned CH with using the blunt dissection technique to allow better vesico-uterine dissection at the gynecology and obstetrics unit of a university hospital between the years 2017–2019. We carried out bilateral IIAL before CH in the study group (group 1) while we performed only CH in the control group (group 2). Results: Group 1 and Group 2 consisted of 50 and 46 patients; respectively. There was no statistical difference between the two groups as regards to the mean estimated blood loss, the mean transfused blood products, the mean operation time, and the number of complications. In total, 24 patients (25%) had complications with the finding that the most common one was bladder injury (16/96, 16,66%).Conclusions: Routine bilateral prophylactic IIAL before CH in placenta percreta cases does not have a beneficial effect on decreasing the amount of bleeding and the amount blood transfusio