Association of future cancer metastases with fibroblast activation protein-α: a systematic review and meta-analysis

IntroductionFibroblast activation protein-α (FAP-α) is a vital surface marker of cancer-associated fibroblasts, and its high expression is associated with a higher tumor grade and metastasis. A systematic review and a meta-analysis were performed to associate future metastasis with FAP-α expression in cancer.MethodsIn our meta-analysis, relevant studies published before 20 February 2024 were systematically searched through online databases that included PubMed, Scopus, and Web of Science. The association between FAP-α expression and metastasis, including distant metastasis, lymph node metastasis, blood vessel invasion, vascular invasion, and neural invasion, was evaluated. A pooled odds ratio (OR) with 95% confidence intervals (CI) was reported as the measure of association.ResultsA total of 28meta-analysis. The random-effects model for five parameters showed that a high FAP-α expression was associated with blood vessel invasion (OR: 3.04, 95% CI: 1.54–5.99, I2 = 63%, P = 0.001), lymphovascular invasion (OR: 3.56, 95% CI: 2.14–5.93, I2 = 0.00%, P < 0.001), lymph node metastasis (OR: 2.73, 95% CI: 1.96–3.81, I2 = 65%, P < 0.001), and distant metastasis (OR: 2.59; 95% CI: 1.16–5.79, I2 = 81%, P < 0.001). However, our analysis showed no statistically significant association between high FAP-α expression and neural invasion (OR: 1.57, 95% CI: 0.84–2.93, I2 = 38%, P = 0.161).ConclusionsThis meta-analysis indicated that cancer cells with a high FAP-α expression have a higher risk of metastasis than those with a low FAP-α expression. These findings support the potential importance of FAP-α as a biomarker for cancer metastasis prediction

The Importance of Initial Evaluation by Trans Vaginal Sonography in Rudimentary Horn Pregnancy: A Case Report and Literature Review

Rudimentary&nbsp; horn&nbsp; pregnancy&nbsp; (RHP)&nbsp; as&nbsp; a&nbsp; rare&nbsp; incidence&nbsp; has&nbsp; been&nbsp; estimated&nbsp; at&nbsp; 1:76,000- 1:150,000 pregnancies. It has been also reported that 80-90% of RHP lead to uterine rupture in second trimester.&nbsp; Early&nbsp; diagnosis&nbsp; with&nbsp; the&nbsp; use&nbsp; of&nbsp; 3-dimentional&nbsp; ultrasonography&nbsp; (3-DUS)&nbsp; that&nbsp; is&nbsp; followed by&nbsp; laparoscopic&nbsp; resection&nbsp; of&nbsp; RH&nbsp; and&nbsp; ipsilateral&nbsp; fallopian&nbsp; tube&nbsp; is&nbsp; likely&nbsp; to&nbsp; be&nbsp; considered&nbsp; as&nbsp; the&nbsp; best management strategy that prevents maternal morbidity and mortality. We present a case of 9-week pregnancy&nbsp; in&nbsp; a&nbsp; non-communicating&nbsp; rudimentary&nbsp; horn&nbsp; with&nbsp; positive&nbsp; fetal&nbsp; heart&nbsp; rate&nbsp; (FHR)&nbsp; that&nbsp; was diagnosed by 3-DUS and successfully treated with laparoscopic resection.</p

Direct Proportional Relationship between Histopathologic and Sonographic Analysis of Laparoscopic Removal Ovarian Endometriotic Cyst: Evaluating the Effects on Ovarian Reserve

Background: The aim of this study was to evaluate ovarian damage following laparoscopic endometrioma cystectomy using ultrasound and pathologic samples.&nbsp;Materials and Methods: This is a prospective cohort study in General Women Hospital affiliated to Tehran University of Medical Sciences. 40 patients with endometrioma, total of 44 cysts including bilateral cysts, underwent laparoscopic cystectomy with stripping technique. Amount of excised parenchyma, number of lost oocytes and cyst wall fibrosis thickness were histologically studied. Before and 3 months after surgery antral follicle count was evaluated by ultrasound.Results: Mean antral follicle count (AFC) before the operation was 4 ± 1.29 and after operation was1.64 ± 1.03. The reduction in AFC after cystectomy was statistically significant (P &lt;0.000), and with each 1 centimeter increase in cyst diameter a reduction of AFC averaging 0.421 was observed. On pathological examination, it was shown that every millimeter of inadvertently excised ovarian tissue and cyst wall fibrosis thickness leads to reduction of 1.06 and 1.2 in AFC respectively.&nbsp;Conclusion: Laparoscopic cystectomy for endometrioma is associated with reduction in ovarian reserve and this reduces proportionally with cyst diameter, amount of normal ovarian parenchyma excised and cyst wall fibrosis.&nbsp;</p