Fenotypowe podgrupy zespołu policystycznych jajników mają różne objawy wewnątrznerkowej oporności

Objective: The polycystic ovary syndrome (PCOS) is known to be related with increased metabolic and cardiovascular risks. Various phenotypic subgroups of PCOS have been proven to have metabolic and endocrine disorders with varying degrees of severity. However, intra-renal vascular resistance, which is an indirect indication ofatherosclerosis, remains unknown in PCOS subgroups. In this study we examined whether PCOS subgroups have different intra-renal resistance symptoms. Material and Methods: 98 PCOS patients (diagnosed according to the Rotterdam criteria) 30 controls were ncluded in the study. The diagnosis of PCOS was established in the presence of at least two of the following criteria: 1- oligo and/or amenorrhea (OM); 2- clinic and/or biochemical signs of hyperandrogenism (HA); 3- polycystic ovarian morphology (PCO) detected by transvaginal ultrasonography. 37 patients (Group 1) met all three criteria (HA+OM+PCO), 29 patients (Group 2) met two of the criteria including hyperandrogenism (HA+OM or HA+PCO) and the remaining 32 patients (Group 3) had no hyperandrogenism but fulfilled the other two criteria; PCO+OM. Renal Doppler ultrasonography and hormonal/ biochemical analyses were carried out. The first outcome measure was designated as the differences in the renal resistive index (RRI) values of the groups, and the second outcome measure was designated as the relation of RRI with the insulin resistance and lipid profile. Results: In Group 1, the RRI and the homeostasis model assessment of insulin resistance (HOMA-IR) values were significantly higher than in Group 3 and controls (P < 0.031, P < 0.001, respectively, after adjusting for age and BMI). The RRI and HOMA-IR values in Group 3 were similar to those of the control group. It was determined that RRI has a positive correlation with HOMA-IR (r=0.784, PCel pracy: Zespół policystycznych jajników jest związany ze zwiększonym ryzykiem metabolicznym i sercowonaczyniowym. Fenotypowe podgrupy w obrębie zespołu PCO charakteryzują się zaburzeniami metabolicznymi i endokrynnymi o rożnym stopniu nasilenia. Jednak wewnątrznerkowa oporność naczyniowa, która jest pośrednim wykładnikiem miażdżycy, pozostaje nieznana w podgrupach zespołu PCO. W badaniu ocenialiśmy czy podgrupy zespołu PCO mają rożne objawy wewnątrznerkowej oporności. Materiał i metoda: do badania włączono 98 pacjentek z zespołem PCO (zdiagnozowanym według kryterium z Rotterdamu) oraz 30 pacjentek kontrolnych. Rozpoznanie zespołu PCO postawiono na podstawie obecności przynajmniej dwóch z poniżej wymienionych kryteriów: 1-oligo i/lub amenorrhea (OM); 2-kliniczne lub biochemiczne objawy hiperandrogenizmu (HA); 3-policystyczny obraz jajnikow (PCO) w przez pochwowym badaniu ultrasonograficznym. Grupę 1 stanowiło 37 pacjentek, które spełniły wszystkie kryteria diagnostyczne (HA+OM+PCO), grupa 2 to 29 pacjentek z dwoma kryteriami, w tym kryterium hiperandrogenizmu (HA+OM lub HA+PCO), pozostałe 32 pacjentki to grupa 3 – bez hiperandrogenizmu ale z dwoma pozostałymi kryteriami; PCO+OM. Przeprowadzono badanie dopplerowskie nerek i hormonalno-biochemiczną ocenę. Jako pierwszą zmierzono różnicę pomiędzy grupami w indeksie oporu nerkowego (RRI), następnie oceniono związek pomiędzy RRI a insulinoopornością i profilem lipidowym. Wyniki: W grupie 1, RRI i wskaźnik oceny insulinooporności (HOMA-IR) były istotnie wyższe niż w grupie 3 oraz kontrolnej (

Predicting tumor recurrence in patients with cervical carcinoma treated with definitive chemoradiotherapy: Value of quantitative histogram analysis on diffusion-weighted MR images

PubMedID: 27445314Background Further research is required for evaluating the use of ADC histogram analysis in more advanced stages of cervical cancer treated with definitive chemoradiotherapy (CRT). Purpose To investigate the utility of apparent diffusion coefficient (ADC) histogram derived from diffusion-weighted magnetic resonance images in cervical cancer patients treated with definitive CRT. Material and Methods The clinical and radiological data of 50 patients with histologically proven cervical squamous cell carcinoma treated with definitive CRT were retrospectively analyzed. The impact of clinicopathological factors and ADC histogram parameters on prognostic factors and treatment outcomes was assessed. Results The mean and median ADC values for the cohort were 1.043 ± 0.135 × 10-3 mm2/s and 1.018 × 10-3 mm2/s (range, 0.787-1.443 × 10-3 mm2/s). The mean ADC was significantly lower for patients with advanced stage (?IIB) or lymph node metastasis compared with patients with stage &lt;IIB or no lymph node metastasis. The mean ADC, 75th percentile ADC (ADC75), 90th percentile ADC (ADC90), and 95th percentile ADC (ADC95) were significantly lower in patients with tumor recurrence compared with patients without recurrence. In multivariate analysis, tumor size, ADC75 and ADC95 were independent prognostic factors for both overall survival and disease-free survival. Conclusion ADC histogram parameters could be markers for disease recurrence and for predicting survival outcomes. ADC75, ADC90, and ADC95 of the primary tumor were significant predictors of disease recurrence in cervical cancer patients treated with definitive CRT. © The Foundation Acta Radiologica