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Determination of nuclear and/or cytoplasmic expression of ß-catenin by immunohistochemistry in patients with endometrial cancer (EC) may constitute a potential diagnostic method for identifying patients with a catenin ß1 (CTNNB1) gene mutation and those at risk of disease recurrence. The present study aimed to investigate ß-catenin expression patterns in hysterectomy specimens of patients with endometrioid type EC using immunohistochemistry, and to examine the prognostic impact of ß-catenin. The study was a single-institutional, retrospective cohort trial enrolling consecutive patients with a postoperative histopathological diagnosis of endometrioid EC who underwent hysterectomy between January 2015 and December 2018. Histopathology slides from 75 patients were stained with a monoclonal antibody targeting the ß-catenin protein. Any percentage of nuclear staining, whether focal or diffuse, was considered 'ß-catenin nuclear-positive'. The cytoplasmic staining reaction of ß-catenin was assessed based on the percentage of stained cells and staining intensity. Immune-reactivity score (IRS) values were determined by multiplying the scores for the percentage of staining and staining intensity. IRS values 0 to 2 were regarded as negative expression, 3 to 4 as low expression, 6 to 8 as moderate expression, and 9 to 12 as high expression. Recurrence-free survival (RFS) was used as the prognostic endpoint. Only 2 out of 75 tissue samples (2.7%) exhibited nuclear ß-catenin expression, with a low staining percentage of 5%. By contrast, cytoplasmic staining was observed in all samples (100%). According to the IRS findings, 1.3% of the samples exhibited negative cytoplasmic expression, 42.7% low expression, 38.7% moderate expression and 17.3% high expression. Cox regression analysis revealed that staining with ß-catenin, either nuclear or cytoplasmic, had no impact on RFS, and stage was the sole independent prognostic factor. In conclusion, based on these results, ß-catenin expression in endometrioid EC was revealed to be mostly cytoplasmic, with only 2.7% of tissue samples exhibiting nuclear expression. Overall, ß-catenin expression has no impact on RFS.
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OBJECTIVES: To evaluate the influence of mucinous differentiation in endometrioid endometrial cancer regarding spread and prognosis. MATERIAL AND METHODS: Endometrioid endometrial cancer cases between 2015 and 2020 were collected retrospectively and divided into two groups according to the cytoplasmic mucin including. Prognostic factors and cancer spread related parameters were evaluated. RESULTS: A total of 219 patients were enrolled in this study. One hundred twenty-two (55.7%) were endometrioid and 97 (44.3%) were in the mucinous differentiated endometrioid catagory. Age was similar between the groups (59.3 vs 58.7, p = 0.62), however, grade 3 lesions were more frequent in endometrioid type endometrial cancer (8.7% vs 1.4%, p < 0.01). Poor prognostic factors including myometrial invasion, lymphovascular space invasion (LVSI), lymph node metastases, peritoneal cytology, endocervical involvement, and stage were not significantly different between groups (p = 0.23, p = 0.49, p = 0.40, p = 0.15, p = 0.17, p = 0.55). The median overall survival time of endometrioid and mucinous differentiated endometrioid type endometrial cancer patients was determined 88.5 and 96.8 months, respectively (p = 0.46). CONCLUSIONS: Mucinous differentiation in the endometrioid type of endometrial cancer does not seem to affect the prognosis in endometrioid endometrial cancer patients.
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This paper reports the measures taken to manage the impact of the COVID-19 pandemic on O&G services in a tertiary referal centre and their outcomes. All the patients included in this study received inpatient treatment and underwent surgery between March 10 2020 and end of June 2020, including obstetric or gynaecologic cases combined. Data including age, diagnosis, operation, duration of preoperative and postoperative hospital stay, COVID-19 status were recorded. COVID-19 status of the patients was diagnosed with a nasopharyngeal swab test. Thirty-seven (20%) of 177 operations were performed because of gynaecologic reasons. The rest of them were caesarean sections (C/S). In gynaecologic cases, 22 (59%) of 37 were emergent operations, nine (24%) cases were oncologic and six (16%) cases were elective gynaecological surgeries. On the other hand, 43 (30%) of 140 patients, who underwent caesarean sections, were urgent surgeries. The rest were elective and planned caesarean sections. Only five patients (2.8%) who had undergone caesarean sections were tested positive for COVID-19. No COVID-19 transmission to staff was recorded in this period. Measures against the COVID-19 pandemic must be multidisciplinary and is crucial to prevent the spread of the disease to staff in close contact.Impact StatementWhat is already known on this subject? COVID-19 pandemic has been a crucial health problem worldwide. Healthcare workers work intensely to protect people from the pandemic. It is especially important to protect healthcare professionals and hospitalized patients from virus transmission. Therefore, utilization of personal protective equipment such as masks, gloves and goggles is obligatory, and hygiene rules such as sanitization of hands are strictly followed.What the results of this study add? This study adds the experience and success of a tertiary centre regarding the measure against COVID-19 to the literature. No viral transmission was detected to healthcare workers and other patients from COVID-19 patients. Hence, measures that mentioned in the present study should be an example to other centres for protection against pandemic.What the implications are of these findings for clinical practice and/or further research? As mentioned above, measures that are explained in the present study should be an example to other centres for protection against the pandemic. Further larger size clinical studies are needed to prove the beneficial effect of the measures that still used against pandemic.