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 Süleyman 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 expression was significantly higher in cases presenting MMR deficiency compared with MMR-proficient cases. MSI status was significantly associated with DFS and OS. KEY WORDS: Serous ovarian cancer, Microsatellite instability, Mismatch repair deficiency.

Relationship between extreme values of first trimester maternal pregnancy associated plasma Protein-A, free-ß-human chorionic gonadotropin, nuchal translucency and adverse pregnancy outcomes.

OBJECTIVE: The aim of our study was to investigate the relationship between extreme values of first trimester screening markers and adverse obstetric outcomes. MATERIALS AND METHODS: Our study was conducted by examining the prenatal and postnatal perinatal records of 786 singleton gestations between the ages of 18-40, who applied to Prof. Dr. Cemil Tasçioglu City Hospital outpatient clinics for first-trimester screening for aneuploidy, between January 1, 2017 and December 31, 2019. RESULTS: The presence of small for gestational age (SGA) was found to be statistically significant for the <5 percentile (<0.37) pregnancy-associated plasma protein A (PAPP-A) group (p = 0.016). For <5 percentile ß-hCG group, the presence of gestational diabetes mellitus (GDM), premature rupture of membrane (PROM) and preterm premature rupture of membrane (PPROM) was determined as a statistically significant risk (p = 0.015, p = 0.005, p = 0.02 respectively) In the univariate test, fetal death rate was found to be high for ≥90 percentile at nuchal translucency (NT), but the presence of fetal death was found to be statistically insignificant in logistic regression analysis. (p: 0.057). CONCLUSION: First trimester screening test can be used in predicting pregnancy complications. In this study we found that serum levels of PAPP-A are associated with developing SGA, while GDM, PROM and PPROM are more common in low serum free ß-hCG.

Efficacy of shear wave elastography in predicting preeclampsia in the first trimester.

OBJECTIVE: This study aimed to investigate the predictive value of shear wave elastography (SWE) for preeclampsia (PE) in first-trimester pregnancies. METHODS: Singleton pregnant women aged 18-45 years, who underwent routine first-trimester prenatal examinations (11-13 weeks+6 days) were enrolled. Pregnancies with anterior placenta and normal first-trimester screening test results were included in the study group. The SWE measurements of six areas of the placenta were performed, and the mean value was estimated. The perinatal outcomes and the demographic data were also collected. The receiver operating characteristic curve analysis was used for the accuracy of predicting PE. RESULTS: This study consisted of 84 patients, of which 9 were diagnosed with PE during the follow-up. The mean SWE value of the PE patients was higher than that of patients with normal pregnancies (p=0.002). The analysis showed that the optimal cutoff value was 7.43 kPa to predict PE in the placentas of first-trimester pregnancies, with 88% sensitivity and 78% specificity. CONCLUSIONS: The SWE values of the placenta in the first trimester were different between normal patients and those who are subsequently developing PE. SWE may be a suitable tool for predicting PE in pregnant women.

Comparison of serum folate, 25-OH vitamin D, and calcium levels between pregnants with and without fetal anomaly of neural tube origin.

AIM: The aim of this study was to compare serum folate, vitamin B12, 25-OH vitamin D, and calcium levels between pregnants with and without fetal anomaly of neural tube origin. METHODS: One hundred seventy-eight pregnants were recruited for this study. Pregnants with and without sonographically detected fetal anomaly of neural tube origin were compared in terms of serum folate, vitamin B12, 25-OH vitamin D, and calcium levels. RESULTS: There were significant differences between groups with regard to age, serum 25 OH vitamin D, 1,25 OH vitamin D, folate, calcium, and B 12 levels. Multivariate regression analyses revealed significant associations between the serum 25 OH vitamin D level, age, and the neural tube defect (NTD). CONCLUSIONS: Vitamin D and the age of pregnants were significantly associated with the NTDs.