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Patel K, Asrani SK, Fiel MI, Levine D, Leung DH, Duarte-Rojo A, Dranoff JA, Nayfeh T, Hasan B, Taddei TH, Alsawaf Y, Saadi S, Majzoub AM, Manolopoulos A, Alzuabi M, Ding J, Sofiyeva N, Murad MH, Alsawas M, Rockey DC, Sterling RK. Accuracy of blood-based biomarkers for staging liver fibrosis in chronic liver disease: A systematic review supporting the AASLD Practice Guideline. Hepatology 2024:01515467-990000000-00805. [PMID: 38489517 DOI: 10.1097/hep.0000000000000842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 02/19/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND AND AIMS Blood-based biomarkers have been proposed as an alternative to liver biopsy for non-invasive liver disease assessment (NILDA) in chronic liver disease (CLD). Our aims for this systematic review were to evaluate the diagnostic utility of selected blood-based tests either alone, or in combination, for identifying significant fibrosis (F2-4), advanced fibrosis (F3-4) and cirrhosis (F4), as compared to biopsy in CLD. APPROACH AND RESULTS We included a comprehensive search of databases including Ovid MEDLINE(R), EMBASE, Cochrane Database, and Scopus through to April 2022. Two independent reviewers selected 286 studies with 103,162 patients. The most frequently identified studies included the simple aminotransferase-to-platelet ratio index (APRI) and fibrosis (FIB)-4 markers (with low-to-moderate risk of bias) in hepatitis B virus (HBV) and C virus (HCV), HIV-HCV/HBV co-infection, and nonalcoholic fatty liver disease (NAFLD). Positive (LR+) and negative (LR) likelihood ratios across direct and indirect biomarker tests for HCV and HBV for F2-4, F3-4, or F4 were 1.66-6.25 and 0.23-0.80, 1.89-5.24 and 0.12-0.64, and 1.32-7.15 and 0.15-0.86 respectively; LR+ and LR for NAFLD F2-4, F3-4 and F4 were 2-65-3.37 and 0.37-0.39, 2.25-6.76 and 0.07-0.87, and 3.90 and 0.15 respectively. Overall, proportional odds ratio indicated FIB-4 <1.45 was better than APRI <0.5 for F2-4. FIB-4 >3.25 was also better than APRI >1.5 for F3-4 and F4. There was limited data for combined tests. CONCLUSIONS Blood-based biomarkers are associated with small-to-moderate change in pre-test probability for diagnosing F2-4, F3-4, and F4 in viral hepatitis, HIV-HCV co-infection, and NAFLD, with limited comparative or combination studies for other CLD.
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Affiliation(s)
- Keyur Patel
- Division of Gastroenterology and Hepatology, University Health Network, University of Toronto, Toronto, ON, Canada
| | - Sumeet K Asrani
- Division of Hepatology, Baylor University Medical Center, Dallas, Texas
| | - Maria Isabel Fiel
- Department of Pathology, Molecular and Cell-Based Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Deborah Levine
- Department of Radiology, Beth Israel Deaconess Medical Center, Boston, Harvard Medical School
| | - Daniel H Leung
- Department of Pediatrics, Baylor College of Medicine and Division of Gastroenterology, Hepatology and Nutrition, Texas Children's Hospital, Houston, TX
| | - Andres Duarte-Rojo
- Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jonathan A Dranoff
- Section of Digestive Diseases, Yale School of Medicine, New Haven, CT, and VA Connecticut Healthcare System, West Haven, CT
| | - Tarek Nayfeh
- Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota
| | - Bashar Hasan
- Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota
| | - Tamar H Taddei
- Section of Digestive Diseases, Yale School of Medicine, New Haven, CT, and VA Connecticut Healthcare System, West Haven, CT
| | - Yahya Alsawaf
- Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota
| | - Samer Saadi
- Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota
| | | | | | - Muayad Alzuabi
- Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota
| | - Jingyi Ding
- Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota
| | - Nigar Sofiyeva
- Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota
| | - M Hassan Murad
- Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota
| | - Mouaz Alsawas
- Mayo Clinic Evidence-based Practice Center, Mayo Clinic, Rochester, Minnesota
- Department of Pathology, University of Iowa, Iowa City, Iowa
| | - Don C Rockey
- Digestive Disease Research Center, Medical University of South Carolina, Charleston, SC
| | - Richard K Sterling
- Section of Hepatology, Virginia Commonwealth University, Richmond, Virginia
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Sofiyeva N, Krakstad C, Halle MK, O'Mara TA, Romundstad P, Hveem K, Vatten L, Lønning PE, Gansmo LB, Knappskog S.
APOBEC3A
/B
deletion polymorphism and endometrial cancer risk. Cancer Med 2022; 12:6659-6667. [PMID: 36394079 PMCID: PMC10067079 DOI: 10.1002/cam4.5448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/01/2022] [Accepted: 11/04/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND A common 30 kb deletion affecting the APOBEC3A and APOBEC3B genes has been linked to increased APOBEC activity and APOBEC-related mutational signatures in human cancers. The role of this deletion as a cancer risk factor remains controversial. MATERIALS AND METHODS We genotyped the APOBEC3A/B deletion in a sample of 1,470 Norwegian endometrial cancer cases and compared to 1,918 healthy controls. For assessment across Caucasian populations, we mined genotypes of the SNP rs12628403, which is in strong linkage disequilibrium with the deletion, in a GWAS dataset of 4,274 cases and 18,125 healthy controls, through the ECAC consortium. RESULTS We found the APOBEC3A/B deletion variant to be significantly associated with reduced risk of endometrial cancer among Norwegian women (OR = 0.75; 95% CI = 0.62-0.91; p = 0.003; dominant model). Similar results were found in the subgroup of endometrioid endometrial cancer (OR = 0.64; 95% CI = 0.51-0.79; p = 3.6 × 10-5 ; dominant model). The observed risk reduction was particularly strong among individuals in the range of 50-60 years of age (OR = 0.51; 95% CI = 0.33-0.78; p = 0.002; dominant model). In the different populations included in the ECAC dataset, the ORs varied from 0.85 to 1.05. Although five out of six populations revealed ORs <1.0, the overall estimate was nonsignificant and, as such, did not formally validate the findings in the Norwegian cohort. CONCLUSION The APOBEC3A/B deletion polymorphism is associated with a decreased risk of endometrial cancer in the Norwegian population.
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Affiliation(s)
- Nigar Sofiyeva
- K.G. Jebsen Center for Genome‐Directed Cancer Therapy, Department of Clinical Science University of Bergen Bergen Norway
- Department of Oncology Haukeland University Hospital Bergen Norway
| | - Camilla Krakstad
- Department of Clinical Science, Centre for Cancer Biomarkers University of Bergen Bergen Norway
- Department of Obstetrics and Gynaecology Haukeland University Hospital Bergen Norway
| | - Mari K. Halle
- Department of Clinical Science, Centre for Cancer Biomarkers University of Bergen Bergen Norway
- Department of Obstetrics and Gynaecology Haukeland University Hospital Bergen Norway
| | - Tracy A. O'Mara
- Cancer Program QIMR Berghofer Medical Research Institute Brisbane Australia
| | - Pål Romundstad
- Department of Public Health, Faculty of Medicine Norwegian University of Science and Technology Trondheim Norway
| | - Kristian Hveem
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health, Faculty of Medicine Norwegian University of Science and Technology Trondheim Norway
| | - Lars Vatten
- Department of Public Health, Faculty of Medicine Norwegian University of Science and Technology Trondheim Norway
| | - Per E. Lønning
- K.G. Jebsen Center for Genome‐Directed Cancer Therapy, Department of Clinical Science University of Bergen Bergen Norway
- Department of Oncology Haukeland University Hospital Bergen Norway
| | - Liv B. Gansmo
- K.G. Jebsen Center for Genome‐Directed Cancer Therapy, Department of Clinical Science University of Bergen Bergen Norway
- Department of Oncology Haukeland University Hospital Bergen Norway
| | - Stian Knappskog
- K.G. Jebsen Center for Genome‐Directed Cancer Therapy, Department of Clinical Science University of Bergen Bergen Norway
- Department of Oncology Haukeland University Hospital Bergen Norway
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Gansmo L, Sofiyeva N, Bjørnslett M, Lønning P, Knappskog S. Is APOBEC3A/B deletion polymorphism associated with the risk of ovarian cancer in Norwegian population? A case-control study (237). Gynecol Oncol 2022. [DOI: 10.1016/s0090-8258(22)01461-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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4
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Wang Z, Nayfeh T, Sofiyeva N, Ponte OJ, Rajjoub R, Malandris K, Seisa M, Chu H, Murad MH. Including Non-inferiority Trials in Contemporary Meta-analyses of Chronic Medical Conditions: a Meta-epidemiological Study. J Gen Intern Med 2020; 35:2162-2166. [PMID: 32318902 PMCID: PMC7352026 DOI: 10.1007/s11606-020-05821-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 03/25/2020] [Indexed: 12/30/2022]
Affiliation(s)
- Zhen Wang
- Mayo Clinic Evidence-based Practice Center, Rochester, MN, USA. .,Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA. .,Mayo Clinic College of Medicine and Science, Rochester, MN, USA. .,Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
| | - Tarek Nayfeh
- Mayo Clinic Evidence-based Practice Center, Rochester, MN, USA.,Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA
| | - Nigar Sofiyeva
- Mayo Clinic Evidence-based Practice Center, Rochester, MN, USA.,Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA
| | - Oscar J Ponte
- Mayo Clinic Evidence-based Practice Center, Rochester, MN, USA.,Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA
| | - Rami Rajjoub
- Mayo Clinic Evidence-based Practice Center, Rochester, MN, USA.,Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA
| | - Konstantinos Malandris
- Mayo Clinic Evidence-based Practice Center, Rochester, MN, USA.,Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA
| | - Mohamed Seisa
- Mayo Clinic Evidence-based Practice Center, Rochester, MN, USA.,Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA
| | - Haitao Chu
- University of Minnesota, Minneapolis, MN, USA
| | - Mohammad Hassan Murad
- Mayo Clinic Evidence-based Practice Center, Rochester, MN, USA.,Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN, USA
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Ho TP, Helgeson JM, Andring AL, Reed JC, Boyle VL, Sofiyeva N, Leventakos K, Haddad TC, Hendrickson AEW, Weroha S(J. Abstract 01: Implementation of cognitive computing to match clinical trials in gynecologic cancers: A single-institution experience. Clin Cancer Res 2020. [DOI: 10.1158/1557-3265.advprecmed20-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Objectives: Cognitive computing has the potential to improve efficiency and accuracy of clinical trial enrollment using artificial intelligence. The cognitive computing clinical trial matching (CTM) system used for this study utilizes natural language processing to derive patient and tumor attributes from structured and unstructured electronic medical record (EMR) data. The attributes are matched to complex eligibility criteria in trial protocols. This CTM system has been implemented in our gynecologic oncology practice, for which there is lower representation of ethnic minorities, elderly, and uninsured in National Cancer Institute-sponsored trials.
Methods: A clinical research coordinator (CRC) used the CTM system to screen patients for potential clinical trials one day prior to their clinic visit. Trial matches were shared with gynecologic oncology clinicians to raise awareness for study opportunities and assist in treatment decisions. Clinicians were surveyed regarding their experience with the CTM system prepared matches. The identical patients were evaluated by a clinician using the traditional manual screening method.
Results: Seventeen patients with new diagnosis, recent resection, or restaging scans were screened for 41 potential gynecologic, phase I, and supportive care clinical trials. Trial screening by the CRC using the CTM system resulted in a total of 119 matched trials (mean: 7 trials/patient) compared to the clinician-generated list of 271 matched trials (mean: 16 trials/patient). The CRC using the CTM system spent an average of 18 minutes/patient (range: 7 to 40 minutes) compared to the clinician average of 22 minutes/patient (range: 7 to 37 minutes). A survey of 8 gynecologic oncology clinicians reported they were willing to spend an average of 8 minutes/patient (range: 1 to 15 minutes) to screen patients for trial eligibility. On independent review, discrepancies occurred when the clinician identified trials that the CRC excluded due to inclusion/exclusion criteria or were unknowingly closed to accrual. In addition, the CRC identified trials that were inadvertently missing from the clinician’s list of active protocols. Consistent with these observations, 100% of surveyed clinicians (8 of 8) agreed that “The CTM system has helped to include and exclude trials prior to discussion with patients.”
Conclusions: Use of the CTM system by a CRC was superior to a clinician alone for the accuracy and efficiency of screening clinical trial eligibility. This process improved the identification of trials that a clinician might otherwise miss and the exclusion of trials that were not available or appropriate for patients. The CTM system can reduce the burden of clinicians and research staff to screen patients. Additional research is needed to determine if the process can improve clinical trial enrollment in gynecologic cancers.
Citation Format: Thanh P. Ho, Jane M. Helgeson, Angela L. Andring, Jennifer C. Reed, Venessa L. Boyle, Nigar Sofiyeva, Konstantinos Leventakos, Tufia C. Haddad, Andrea E. Wahner Hendrickson, Saravut (John) Weroha. Implementation of cognitive computing to match clinical trials in gynecologic cancers: A single-institution experience [abstract]. In: Proceedings of the AACR Special Conference on Advancing Precision Medicine Drug Development: Incorporation of Real-World Data and Other Novel Strategies; Jan 9-12, 2020; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(12_Suppl_1):Abstract nr 01.
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Karataş S, Şal V, Kahramanoğlu İ, Demirkıran F, Beşe T, Arvas M, Sofiyeva N, Güralp O, Uzun H. Ykl-40 and cancer antigen 72-4 as new and promising diagnostic and prognostic markers for endometrial cancer. Turk J Obstet Gynecol 2019; 15:235-242. [PMID: 30693139 PMCID: PMC6334238 DOI: 10.4274/tjod.77906] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 09/03/2018] [Indexed: 12/14/2022] Open
Abstract
Objective: To determine the predictive role of serum levels of YKL-40 and cancer antigen (CA) 72-4 in the diagnosis of endometrial cancer (EC). Materials and Methods: Forty-one patients with EC and 21 women with uterine polyps were evaluated between January and December 2015 in a prospective study. Results: Age, body mass index, preoperative serum YKL-40 and CA 72-4 levels were significantly higher in the malignant group compared with the control group. Serum YKL-40 levels were significantly higher in patients with superficial myometrial invasion and no lymph node involvement (p=0.042; p=0.004). No relationship between clinicopathologic factors and serum CA 72-4 levels was found. Conclusion: Serum CA 72-4 and YKL-40 levels are increased in women with EC compared with uterine polyps. Preoperative serum YKL-40 levels may be associated with favorable prognostic factors. The determination of YKL-40 before surgery may be helpful in the evaluation of the regional lymph nodes.
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Affiliation(s)
- Suat Karataş
- İstanbul Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Veysel Şal
- İstanbul Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - İlker Kahramanoğlu
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, İstanbul, Turkey
| | - Fuat Demirkıran
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, İstanbul, Turkey
| | - Tugan Beşe
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, İstanbul, Turkey
| | - Macit Arvas
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, İstanbul, Turkey
| | - Nigar Sofiyeva
- Yale University Faculty of Medicine, Department of Obstetrics and Gynecology and Reproductive Sciences, New Haven, CT, USA
| | - Onur Güralp
- Klinikum Oldenburg University Hospital, Clinic of Obstetrics and Gynecology, Oldenburg, Germany
| | - Hafize Uzun
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Biochemistry, İstanbul,Turkey
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Aydogan Mathyk B, Aslan Cetin B, Vardagli D, Zengin E, Sofiyeva N, Irez T, Ocal P. Comparison of antagonist mild and long agonist protocols in terms of follicular fluid total antioxidant capacity. Taiwan J Obstet Gynecol 2018; 57:194-199. [PMID: 29673660 DOI: 10.1016/j.tjog.2018.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2017] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE A high dose of prolonged gonadotropins can yield higher numbers of oocytes and embryos. The high dose or prolonged regimens can be associated with ovarian hyperstimulation syndrome (OHSS), multiple gestations, emotional stress, economical burden and treatment dropout. In mild stimulation lower doses and shorter duration times of gonadotropin are used in contrast to the conventional long stimulation protocol in IVF. It has been proposed that supraphysiologic levels of hormones may adversely affect endometrium and oocyte/embryo. Also it has been proposed that oxidative stress (OS) may alter ovarian hormone dynamics and could be further affected by additional exogenous hormonal stimulation. Therefore our aim was to compare follicular fluid total antioxidant capacity (TAC) in antagonist mild and long agonist stimulations. MATERIALS AND METHODS Forty patients received antagonist mild stimulation, starting on the 5th day of their cycle and forty patients received long agonist treatment. Seventy-five patients undergoing their first IVF cycle were included in the final analysis. Follicular fluid (FF) samples were analyzed for estradiol (E2), antimullerian hormone (AMH) and TAC. RESULTS FF-Total antioxidant capacity (TAC) levels were higher in the long agonist group as opposed to the antagonist group [1.07 ± 0.04 mmol Trolox equivalent/L vs 1 ± 0.13 mmol Trolox equivalent/L] (Fig. 1). Pregnancy rates were not significantly different between the two treatments. The FF-TAC levels were not different among infertility etiologies (Fig. 3). FF-TAC levels did not have a direct correlation with pregnancy but a positive correlation with the total gonadotropin dose was observed. CONCLUSION Patients with good ovarian reserves and under the age of 35 effectively responded to mild stimulation treatment. Using lower amounts of gonadotropin, yielded less FF-TAC levels in patients who underwent antagonist mild protocol. In patients under the age of 35, antagonist mild stimulation is a patient friendly and effective procedure when undergoing their first IVF cycle.
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Affiliation(s)
- Begum Aydogan Mathyk
- Istanbul University Cerrahpasa Faculty of Medicine, Department of Obstetrics and Gynecology, Istanbul, Turkey.
| | - Berna Aslan Cetin
- Kanuni Sultan Suleyman Research and Training Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey
| | - Duygu Vardagli
- Istanbul Esenyurt University Medical Laboratory Technologies, Istanbul, Turkey
| | - Emel Zengin
- Istanbul University Cerrahpasa Faculty of Medicine, Department of Biochemistry, Istanbul, Turkey
| | - Nigar Sofiyeva
- Yale University School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, New Haven, 06510, CT, USA
| | - Tulay Irez
- Biruni University Faculty of Medicine, Department of Histology and Embryology, Istanbul, Turkey
| | - Pelin Ocal
- Istanbul University Cerrahpasa Faculty of Medicine, Department of Obstetrics and Gynecology, Istanbul, Turkey
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Sofiyeva N, Siepmann T, Barlinn K, Seli E, Ata B. Gonadotropin-Releasing Hormone Analogs for Gonadal Protection During Gonadotoxic Chemotherapy: A Systematic Review and Meta-Analysis. Reprod Sci 2018; 26:939-953. [PMID: 30270741 DOI: 10.1177/1933719118799203] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE A systematic review and meta-analysis was conducted to investigate whether gonadotropin-releasing hormone analogs (GnRHa) have a protective role in women treated with alkylating agents. DATA SOURCES Major databases (PubMED, EMBASE, Cochrane Central Register of Controlled Trials), systematic snowballing, and trial registries were screened from the inception dates until September 2017. METHODS AND STUDY SELECTION Comparative studies involving reproductive-aged women undergoing chemotherapy with or without coadministration of GnRHa were included. Spontaneous menstrual resumption was assessed as a main outcome. Statistical analyses were performed with STATA 14.2 statistical software. Effect estimates were presented as risk ratios (RR) with 95% confidence intervals (CIs). RESULTS The literature search yielded 25 436 citations and 84 papers were assessed in full text. Eighteen studies (11 randomized controlled trials [RCTs] and 7 cohort studies) published between 1987 and 2015 were included in the analysis, revealing a significant protective effect of GnRHa (n = 1043; RR:1.38; 95% CI: 1.18-1.63) although with high heterogeneity (I2 = 83.3%). Subgroup analyses revealed a significant benefit of GnRHa cotreatment both in RCTs and in cohort studies. Statistical significance was found in all subgroups by the underlying disease, that is, hematological malignancies, autoimmune diseases, and breast cancer. Sensitivity analyses in GnRH agonist-treated patients, in patients younger than 40 years old, and in patients without supradiaphragmatic radiotherapy also revealed a significant benefit of GnRHa cotreatment. CONCLUSION Our results indicate that concurrent GnRHa administration is an effective method to decrease gonadotoxicity of alkylating agents. The presence of low-quality evidence favoring gonadoprotective effect requires a strong recommendation for offering GnRHa coadministration to young women who are to undergo gonadotoxic chemotherapy. CAPSULE The present systematic review and meta-analysis shows a significant gonadoprotective effect of gonadotropin-releasing hormone analogs in women treated with alkylating agents.
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Affiliation(s)
- Nigar Sofiyeva
- 1 Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University, School of Medicine, New Haven, CT, USA.,2 Division of Health Care Sciences, Center for Clinical Research and Management Education, Dresden International University, Dresden, Germany
| | - Timo Siepmann
- 2 Division of Health Care Sciences, Center for Clinical Research and Management Education, Dresden International University, Dresden, Germany.,3 Department of Neurology, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Dresden, Germany
| | - Kristian Barlinn
- 3 Department of Neurology, University Hospital Carl Gustav Carus, Technische Universitaet Dresden, Dresden, Germany
| | - Emre Seli
- 1 Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University, School of Medicine, New Haven, CT, USA
| | - Baris Ata
- 1 Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University, School of Medicine, New Haven, CT, USA.,4 Department of Obstetrics and Gynecology, Koc University, School of Medicine, Istanbul, Turkey
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Sofiyeva N, Oral E. Letter from original author re. Does telomerase activity have an effect on infertility in patients with endometriosis? Methodological issues. Eur J Obstet Gynecol Reprod Biol 2017; 216:259-260. [DOI: 10.1016/j.ejogrb.2017.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Arvas M, Salihoglu Y, Sal V, Gungor T, Sozen H, Kahramanoglu I, Topuz S, Demirkiran F, Iyibozkurt C, Bese T, Ozgu BS, Vatansever D, Tokgozoglu N, Berkman S, Turan H, Bengisu E, Sofiyeva N, Demiral I, Meydanli M. Tertiary Cytoreduction for Recurrent Epithelial Ovarian Cancer: a Multicenter Study in Turkey. Asian Pac J Cancer Prev 2017; 17:1909-15. [PMID: 27221875 DOI: 10.7314/apjcp.2016.17.4.1909] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to determine the benefit of tertiary cytoreductive surgery (TC) for secondary recurrent epithelial ovarian cancer (EOC), focusing on whether optimal cytoreduction has an impact on disease-free survival, and whether certain patient characteristics could identify ideal candidates for TC. MATERIALS AND METHODS Retrospective analysis of secondary recurrent EOC patients undergoing TC at three Turkish tertiary institutions from May 1997 to July 2014 was performed. All patients had previously received primary cytoreduction followed by intravenous platinum-based chemotherapy and secondary cytoreduction for first recurrence. Clinical and pathological data were obtained from the patients' medical records. Survival analysis was caried out using the Kaplan Meier method. Actuarial curves were compared by the two tailed Logrank test with a statistical significance level of 0.05. RESULTS Median age of the patients was 49.6 years (range, 30-67) and thirty-eight (72%) had stage III-IV disease at initial diagnosis. Twenty six (49%) had optimal and 27 (51%) suboptimal cytoreduction during tertiary debulking surgery . Optimal initial cytoreduction, time to first recurrence, optimal secondary cytoreduction, time interval between secondary cytoreduction and secondary recurrence, size of recurrence, disease status at last follow-up were found to be significant risk factors to predict optimal TC. Optimal cytoreduction in initial and tertiary surgery and serum CA-125 level prior to TC were independent prognostic factors on univariate analysis. CONCLUSIONS Our results and a literature review clearly showed that maximal surgical effort should be made in TC, since patients undergoing optimal TC have a better survival. Thus, patients with secondary recurrent EOC in whom optimal cytoreduction can be achieved should be actively selected.
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Affiliation(s)
- Macit Arvas
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Cerrahpasa Faculty of Medicine, Istanbul, Turkey E-mail : ilkerkahramanoglu@ hotmail.com
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Andriotti T, Stavale R, Nafee T, Fakhry S, Mohamed MMA, Sofiyeva N, Ganho-Ávila A, Bogner A, Barbosa SP, Piton LS, Hirayama ALS, Gaccia G, Smith-Howard Junior TP, Miranda PC, Reyes KJC, Gragera A, Nishiwaki H, Boechat-Barros R. ASSERT trial - How to assess the safety and efficacy of a high frequency rTMS in postpartum depression ? A multicenter, double blinded, randomized, placebo-controlled clinical trial. Contemp Clin Trials Commun 2017; 5:86-91. [PMID: 29740625 PMCID: PMC5936708 DOI: 10.1016/j.conctc.2017.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 12/17/2016] [Accepted: 01/10/2017] [Indexed: 01/04/2023] Open
Abstract
Background Postpartum Depression affects a considerable number of women worldwide. This condition inflicts severe consequences to mother and child health. Thus far, available treatments have low response and high relapse rates. We designed this trial to evaluate a safe and more efficacious innovative therapy. Aims To report a feasible and ethical study design to assess the safety and efficacy of a high frequency repetitive Transcranial Magnetic Stimulation 10 Hz (rTMS) compared to sham rTMS in women with moderate to severe Post-Partum Depression using standard treatment (sertraline). To conduct an ancillary, exploratory, randomized, active controlled, double blind study with a hypothesis to assess the safety and efficacy of 10 Hz rTMS compared to sertraline. Methods A multicenter, parallel arm, randomized, placebo-controlled, double-blind design to assess safety and efficacy of 10 Hz rTMS compared to sham. An ancillary study will be conducted with parallel arm, randomized, active controlled and double dummy design to assess safety and efficacy of 10 Hz rTMS compared to sertraline.
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Affiliation(s)
- Tomas Andriotti
- Sao Camilo Hospital, Rua Dr. Plinio Barreto, 173, 174B, São Paulo, SP, 01313020, Brazil
| | - Rafaelly Stavale
- University of Brasilia, School of Health Sciences, Department of Nursing, Campus Universitario Darcy Ribeiro, Brasilia, DF, 70910-900, Brazil
| | - Tarek Nafee
- Beth Israel Deaconess Medical Center, Department of Cardiology, Perfuse Study Group, 330 Brookline Ave, Boston, MA, 02215, United States
| | - Stephanie Fakhry
- Iberoamerican University, School of Medicine, Av. Francia No. 129, Santo Domingo, DN, 10204, Dominican Republic
| | - Mahmoud M A Mohamed
- Umm Al-Quara University, Department of Clinical Pharmacy, Al Taif Road, Makkah, 24382, Saudi Arabia
| | - Nigar Sofiyeva
- Istanbul University, Cerrahpasa Medical Faculty, Department of Obstetrics and Gynecology, Cerrahpasa cad., Kocamustafapasa Mah., Faith, 34098, Istanbul, Turkey.,Yale University, School of Medicine, Department of Obstetrics and Gynecology, New Haven, 06510, Connecticut, USA
| | - Ana Ganho-Ávila
- Proaction Laboratory, Univeristy of Coimbra, Faculty of Psychology and Educational Sciences, Rua do Colegio Novo, 6153, 3001-802, Coimbra, Portugal.,Neuropsychophysiology Laboratory, University of Minho, Research Center in Psychology, Campus de Gualtar, 4710-057, Braga, Portugal
| | - Andreas Bogner
- Clinica of Visceral, Thoracic and Vascular Surgery, Technical University of Dresden, 01069, Dresden, Germany
| | - Sara P Barbosa
- University of São Paulo at Ribeirão Preto, College of Nursing, Av. dos Bandeirantes, 3900 Campus Universitário Ribeirão Preto, SP, 14040-902, Brazil
| | - Luciana S Piton
- Faculty of Medicine of ABC, Av. Príncipe de Galés, 821 - Vila Principe de Gales, Santo André, SP, 09060-650, Brazil
| | | | - Gisele Gaccia
- Univeristy of Mogi of Crosses, Av. Imperatriz Leopoldina, 550 - Vila Leopoldina, São Paulo, SP, 05305-000, Brazil
| | - Tomas P Smith-Howard Junior
- Metropolitan University of Santos, Campus Bandeirante I, Rua da Constituição no. 374, Vila Nova, Santos, SP, 11015-470, Brazil
| | - Priscila C Miranda
- University of Brasilia, Campus Universitario Darcy Ribeiro, Brasilia, DF, 70910-900, Brazil
| | - Karen J Campoverde Reyes
- Massachusetts General Hospital, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, United States
| | - Alvaro Gragera
- University of Huelva Hospital Complex, Clinical Analysis Service, Ronda Exterior Nte, s/n, 21005, Huelva, Spain
| | - Hiroki Nishiwaki
- Center for Innovative Research for Communities and Clinical Excellence, Fukushima Medical University, 〒960-1295 Fukushima Prefecture, Fukushima, Hikarigaoka, Japan
| | - Raphael Boechat-Barros
- University of Brasilia, Psychiatric Department of Medicine School, Campus Universitario Darcy Ribeiro, Brasili, DF, 70910-900, Brazil
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12
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Sal V, Kahramanoglu I, Bese T, Demirkiran F, Sofiyeva N, Soyman Z, Durmus S, Gelisgen R, Arvas M, Uzun H. Is serum level of nestin useful in detecting epithelial ovarian cancer? J Obstet Gynaecol Res 2016; 43:371-377. [DOI: 10.1111/jog.13220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 09/03/2016] [Accepted: 09/23/2016] [Indexed: 01/16/2023]
Affiliation(s)
- Veysel Sal
- Department of Obstetrics and Gynecology; Division of Gynecologic Oncology; Istanbul Turkey
| | - Ilker Kahramanoglu
- Department of Obstetrics and Gynecology; Division of Gynecologic Oncology; Istanbul Turkey
| | - Tugan Bese
- Department of Obstetrics and Gynecology; Division of Gynecologic Oncology; Istanbul Turkey
| | - Fuat Demirkiran
- Department of Obstetrics and Gynecology; Division of Gynecologic Oncology; Istanbul Turkey
| | - Nigar Sofiyeva
- Department of Obstetrics and Gynecology; Division of Gynecologic Oncology; Istanbul Turkey
| | - Zeynep Soyman
- Department of Obstetrics and Gynecology; Istanbul Education and Research Hospital; Istanbul Turkey
| | - Sinem Durmus
- Department of Biochemistry; Istanbul University Cerrahpasa Faculty of Medicine; Istanbul Turkey
| | - Remisa Gelisgen
- Department of Biochemistry; Istanbul University Cerrahpasa Faculty of Medicine; Istanbul Turkey
| | - Macit Arvas
- Department of Obstetrics and Gynecology; Division of Gynecologic Oncology; Istanbul Turkey
| | - Hafize Uzun
- Department of Biochemistry; Istanbul University Cerrahpasa Faculty of Medicine; Istanbul Turkey
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13
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Demirkiran F, Sal V, Bese T, Tokgozoglu N, Erenel H, Sofiyeva N, Kahramanoglu I, Arvas M. Risk factors for recurrence of borderline ovarian tumours: A tertiary centre experience. J OBSTET GYNAECOL 2016; 36:1036-1040. [DOI: 10.1080/01443615.2016.1188276] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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14
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Yuksel MA, Mammadov Z, Sofiyeva N, Alici Davutoglu E, Temel Yuksel I, Madazli R. An unusual case of Meckel-Gruber syndrome (MKS) associated with visceroatrial heterotaxy and facial anomalies. J OBSTET GYNAECOL 2016; 36:524-5. [PMID: 26982535 DOI: 10.3109/01443615.2015.1110123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Mehmet Aytac Yuksel
- a Department of Obstetrics and Gynecology , Cerrahpasa School of Medicine, Istanbul University , Istanbul , Turkey and
| | - Zahid Mammadov
- a Department of Obstetrics and Gynecology , Cerrahpasa School of Medicine, Istanbul University , Istanbul , Turkey and
| | - Nigar Sofiyeva
- a Department of Obstetrics and Gynecology , Cerrahpasa School of Medicine, Istanbul University , Istanbul , Turkey and
| | - Ebru Alici Davutoglu
- a Department of Obstetrics and Gynecology , Cerrahpasa School of Medicine, Istanbul University , Istanbul , Turkey and
| | - Ilkbal Temel Yuksel
- b Department of Obstetrics and Gynecology , Istanbul Okmeydani Research and Training Hospital , Istanbul , Turkey
| | - Riza Madazli
- a Department of Obstetrics and Gynecology , Cerrahpasa School of Medicine, Istanbul University , Istanbul , Turkey and
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Abstract
Endometriosis is traditionally defined as the presence of endometrial glands and stroma in ectopic locations, especially the pelvic peritoneum, ovaries and rectovaginal septum. YKL-40, a new biomarker of inflammation, is secreted by activated macrophages and neutrophils in different tissues with inflammation. Serum concentrations of YKL-40 are elevated in patients with diseases characterized by inflammation. We aimed to investigate the possible association between serum YKL-40 levels and endometriosis. A total number of 88 women were recruited for this case-control study. About 53 patients with surgically proven endometriosis were included, while 35 patients without endometriosis comprised the control group. Patients were classified as having minimal, mild, moderate and severe disease in accordance with the severity. Two new groups were formed by combining patients with minimal and mild disease (Stage 1-2) and with moderate and severe disease (Stage 3-4). Serum YKL-40 levels were statistically higher in the endometriotic group compared to control group (p:0.001). YKL-40 levels were significantly higher in Stage 3-4 group compared to Stage 1-2 group (p values 0.001) as well. Correlation analysis revealed a positive correlation between serum YKL-40 levels and the stage of the disease. YKL-40 may be utilized as a marker for determining the severity of endometriosis.
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