Caner Kose

Is hemoglobin A1c valuable for predicting concurrent endometrial cancer in diabetic women with endometrial intraepithelial neoplasia?

The purpose of this study was to determine the predictive value of preoperative hemoglobin A1c (HgA1c) level for endometrial cancer in diabetic women with endometrial intraepithelial neoplasia (EIN). Six hundred patients with EIN were retrospectively studied in a tertiary referral center in Turkey between January 2014 and December 2021. One hundred and thirteen diabetic patients with EIN who met the inclusion criteria were enrolled in the study and divided into three groups according to the final pathological results: Group 1 with benign findings ( Mean preoperative HgA1c levels were different among three groups (5.41 ± 0.64, 6.01 ± 0.72, 6.65 ± 1.15, HgA1c could be used in prediction of endometrial cancer. The optimal cutoff value determined in our study could be considered in predicting endometrial cancer in diabetic women with EIN.

Preoperative hemoglobin A1c as a predictor of lymph node metastasis in diabetic women with endometrial cancer

Glycated hemoglobin A1c (HbA1c) is a well-established marker for glycemic control; recent studies suggest its potential role in cancer prognosis. Understanding the relationship between preoperative HbA1c levels and lymph node metastasis (LNM) in diabetic women with endometrial cancer (EC) can enhance prognostic assessments and treatment strategies. This study aimed to evaluate the predictive value of preoperative HbA1c levels for LNM in diabetic women with EC. A retrospective analysis was conducted on 233 diabetic women who underwent surgery for endometrioid-type EC at a tertiary referral hospital between 2010 and 2021. Data collected included demographic information, fasting plasma glucose, HbA1c levels, ultrasound findings, and tumor characteristics. Receiver operating characteristic (ROC) analysis was used to assess the predictive power of HbA1c levels for LNM. Univariate and multivariate regression analyses were performed to identify independent risk factors for LNM. The mean preoperative HbA1c level was 7.03 ±1.37%. A cutoff HbA1c level ≥7.26% demonstrated a sensitivity of 73.7%, a specificity of 72.3% and an area under the curve (AUC) of 0.781 for predicting LNM (p < 0.001). Significant correlations were found between HbA1c levels and endometrial thickness (r = 0.231, p < 0.001), primary tumor diameter (PTD) (r = 0.173, p = 0.008) and duration of diabetes (r = 0.203, p = 0.002). Multivariate analysis identified HbA1c level (odds ratio (OR) = 2.621, 95% confidence interval (95% CI): 1.722-3.987, p < 0.001), lymphovascular space involvement (LVSI) (OR = 19.193, 95% CI: 5.805-63.458, p < 0.001), body mass index (BMI) (OR = 1.095, 95% CI: 1.010-1.188, p = 0.029), and duration of diabetes (OR = 1.019, 95% CI: 1.001-1.301, p = 0.039) as independent risk factors for LNM. Preoperative HbA1c levels serve as a significant predictor for LNM in diabetic women with EC. A cutoff HbA1c level ≥7.26% indicates higher risk of LNM. These findings underscore the importance of glycemic control in reducing cancer progression risks and improving the prognosis of diabetic patients with EC. Integrating HbA1c monitoring into preoperative assessments can help tailor personalized treatment strategies for better outcomes.

Association between uterine leiomyoma and fragmented QRS waves: a prospective case-control study

The aim of this study was to evaluate the relationship between uterine leiomyoma and fragmented QRS, a non-invasive indicator of cardiovascular risk and myocardial ischemia, in women with uterine leiomyoma. In this prospective case-control study, a total of 47 patients diagnosed with uterine leiomyoma (case group) and 47 healthy individuals without uterine leiomyoma (control group) who had undergone bilateral tubal ligation surgery were included. Various demographic, clinical, and laboratory parameters and the presence of fragmented QRS were recorded. The leiomyoma group showed significantly higher body mass index (27.46±2.18 vs. 25.9±2.87 kg/m2, p=0.005) and waist circumference (91.34±9.30 vs. 84.97±9.3 cm, p=0.001) compared with the control group. Uterine volumes were also significantly higher in the leiomyoma group (235.75±323.48 vs. 53.24±12.81 mm3, p<0.001). The presence of fragmented QRS was detected in 18.1% of the patients. Multiple regression analysis identified age, fasting blood glucose value, and the presence of fragmented QRS as independent risk factors for the presence of leiomyoma. This study provides valuable insights into the relationship between uterine leiomyoma and fragmented QRS. The presence of fragmented QRS was identified as an independent risk factor for the presence of leiomyoma. Further research is needed to better understand the underlying mechanisms connecting uterine leiomyoma and cardiovascular health.