Naina Kumar

Clinical value of serum biomarkers, magnetic resonance imaging risk scoring, and malignancy risk indices in distinguishing benign and malignant ovarian masses: an observational study

Accurate preoperative differentiation between benign and malignant adnexal masses is essential for guiding optimal surgical management. This study aimed to assess the diagnostic performance, calibration, and clinical utility of serum biomarkers (CA-125, CEA), the O-RADS MRI risk score, and Risk of Malignancy Indices (RMI-I-V) in both premenopausal and postmenopausal women. This retrospective study included data from consecutive patients who underwent surgical management for ovarian masses at a rural tertiary care center in Southern India over 2 years. Preoperative ultrasonography, serum CA-125, CEA levels, and O-RADS MRI risk scores were recorded. RMI-I-V were calculated for each case. Statistical analyses included Receiver Operating Characteristic (ROC) curves, calibration plots, and decision curve analysis to assess discrimination and clinical utility across decision thresholds (5-50%). A total of 129 women were evaluated-98 (75.9%) had benign, 5 (3.9%) borderline, and 26 (20.2%) malignant ovarian masses. At recommended cut-offs, all RMI models and serum biomarkers significantly differentiated between benign, borderline, and malignant cases. RMI-IV and RMI-V demonstrated the best sensitivity (92.31%), specificity (90.82% and 92.86%), and negative predictive values (97.80% and 97.85%), whereas CEA showed the poorest sensitivity (23.08%). Calibration was most accurate for RMI-V, with RMI-II and RMI-IV also performing well. Decision curve analysis confirmed the highest net clinical benefit for RMI-II and RMI-IV across thresholds of 5-50%. RMI-based models, especially RMI-IV, demonstrated excellent diagnostic accuracy and clinical utility, supporting their use as a reliable, cost-effective tool for adnexal mass evaluation.

Infecting Cancer to Cure It: The Power of Oncolytic Viruses in Gynecologic Oncology – A Narrative Review

AbstractGynecological cancers, including ovarian, cervical, and endometrial malignancies, contribute significantly to the global cancer burden. Oncolytic virotherapy (OVT), using both double-stranded DNA viruses (such as adenovirus, vaccinia, and herpesvirus) and single-stranded RNA viruses (including positive-sense viruses like coxsackievirus and poliovirus, and negative-sense viruses like measles and Newcastle disease virus), has emerged as a promising therapeutic approach. This review aims to evaluate the current state and future prospects of OVT in treating gynecological cancers.A literature search was conducted from December 2005 to December 2024 using databases like PubMed, Scopus, and Web of Science with keywords such as “oncolytic virotherapy,” “gynecological cancers,” and specific virus types. Studies were included after assessing the efficacy, safety, mechanisms of action, and combinatorial use of OVT with other therapies. Exclusions included non-English publications, non-gynecological cancer studies, and those without relevant clinical or experimental data. This review thoroughly explores OVT’s potential in gynecological cancer treatment.Oncolytic virotherapy demonstrates transformative potential for managing gynecological cancers. Whether used as monotherapy or in combination with other treatments, OVT shows promise in improving therapeutic outcomes and patient survival. However, further research is necessary to optimize its clinical application.

Genome Editing in Gynecological Oncology: The Emerging Role of CRISPR/Cas9 in Precision Cancer Therapy

Nanotechnology and nanobots unleashed: pioneering a new era in gynecological cancer management – a comprehensive review