Journal of Medicine and Life

Cancer testis antigen XAGE-1 is a promising marker for the diagnosis and treatment of ovarian cancer

Cancer testis antigens have been discovered in various cancers, and several studies have suggested that since they exhibit such distinct patterns of expression, these antigens might be attractive targets for cancer detection and immunotherapy. Our work attempted to clarify the function played by cancer-testis antigens in ovarian cancers, notably in the XAGE1 gene. The investigation was conducted on 74 tissue samples from newly diagnosed patients with ovarian cancer. The control group included twenty-eight benign ovarian tumors. The expression of XAGE1 mRNA was assessed using RT-PCR. Compared to benign tumors, cancer samples exhibited higher levels of XAGE1 gene expression, which was statistically significant (P0.01). There were no statistically significant differences between menopausal status and family history. Gene expression was substantially connected with age groups as the higher level of gene expression in patients 50-74 years of age (P 0.01) was seen. Mucinous tumors exhibited significant correlations (P0.01) across histopathological tumor types. In correlation with tumor stages, stage III was substantially linked compared to stage I (P0.01). In conclusion, we referred to the potential to use XAGE1 to discriminate malignant ovarian tumors as a diagnostic biomarker. The connection of high XAGE 1 level with advanced ovarian cancer stages has also been established, supporting XAGE 1's proposed role in poor prognosis. Finally, finding the specific involvement of this gene in ovarian cancer and other kinds of malignancies may require further investigations.

Pathogenic variants in BRCA1 and BRCA2 genes associated with female breast and ovarian cancer in the Mexican population

Breast and ovarian cancers are significant global health challenges, with inherited variations in breast cancer gene 1 (

Staging discordance in apparent early-stage ovarian neoplasms: prevalence, prognosis, and practical risk stratification

Up to 1 in 13 patients with apparent early-stage ovarian neoplasms harbor occult advanced disease, posing a diagnostic dilemma with major therapeutic implications that remains poorly characterized. We conducted a retrospective consecutive cohort study of 106 patients with apparent early-stage ovarian neoplasms at a tertiary gynecological oncology center (2014-2023) to determine the prevalence, consequences, and clinical correlates of staging discordance and develop the first descriptive risk stratification for surgical planning. Staging discordance occurred in 8/106 patients (7.5%), all of whom were upstaged to Stage III disease. All malignant cases (5/106, 4.7%) were discordant, demonstrating universally advanced disease requiring chemotherapy (100% vs. 1.0% concordant,

Fertility-sparing surgery: a hopeful strategy for young women with cancer

Somatic and germline mutations in endometrial cancer

Endometrial cancer is a complex disease influenced by both somatic and germline mutations. While individual mutations in genes such as

From guidelines to clinical practice: the impact of sentinel lymph node mapping on surgical management in endometrial cancer

Sentinel lymph node (SLN) mapping using indocyanine green (ICG) fluorescence has emerged as a less invasive alternative to systematic lymphadenectomy in the surgical management of early-stage endometrial cancer. This study aimed to evaluate the feasibility, accuracy, and clinical outcomes of SLN mapping integrated into laparoscopic staging for endometrial cancer based on our institutional experience. A retrospective study was conducted on 29 patients with early-stage endometrial cancer who underwent laparoscopic hysterectomy with bilateral salpingo-oophorectomy and SLN mapping using ICG. Detection rates, histopathological findings, complication rates, and follow-up outcomes were recorded. SLN detection was successful in 100% of patients, with bilateral mapping achieved in 75.9% of cases. Metastatic involvement was found in 13.8% of cases, with micrometastases detected through ultrastaging. No significant intraoperative or postoperative complications were reported. Risk-adapted adjuvant treatment was administered according to ESGO/ESTRO/ESP guidelines. After a median follow-up of 18 months, 93.1% of patients remained disease-free. SLN mapping with ICG is a reliable and safe technique for lymphatic staging in endometrial cancer, enabling accurate nodal assessment while minimizing surgical morbidity. These findings support the routine implementation of this approach in the laparoscopic management of early-stage disease.

Determining the level of stromal and epithelial cells activity in normal and hyperplastic endometrium of late reproductive and perimenopausal women

Hyperplastic processes of the endometrium (HPE) are a group of benign endometrial and stromal cells that have undergone altered growth. This study aimed to investigate the potential role of hypoxia (as indicated by Hif-1α) and apoptosis markers (p53 and BCL-2) in the development of hyperplastic processes of the endometrium (HPE). Results showed that endometrial cells with atypical hyperplasia had increased levels of Hif-1ɑ, which indicates the presence of endometrial hypoxia and may trigger pathological manifestations. Though this result was not statistically significant, it could be the cause of atypia hyperplasia in the late reproductive period (Hif-1ɑ=1.89±0.09 units) and the perimenopausal period (Hif-1ɑ=2.09±0.07 units). Additionally, the study found that p53 markers were elevated in epithelial cells in the late reproductive period, and similar patterns were observed in the perimenopausal period, with the biggest expression in atypical hyperplasia. The study also found that the high expression of BCL-2 indicator (+++) was less common in late reproductive period women with atypia than those without it (χ2=7.2 p=0.01). A similar situation was observed in women in the perimenopausal period (χ2=4.2 p=0.04). These findings suggest that hypoxia may play a role in the development of HPE, as well as changes in apoptotic markers present in the endometrial tissue.

Evaluation of immunohistochemical expression of stem cell markers (NANOG and CD133) in normal, hyperplastic, and malignant endometrium

Cancer stem cells (CSC) are a potential cause for recurrence, metastasis, and resistance of tumors to different therapeutic modalities like hormonal radiotherapy and chemotherapy. We investigated two CSC markers (NANOG and CD 133) in normal, hyperplastic endometrium and endometrial carcinoma. A total of 93 formalin-fixed paraffin-embedded tissue blocks were used for immunohistochemical expression of NANOG and CD133 markers. NANOG expression was detected in 88.37% of endometrial carcinoma cases compared to 15% of the normal proliferative endometrium and 60% of hyperplasia cases. In endometrial carcinoma, high NANOG expression was significantly correlated with high grade, deep myometrial invasion, lymph node metastasis, and high stage with p-values (0.009, 0.005, 0.014, and 0.003, respectively). CD133 was positive in 76.74% of endometrial carcinoma cases, and it showed a significant correlation with deep myometrial invasion, positive lymph node, positive lymphovascular invasion, and high stage (p-values 0.003, 0.001, 0.003, and 0.013, respectively). Normal endometrium showed less expression of CD133 (only 5%) than hyperplasia and endometrial carcinoma with a statistically highly significant difference (p less than 0.0001). Hyperplastic cases with atypia expressed higher CD133 than those without atypia (6 out of 12 versus 3 out of 18). However, this difference was not statistically significant (p-value 0.111). The cancer stem cell markers NANOG and CD 133 are expressed in a high percentage in endometrial carcinoma compared to normal and hyperplasia and their expression is positively correlated with the aggressive behavior of the tumor. High expression of these two markers in apparently normal tissue around the tumor and in hyperplastic conditions with atypia suggests the possibility to use NANOG and CD133 expression as a diagnostic marker distinguishing dysplasia from reactive atypia. Therefore, inhibition of these markers can be a promising method to stop the progression of early cancers.

Prioritizing the risk of cervical cancer: findings from the SCCUT Multicentre Initiative

Cervical cancer (CC) remains a significant global health burden, ranking eighth in incidence and ninth in cancer-related mortality among women worldwide. Persistent infection with high-risk human papillomavirus (HPVhr) is the primary etiological factor in CC development. The SCCUT program in Romania was designed to enhance access to primary screening and assess HPVhr prevalence among women aged 25-65 years in the South-Muntenia region. Between August 2022 and November 2023, a total of 36,813 women were enrolled in the SCCUT program after providing informed consent. Based on age, participants underwent either a Pap test and/or HPVhr testing. Clinical and demographic data-including age, hormonal status, intrauterine device (IUD) use, presence of leucorrhea, and history of cervical interventions-were collected via structured questionnaires. HPVhr testing was performed using the AmpFire

Comparison between non-spherical polyvinyl alcohol particles and tris-acryl gelatin microspheres after uterine artery embolization: a retrospective study

The aim of this study was to compare leiomyoma infarction rates and embolization success using pelvic MRI following uterine artery embolization (UAE) using non-spherical polyvinyl-alcohol particles (nsPVA) or tris-acryl-gelatin microspheres (TAGM). A retrospective analysis was performed in 141 patients (mean age, 38 years) who underwent standard bilateral UAE with either nsPVA (

Cervical cancer screening in Europe and Romania: a review of policies, progress, and persistent disparities

Cervical cancer remains one of the leading causes of cancer-related death among women globally, despite being largely preventable through human papillomavirus (HPV) vaccination and regular screening. While many European countries have made significant progress in reducing incidence and mortality, Romania continues to report the highest rates within the European Union. This narrative review synthesized data from PubMed, Web of Science, Embase, and Google Scholar to evaluate cervical cancer screening policies across Europe, with a particular focus on Romania. The review included studies on HPV vaccination, cytology- and HPV-based screening, national program implementation, and public health strategies. Countries with organized, population-based screening programs and high HPV vaccine coverage, such as the Netherlands, Finland, and the UK, demonstrate lower incidence and mortality. In contrast, Romania faces persistent systemic barriers: limited public awareness, insufficient infrastructure, low screening participation (<20%), and suboptimal HPV vaccine uptake. Efforts to align national policies with WHO and EU cancer control strategies remain fragmented. Romania illustrates the deep disparities in cervical cancer prevention within Europe. Strategic reforms, including transitioning to HPV-based screening, expanding access to vaccination, enabling self-sampling, and enhancing public education, are critical. Integration into broader EU frameworks such as Europe's Beating Cancer Plan may accelerate progress. While the tools for cervical cancer prevention are well established, Romania's case underscores the need for systemic, context-specific interventions to reduce disease burden and promote equity across Europe.

Analysis of molecular marker expression in cutaneous lesions and cervical carcinoma associated with HPV infection

The study sought to systematically compare the expression of molecular markers in benign cutaneous lesions and squamous cell cervical carcinoma associated with HPV infection to better understand the pathophysiological mechanisms involved in HPV-related lesions and their progression to malignancy. We included 200 patients recruited from a gynecological clinic divided into two groups: 100 patients with positive HPV tests presenting with cutaneous lesions and 100 patients diagnosed with squamous cell cervical carcinoma and testing positive for HPV. The participants were selected to ensure diverse ethnic and demographic representation. The study utilized different statistical analyses, including Chi-square tests to assess associations between categorical variables and logistic regression to evaluate factors influencing lesion progression and compare marker expressions across different lesion types. The results indicated significant differences in the expression of specific molecular markers between cutaneous lesions and cervical carcinomas, highlighting distinct molecular pathways involved in HPV-related lesion development. Notably, markers such as p16, p53, and E-cadherin showed varying expression, suggesting their potential role in distinguishing between benign and malignant lesions. The findings emphasize the significance of molecular marker profiling in improving diagnostic and therapeutic strategies for HPV-related lesions. The differential expression of molecular markers can offer valuable insights into the pathogenesis of HPV-induced lesions and help develop targeted interventions to prevent malignant transformation. Further research is necessary to validate these markers in larger cohorts and diverse populations.

Exploring the attitudes and practices of female doctors towards cervical cancer screening in primary health care centers

Cervical cancer is a significant cause of female mortality worldwide, and early detection through regular screening is crucial for reducing mortality rates. However, in developing countries, the uptake of Pap smear tests (PST) is low, mostly due to cultural and social factors and a lack of knowledge. This cross-sectional study assessed knowledge, attitude, and practice of cervical cancer screening among practitioners working at primary healthcare centers in Saudi Arabia. Furthermore, the study aimed to identify the potential barriers that prevent female physicians from performing cervical cancer screening tests. A self-administrated, well-structured questionnaire was used to survey 95 female physicians, including residents, specialists, and consultants in several primary health care centers (PHCCs) in Jeddah managed by the Ministry of Health during September 2019. The results showed that 80% of participants knew about cervical cancer, and 97.8% were aware that PST is a screening tool. However, only 47% advised female patients to get tested for cervical cancer. The factors identified as barriers to test uptake included asymptomatic females (34%), lack of time on the part of the practitioner (24%), and a lack of evidence for risk factors (23%). Additionally, only 42.2% of the participating physicians had undergone a Pap smear test themselves. The study highlights the need for further research to assess HPV status in the population and explore the correlation between circumcision and cervical cancer, as well as polygamy and cervical cancer. The findings suggest that while a good level of knowledge about cervical cancer exists, there is a need to improve compliance with cervical cancer screening guidelines among female physicians in Saudi Arabia.

Multiparametric Ultrasound Examination in Tumor-Like Formations of the Ovaries

Properly diagnosed tumor-like formations of the ovaries facilitate the correct selection of patients who may not require surgery, or choose surgery with minimal access if such intervention is required. Subjective assessment of the features of tumor-like formations with the help of ultrasound diagnostics, including compression elastography, proved to be highly effective in the differential diagnosis of bulky ovarian formations. All tumor-like formations have their sonographic features that allow making a reliable diagnosis of a particular formation. The article reveals data on the diagnostic significance of multiparametric ultrasound imaging in the detection of ovarian tumor-like formations. A detailed sonographic picture of tumor-like formations in B-mode, color, and pulse Doppler mode and compression sonoelastography mode was analyzed. This examination was especially relevant for women of reproductive age, as it depended on the further tactics of treatment of each patient. For all types of tumor-like formations ovaries, a qualitative feature was determined - elastotype on the Ueno scale and the index of stiffness (Strain Ratio) - a quantitative indicator. Follicular cysts, endometrioid and periovarian cysts were found to belong to the 0 elastotype. Cysts of the corpus luteum belonged to the II elastotype on the Ueno scale. The lowest values of the stiffness index were seen in follicular and periovarian cysts, and the highest value was observed in endometrioid cysts. Our results have shown that ultrasound examination of ovarian tumors is an accurate and highly informative method.

The prevalence of high-risk human papillomavirus genotypes and related risk factors among Iranian women

Human papillomavirus (HPV) infection, which often includes high-risk genotype infection, is one of the leading causes of cervical cancer. This cross-sectional research included 503 Iranian women referred to the gynecology clinic of Kamali Hospital in Karaj, Iran, for routine cervical cancer screening between 2020 and 2021. Cervical specimens were collected from all participants with a special brush and transported to the laboratory for cervical cytology diagnosis. Overall HPV incidence among Iranian women was 39.96%, of which 23.06% had high-risk HPV genotypes and 9.7% had low-risk HPV types. The risk associated with HR-HPV types was considerably associated with employment and marital status.