An elevated serum CA125 level in association with a pelvic mass, pleural effusion, and massive ascites usually signifies a dismal prognosis in a postmenopausal woman. However, surgery and histopathological examination are required for the correct diagnosis and treatment, since an elevated CA125 level can be falsely positive for ovarian malignancy. We present a case of Meigs’ syndrome due to right ovarian fibroma with elevated CA125 level in a postmenopausal woman.

Asian Pac J Cancer Prev, 15 (1), [423][424][425][426] IntroductionCervical cancer is the second most common malignancy in women worldwide after breast cancer (Ferlay et al.). In Thailand, its incidence was 17.7/100,000 of Thai female population during (Khunhaprema et al., 2012. Cervical cancer incidences and deaths have decreased since the implementation of widespread cervical cancer screening with cervical cytology and/or human papilloma virus (HPV) (Saslow et al., 2012). The knowledge of HPV has been advanced. However, the cervical cytology is still the mainstay of cervical cancer screening. Colposcopy is the next investigation step for abnormal cervical screening patients after the followings; a) two consecutive unsatisfactory cytology results; b) most cases of positive HPV testing; c) repeated atypical squamous cell of undetermined significance (ASC-US) cytology; d) low grade squamous intraepithelial lesion (LSIL) cytology; e) atypical squamous cell, cannot exclude high grade squamous intraepithelial lesion (ASC-H) cytology; f) high grade squamous intraepithelial lesion (HSIL) cytology; g) some types of glandular abnormality (Massad et al., 2013

Objective-Heritable polymorphisms modulate metastatic efficiency in cancer. Single nucleotide polymorphisms (SNPs) in MMP9 (rs17576) and SIPA1 (rs746429, rs931127) have been associated with nodal metastases in multiple cancers. We investigated the association of these SNPs with nodal metastases in early stage cervical cancer.Methods-Consecutive patients with stage IB cervical cancer who underwent a pelvic lymph node (LN) dissection were included. Cases (≥ 1 positive LN, n=101) were compared with controls (negative LN pathology, n=273). Genotyping was performed on genomic DNA in the 3 SNPs using a Taqman assay, and correlated with clinical variables.Results-The G allele at SIPA1 rs931127 was associated with an increased risk of nodal disease (OR 1.9, p=0.03), and approached significance at SIPA 1 rs746429 (OR 2.2, p=0.09) and MMP9 rs17576 (OR 1.5, 0.08). In patients with stage Ib1 lesions (n=304), the G allele at both SIPA1 SNPs were associated with LN metastases (rs746429 OR 10.1, p=0.01; rs931127 OR 2.4, p=0.01). In patients with no lymph vascular space invasion, SIPA1 SNPs were again associated with LN metastases, and all patients with nodal disease had at least one G allele at SIPA1 rs746429.Conclusions-In this case control study, SNPs in SIPA1 varied statistically in cervical cancer patients with and without nodal metastases, and in MMP9 after controlling for stage and lymphvascular space invasion. Further work is needed to characterize inherited polymorphisms that provide a permissive background for the metastatic cascade. Conflict of Interest Statement:The authors have no conflicts of interest to declare Article Precis: SNPs in MMP9 (rs17576) and SIAP1 (rs746429, rs931127) differ between cervical cancer patients with and without nodal metastases and after controlling for clinicopathologic factors.

Introduction: Distinguishing benign adnexal masses from malignant tumors plays an important role in preoperative planning and improving patients’ survival rates. The International Ovarian Tumor Analysis (IOTA) group developed a model termed the Assessment of Different NEoplasias in the adneXa (ADNEX). Objective: Our objective was to evaluate the performance of the ADNEX model in distinguishing between benign and malignant tumors at a cutoff value of 10%. Methods: This was a prospective diagnostic study. 357 patients with an adnexal mass who were scheduled for surgery at Siriraj Hospital were included from May 1, 2018, to May 30, 2019. All patients were undergoing ultrasonography, and serum CA125 was measured. Data were calculated by the ADNEX model via an IOTA ADNEX calculator. Results: Of the 357 patients, 296 had benign tumors and 61 had malignant tumors. The area under the receiver operating characteristic curve for using the ADNEX model was 0.975 (95% confidence interval, 0.953–0.988). At a 10% cutoff, the sensitivity was 98.4% and specificity was 87.2%. The best cutoff value was at 16.6% in our population. Conclusions: The performance of the ADNEX model in differentiating benign and malignant tumors was excellent.

Parecoxib did not demonstrate effectiveness in reducing patient requirement for supplementary meperidine after CD. However, administration of a single 40-mg dose of i.v. parecoxib after elective CD demonstrated effectiveness in reducing pain scores, with a resulting increase in patient satisfaction.

Advanced imaging approaches (computed tomography, CT; magnetic resonance imaging, MRI;

ObjectiveTo evaluate the recurrence rates and patterns of failure in patients with stage I endometrial carcinoma after surgical staging without adjuvant therapy.MethodsMedical records of 229 patients with stage I endometrial carcinoma, treated with surgery alone between 2002 and 2010 at Siriraj Hospital were retrospectively reviewed. The primary objective of this study was recurrence rates. The secondary objectives were patterns of failure, disease-free survival, overall survival, and prognostic factors related to outcomes.ResultsDuring median follow-up time of 53.3 months, 11 recurrences (4.8%) occurred with a median time to recurrence of 21.2 months (range, 7.7 to 77.8 months). Vaginal recurrence was the most common pattern of failure (8/11 patients, 72.7%). Other recurrences were pelvic, abdominal and multiple metastases. Factors that appeared to be prognostic factors on univariate analyses were age and having high intermediate risk (HIR) (Gynecologic Oncology Group [GOG] 99 criteria), none of which showed significance in multivariate analysis. The recurrence rates were higher in the patients with HIR criteria (22.2% vs. 4.1%, p=0.013) or patients with stage IB, grade 2 endometrioid carcinoma (9.4% vs. 4.3%, p=0.199). Five-year disease-free survival and 5-year overall survival were 93.9% (95% CI, 89.9 to 5.86) and 99.5% (95% CI, 97.0 to 99.9), respectively.ConclusionThe patients with low risk stage I endometrial carcinoma had excellent outcomes with surgery alone. Our study showed that no single factor was demonstrated to be an independent predictor for recurrence.

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