Platelets seem to play a role in the development of ovarian cancer. Platelet count (PLT) is an ubiquitous available parameter. We analyzed retrospectively data of 756 patients with primary adnexal tumors: 584 benign and 172 malignant (148 invasive and 24 borderline) cases. We compared the diagnostic accuracy of CA125, PLT, and a combination of CA125 and PLT. The cutoff values for CA125 and PLT were 35 U/ml and 350/nl, respectively. The median age of patients with benign and malignant tumors was 45 and 64 years, respectively. A total of 77/172 (44.8 %) malignant and 50/584 (8.6 %) benign cases presented with thrombocytosis (PLT ≥350/nl). The median PLT differed between benign and malignant cases (257/nl vs. 330/nl; p < 0.001), similarly as CA125 did (17 vs. 371 U/ml; p < 0.001). In the multivariate analysis, age, CA125, and thrombocytosis predicted independently the presence of malignancy. The results of CA125 were false positive in 21 % and false negative in 13 %. If considered together, thrombocytosis + CA125 were false positive only in 9 %, whereas the false negative rate was 12 %. The sensitivity and specificity of CA125, thrombocytosis, and thrombocytosis + CA125 for detecting adnexal malignancy were 0.88/0.78, 0.45/0.91, and 0.81/0.94, respectively. The positive predictive value (PPV) of CA125, thrombocytosis, and thrombocytosis + CA125 was 0.79, 0.61, and 0.91, respectively. In conclusion, PLT is an ubiquitously available parameter that could be useful in the diagnostic evaluation of pelvic mass. Considering thrombocytosis additionally to CA125 improves the specificity and PPV and reduces the false positive rate in detecting adnexal malignancy.
The mode of inheritance of hymenal variants has not been determined so far. Because surgical corrections of hymenal variants should be carried out in asymptomatic patients (before menarche), gynecologists and pediatricians should keep in mind that familial occurrences may occur.
Abstract. Aim: To assess the impact of the use of intraoperative hemostatic gelatin-thrombin matrix (HM)( (168 vs. 199 min, p=0.02) and hospitalization (9 vs. 14 days, p<0.001) times. The mean postoperative Hb drop (3.33 vs. 4.51 g/dl, p<0.001), and the mean postoperative increase in CRP (94.9 vs. 149.1 mg/l, p<0.001) were significantly less pronounced within the HM group. Despite more prevalent coagulopathy (48 vs. 31%, p=0.02), e.g. due to anticoagulant use (15.7 vs. 3%, p<0.001), patients treated using HM needed less frequent transfusions of packed red blood cells [odds ratio (OR)= 0.13, 95% confidence interval (CI) =0.07-0.24) and fresh frozen plasma (OR=0.51,. In comparison to controls, the need for surgical revisions (OR 0.1,) and intensive-care unit admissions (OR 0.15, Intraoperative bleeding is a complication of gynecological surgery (1, 2). Increased perioperative blood loss (PBL) disrupts the operation, impairs organ exposure, contributes to prolonged surgical and hospitalization times, increases the need for transfusion, and negatively impacts therapy costs (1, 3). In non-oncological gynecological surgery, acute postoperative hemorrhage is the most frequent cause of returning to the operating theater (2). A PBL of more than 1 l complicates 15-40% of radical oncological operations, resulting in transfusion rates of 30-60% (4-6). In general surgery, intraoperative transfusion of only one to two units of packed red blood cells (PRBC) has been shown to significantly elevate the risk for surgical-site infection, pneumonia, sepsis and 30-day mortality (7). In gynecological patients, blood transfusions are clearly associated with increased surgical wound infections and composite morbidity and mortality (8). Additionally, a low perioperative hemoglobin (Hb) level and blood transfusions themselves may worsen the prognosis of pelvic cancers (9, 10). Typical intraoperative hemostatic maneuvers comprise of compression, sutures, clips and electrocoagulation. However, in some cases, conventional hemostasis can be insufficient (e.g. due to intraoperative coagulopathy), unsafe (e.g. due to proximity of structures sensitive to thermal damage) or impractical (e.g. diffuse bleeding area) (1, 11). Additionally, a subset of patients undergoing surgery have impaired hemostasis, e.g. due to use of oral anticoagulant. In the past two decades, an increasing number of topical hemostats, sealants and adhesives have been available to surgeons (1,12 in vivo 31: 251-258 (2017) Patients and MethodsPatients and definitions. This was a retrospective single-center study, conducted at the St. Josefskrankenhaus, Academic Teaching Hospital of the University of Freiburg, Freiburg, Germany. The study period was January 1, 2008 to October 30, 2013. The study was approved by the Institutional Review Board of the University of Freiburg (Reference No. 194/12), and was registered with the German Clinical Trials Register (DRKS), a primary register of the WHO International Clinical Trials Registry Platform, trial number DRKS00004...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.