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  • Original Article

    Evaluation of Probably Benign Adnexal Masses in Postmenopausal Women

    Rev Bras Ginecol Obstet. 2017;39(5):229-234

    Summary

    Original Article

    Evaluation of Probably Benign Adnexal Masses in Postmenopausal Women

    Rev Bras Ginecol Obstet. 2017;39(5):229-234

    DOI 10.1055/s-0037-1601454

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    Abstract

    Background

    Preoperatively identification of malignancy potential of a postmenopausal adnexal masses is important.

    Aim

    To evaluate the effectiveness of the Risk of Malignancy Index-2 in presumably benign adnexal masses in postmenopausal women.

    Study Design

    Retrospective, observational study.

    Methods

    119 women with postmenopausal adnexal masses with a preliminary diagnosis of benign tumors according to the Risk of Malignancy Index-2 were included. Age, duration of menopause, ultrasonographic findings, and serum CA-125 levels were recorded preoperatively. The definitive diagnosis was based on postoperative histopathological examination.

    Results

    Of 119 adnexal mass, 10 were malignant and 109 were benign. There was no statistically significant difference with regard to age and tumor size between the groups. The two significant ultrasonographic parameter between groups were the presence of solid area in the mass and bilaterality. Moreover, if the cut off point for serum CA-125 was adjusted to 14.75 IU/mL according to ROC curve, a sensitivity value of 80% and a specificity value of 72% could be achieved to discriminate benign and malign cysts.

    Conclusion

    In the differential diagnosis of benign and malignant adnexal masses in postmenopausal women, the presence of a solid component, bilaterallity based on ultrasonography and high CA-125 values may be used as discriminative criteria. There is no direct relation between the size of the adnexal mass and malignancy potential. Therefore, in the malignancy indexes of postmenopausal women, we recommend lower cut-off values of CA-125 to increase the sensitivity of preoperative evaluation tests without having a great impact on negative predictive values.

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    Evaluation of Probably Benign Adnexal Masses in Postmenopausal Women
  • Original Article

    Sirtuin 1 Levels in Recurrent Implantation Failure

    Rev Bras Ginecol Obstet. 2017;39(10):541-544

    Summary

    Original Article

    Sirtuin 1 Levels in Recurrent Implantation Failure

    Rev Bras Ginecol Obstet. 2017;39(10):541-544

    DOI 10.1055/s-0037-1606349

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    Abstract

    Sirtuin 1 has an important role in cellular processes, including apoptosis and cellular stress. The purpose of this study was to assess serum sirtuin 1 levels in women with recurrent implantation failure (RIF). In this cross-sectional study, we included 28 women with RIF, 29 healthy women who had conceived by in vitro fertilization (IVF), and 30 women with a 1-cycle failure of IVF as controls. Human serum nicotinamide adenine dinucleotide (NAD)-dependent deacetylase sirtuin-1 (SIRT1/SIRT2L1) levels were detected using a commercial colorimetric kit. Recurrent implantation failure patients have higher sirtuin 1 levels than non-pregnant women and healthy pregnant women, but this difference did not reach statistical significance due to the low number of patients in our study. These higher sirtuin 1 levels may result from the inflammation imbalance of RIF patients. The only statistically significant correlation found was between age and sirtuin (r = 0.277, p = 0.009).

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