Objective: To evaluate hepatic artery Doppler parameters in fetuses with fetal growth restriction (FGR) and to investigate their relationship with composite adverse neonatal outcomes (CANO). Methods: This prospective cohort study included 108 pregnancies (54 FGR; 54 appropriate-for-gestational-age controls) between 34 and 37 weeks’ gestation. Hepatic artery (HA), umbilical artery (UA), middle cerebral artery (MCA), and uterine artery Doppler indices were recorded. Logistic regression and ROC analyses were used to determine predictors of FGR and CANO. Results: HA pulsatility index (PI), systolic/diastolic ratio, and peak systolic velocity (PSV) were significantly higher in FGR fetuses (p < 0.05). In multivariate regression, HA-PI remained independently associated with FGR (aOR 1.74, 95% CI 1.07–2.87, p = 0.025). For predicting CANO, HA-PSV was the only independent predictor (aOR 1.05, 95% CI 1.00–1.10, p = 0.020). ROC analysis demonstrated moderate discriminative ability for HA-PI (AUC 0.681) and HA-PSV (AUC 0.703). Conclusions: Increased HA-PSV in FGR reflects activation of the hepatic arterial buffer response as an adaptive mechanism to maintain hepatic perfusion under hypoxic stress, whereas elevated HA-PI may represent evolving microvascular resistance. Hepatic artery Doppler evaluation may serve as a complementary tool for assessing fetal well-being and identifying fetuses at risk for adverse neonatal outcomes, particularly in late-onset FGR.

Background/Objectives: Lymphovascular space invasion (LVSI) is an established prognostic factor in endometrial cancer, yet current risk stratification relies on a binary focal/substantial classification. Whether further substratification into a “prominent” LVSI category (≥10 involved vessels) provides independent prognostic value beyond the FIGO 2023 staging framework remains unclear. We aimed to investigate the prognostic significance and clinical outcomes regarding the extent of lymphovascular space invasion (LVSI) in patients with LVSI-positive endometrioid endometrial cancer (EEC). Methods: We retrospectively identified 94 patients with International Federation of Gynecology and Obstetrics (FIGO) 2009 stage I–IV EEC who underwent surgical staging. LVSI-positive cases were classified as focal (1–4 involved vessels), substantial (5–9 involved vessels), or prominent (≥10 involved vessels). Results: Of the 94 LVSI-positive patients, 58 (61.7%) had focal, 11 (11.7%) had substantial, and 25 (26.6%) had prominent LVSI. Five-year overall survival (OS) rates were 95.3%, 72.7%, and 53.0% for focal, substantial, and prominent LVSI, respectively (p < 0.001), with corresponding progression-free survival rates of 87.6%, 71.6%, and 34.3% (p < 0.001). On multivariable analysis, prominent LVSI emerged as an independent predictor of both mortality (HR 14.31, p < 0.001) and disease progression (HR 4.02, p = 0.009), retaining significance after re-assessment for FIGO 2023 stage. Tumor size > 4 cm and p53-abnormal status were also independently associated with OS. Conclusions: Prominent LVSI was independently associated with aggressive disease and poor survival in EEC; recognizing its extent as a prognostic parameter may improve both clinical management and future risk classification frameworks. As these findings are derived from a single-institution, LVSI-positive cohort with an empirically defined threshold, external validation is warranted before clinical adoption.

Background: Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder characterized by hyperandrogenism, ovulatory dysfunction, and an increased prevalence of metabolic syndrome. Clusterin (CLU), a chaperone protein induced by cellular stress and known to play roles in inflammation, oxidative stress, and lipid metabolism, may be associated with the metabolic abnormalities observed in patients with PCOS. The purpose of this current study is to investigate serum CLU levels and their link with endocrine, biochemical, and metabolic parameters, such as metabolic syndrome, among women with PCOS. Methods: This cross-sectional study included 40 women aged 18–30 with PCOS diagnosed according to the Rotterdam criteria and 40 age- and BMI-matched healthy controls. Demographic data, Ferriman–Gallwey scores, hormonal and metabolic parameters (including TSH, prolactin, 17-OH progesterone, total testosterone, insulin, AMH, HOMA-IR, and serum CLU levels), and ultrasonographic ovarian morphology were assessed. Statistical analyses, including ROC and logistic regression, were performed. Results: Women with PCOS had higher follicle counts, Ferriman–Gallwey scores, LH/FSH ratios, fasting insulin levels, HOMA-IR, triglycerides, and systolic blood pressure than controls, whereas menstrual cycle frequency and HDL levels were lower (all p < 0.05). Serum CLU concentrations were markedly higher in the PCOS cohort. In the PCOS population, CLU showed positive relationships with the Ferriman–Gallwey score, fasting glucose, fasting insulin, HOMA-IR, and triglycerides, and a negative correlation with HDL. CLU levels were significantly higher in women with metabolic syndrome in the PCOS cohort compared to those without. In logistic regression analysis, CLU, AMH, and the LH/FSH ratio emerged as independent predictors of PCOS. Furthermore, CLU remained an independent predictor of metabolic syndrome in the PCOS cohort. In ROC analysis, CLU demonstrated strong diagnostic efficacy in detecting both PCOS (AUC = 0.834) and metabolic syndrome in patients with PCOS (AUC = 0.804). Conclusions: Our results show that serum CLU is higher in women with PCOS and is associated with the clinical and metabolic features peculiar to patients with PCOS. CLU was found to distinguish between patients with PCOS and healthy women and demonstrated a strong association with the presence of metabolic syndrome within the PCOS group. Overall, these findings suggest that CLU may be a valuable auxiliary biomarker for detecting women with PCOS at risk for metabolic disturbances.

Background/Objectives: Angiogenesis plays a central role in the progression of cervical intraepithelial neoplasia (CIN) to cervical cancer (CC). Transvaginal Doppler ultrasonography (TVDUSG) offers a non-invasive means of assessing hemodynamic changes associated with neoplastic transformation. This study aimed to evaluate the diagnostic performance of uterine artery (UA) Doppler parameters across the full cervical disease spectrum and their associations with adverse prognostic features and clinicopathological features in CC. Methods: This prospective observational cohort study enrolled 170 patients who were divided into four groups: controls, CIN 1, CIN 2–3, and CC. All underwent TVDUSG prior to treatment. Pulsatility index (PI), resistance index (RI), peak systolic velocity (PS), end-diastolic velocity (ED), PS/ED ratio, ED/PS ratio, and time-averaged maximum velocity were recorded. ROC curve analysis was performed to assess diagnostic performance. Results: PI and RI increased progressively from controls to CC, while ED declined across groups (all p < 0.001). In patients with CC, PI correlated with tumor volume and was elevated in those with advanced-stage, parametrial and lymph node involvement (all p < 0.001). ROC analysis revealed strong diagnostic performance for PI in distinguishing CC from controls (AUC = 0.861, sensitivity 80.0%, specificity 80.4%); however, PI showed limited ability to distinguish cervical cancer specifically from high-grade CIN (AUC = 0.593). Conclusions: UA Doppler parameters, particularly PI, are associated with cervical neoplastic severity and adverse prognostic features in CC. TVDUSG may serve as a practical, non-invasive adjunct in the preoperative evaluation of cervical neoplasia, especially where advanced imaging is unavailable.