Endometrial sampling is crucial for evaluating abnormal uterine bleeding in postmenopausal women, yet sample adequacy can be compromised by factors such as endometrial atrophy and cervical stenosis, potentially delaying the diagnosis of serious conditions. This cross-sectional study aimed to determine clinical and sonographic factors associated with inadequate endometrial sampling and to evaluate the effect of misoprostol on sample adequacy in postmenopausal women. A total of 500 postmenopausal women who underwent endometrial sampling at a tertiary hospital in Istanbul between January 2017 and March 2022 were included. Data on age, menopause duration, clinical indications, transvaginal ultrasonographic findings, misoprostol use, and histopathology results were analyzed. Samples were classified as adequate or inadequate. Adequate samples were obtained in 65.4% of cases. Inadequate sampling was significantly associated with older age, longer duration of menopause, thinner endometrial thickness, and the presence of intrauterine fluid (p

The Relationship of Tumor Marker Panel with Tumor Size and Histopathological Results in Borderline Ovarian Tumor - Bezmialem Science

Background: In Turkey, where HPV vaccination is not yet routinely implemented, cervical cancer screening with primary HPV testing begins at age 30. This may result in undetected high-grade cervical lesions in younger unvaccinated women. The aim of this study was to evaluate the age-specific prevalence of CIN2+ lesions, HPV persistence, and the diagnostic performance of cytology among women under 30. Methods: A retrospective cohort study was conducted in 689 unvaccinated women aged 18–30 who underwent colposcopy following a positive high-risk HPV (hrHPV) test. Participants were stratified into two groups: 18–24 and 25–30 years. HPV genotypes, 12-month persistence, cytological findings, and biopsy-confirmed histopathology were analyzed using logistic regression and ROC curve analysis. Results: CIN2+ lesions were identified in 17.5% of women aged 18–24 and 44.9% of those aged 25–30 (p < 0.001). Persistent HPV 16 infection was the strongest predictor of CIN2+. Cytology showed low sensitivity in detecting CIN2+ (36.4% and 47.2% in the respective age groups). ROC analysis revealed better model performance in older women (AUC 0.81 vs. 0.73, p = 0.047). Conclusions: A significant proportion of unvaccinated women aged 25–30 harbor undiagnosed CIN2+ lesions. These findings support lowering the age of HPV-based screening to 25 in low-vaccination settings. Cytology alone is insufficient as a triage tool in this population.

The optimal management of women with non-16/18 hrHPV infection and normal cytology remains a topic of clinical debate. While immediate colposcopy is often

Background and Objectives: Accurate preoperative assessment of lymph node metastasis is essential for surgical staging and treatment planning in endometrial carcinoma. Magnetic resonance imaging (MRI) is widely used for local staging; however, its nodal performance is limited by reliance on morphologic criteria. 18F-FDG PET/CT provides whole-body functional assessment and may support decision-making when sentinel lymph node (SLN) mapping is unavailable. This study compared MRI and 18F-FDG PET/CT for preoperative detection of pelvic and paraaortic nodal metastases across pragmatic histologic risk groups. Materials and Methods: This retrospective diagnostic-accuracy study included 255 consecutive surgically treated patients with histologically confirmed endometrial carcinoma who underwent both preoperative pelvic MRI and whole-body 18F-FDG PET/CT at a tertiary gynecologic oncology center between December 2023 and December 2025. All patients underwent pelvic lymphadenectomy, 111 patients (43.5%) also underwent paraaortic lymphadenectomy, and SLN mapping was not performed. Patients were categorized as Group 1 (Grade 1–2 endometrioid adenocarcinoma) or Group 2 (Grade 3 endometrioid or non-endometrioid/aggressive histology). Diagnostic estimates were reported with 95% confidence intervals, paired comparisons were performed using exact McNemar tests, and multivariable bias-reduced logistic regression was used to assess independent imaging associations with nodal metastasis. Results: Any nodal metastasis was documented in 24 patients (9.4%). 18F-FDG PET/CT showed higher sensitivity than MRI for patient-level nodal detection (91.7%, 95% CI 74.2–97.7 vs. 37.5%, 95% CI 21.2–57.3), with similarly high specificity (97.0%, 95% CI 93.9–98.5 vs. 97.8%, 95% CI 95.0–99.1). The NPV of 18F-FDG PET/CT was 99.1% (95% CI 96.8–99.8), compared with 93.8% (95% CI 90.0–96.2) for MRI. MRI sensitivity was particularly low in Group 1 (18.2%, 95% CI 5.1–47.7), whereas PET/CT retained high sensitivity in both groups, though the perfect performance observed in Group 2 had wide confidence limits. Conclusions: 18F-FDG PET/CT demonstrated superior sensitivity and NPV compared with MRI for preoperative nodal assessment in endometrial carcinoma. These results support the selective use of PET/CT as an adjunctive staging tool in settings without SLN mapping, but they should not be interpreted as evidence that PET/CT can replace histologic nodal staging.