The coexistence of adenomyosis and cancer of the endometrium has attracted heightened scrutiny, leading to inquiries regarding their possible interactions and clinical ramifications. This study sought to assess the influence of adenomyosis on tumor features and survival outcomes in patients with endometrioid-type endometrial carcinoma. A retrospective cohort analysis was performed on 422 patients who underwent surgical intervention for endometrioid-type endometrial carcinoma. The cohort was categorized into two groups according to the presence or absence of adenomyosis. Clinical and pathological data were gathered and evaluated to compare tumor features and survival outcomes between the two cohorts. Adenomyosis was present in 144 (34.1%) patients. Patients in the adenomyosis group demonstrated significantly higher gravidity and parity compared to those without adenomyosis. Lymphovascular space invasion was detected in 8.3% of the adenomyosis group compared to 17.6% in the non-adenomyosis group (a 53% reduction, p = 0.010). Similarly, rates of myometrial invasion (81.3% vs. 65.5%, p = 0.001), cervical stromal invasion (9.0% vs. 14.1%, p = 0.005), and lymph node metastasis (4.2% vs. 14.4%, p = 0.001) were significantly lower in patients with adenomyosis. The five-year overall survival rate was 90.8% in the adenomyosis group and 87.1% in the non-adenomyosis group, although this difference was not statistically significant (p = 0.689). This study demonstrates that adenomyosis is associated with a significant reduction in aggressive tumor characteristics such as myometrial invasion, lymphovascular space involvement, and lymph node metastasis in patients with endometrioid-type endometrial cancer. These findings emphasize that adenomyosis may be a potential protective factor in endometrial cancer prognosis and should be considered in clinical risk assessment. Prospective studies with larger cohorts are needed to confirm the long-term effects of adenomyosis on survival.

Aim: To assess the predictive role of hematological indices in the first trimester of pregnancy for gestational diabetes mellitus (GDM) and to compare the progressive changes in these indices between patients with and without GDM in their first and second trimesters. Materials and Methods: Pregnant women screened for GDM in 24-28 gestational weeks and who had CBC test in the first and second trimesters were retrospectively investigated. Platelet mass index (PMI), neutrophil-to-lymphocyte ratios (NLR) and platelet-to-lymphocyte ratios (PLR) were calculated. The first trimester hematological indices were compared between normal glycemic patients and the patients with subsequent GDM. The progressive changes of these indices were compared. Results: Three-hundred-sixty-eight women were enrolled and 17.9% had GDM. There was no difference between first trimester hematological indices, except PLR which was lower in GDM group, however, PLR was not an independent predictor. In normal-glycemic pregnant women hemoglobin, hematocrit, lymphocytes, platelets, mean-platelet-volume (MPV), plateletcrit (PCT), platelet-large-cell-ratio (PLCR) and PMI decreased significantly from first trimester to second trimester. White-blood-cells(WBC), neutrophils, nucleated-red-blood-cells(NRBC), immature granulocytes and NLR increased significantly, while no significant changes were detected in red-cell-distribution-width(RDW), platelet-distribution-width(PDW) and PLR. In GDM patients, hemoglobin, hematocrit, lymphocytes, platelets and PMI significantly decreased while WBC, neutrophils, MPV, immature granulocytes and NLR increased from first trimester to second trimester. RDW, PDW, PCT, PLCR, NRBC and PLR did not change. Conclusion: None of the first trimester hematological indices have a predictive ability for subsequent GDM. The progressive changes in MPV can be used as an indicator to assess the development of GDM.

Background and Objectives: The relationship between preoperative inflammatory markers and lymphovascular space invasion (LVSI) in endometrioid-type endometrial cancer (EC) remains incompletely defined and warrants evaluation using robust statistical methods. This study aimed to evaluate the independent association of preoperative inflammatory markers, analyzed strictly as continuous variables, with the presence of LVSI, and to develop a refined predictive nomogram adjusted for established clinical confounders. Materials and Methods: Data from 156 patients who underwent standard staging surgery for endometrioid-type EC were retrospectively analysed. To preserve statistical power and avoid structural artifacts from data forcing, preoperative glucose-to-lymphocyte ratio (GLR), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR) were modeled on their original continuous scale. Multivariable logistic regression analysis was performed to identify independent risk factors for LVSI, adjusting for patient age and maximum tumor diameter. Internal validation was conducted using bootstrap resampling (1000 iterations). Results: In the multivariable logistic regression model, continuous PLR emerged as a significant independent risk factor for the presence of LVSI (adjusted OR: 1.013 per 1-unit increase, 95% CI: 1.001–1.024; p = 0.033). Among clinical parameters, maximum tumor diameter demonstrated the strongest independent association with LVSI (adjusted OR: 1.595 per 1 cm increase, 95% CI: 1.211–2.099; p = 0.001). Continuous NLR (p = 0.513) and GLR (p = 0.545) did not retain statistical significance due to overlapping explanatory variance and shared hematological components. The optimized 3-variable nomogram (PLR, tumor size, and age) demonstrated an apparent C-index of 0.816 (95% bootstrap CI: 0.719–0.920) and a robust optimism-corrected C-index of 0.794. The bootstrap-corrected calibration slope was 0.909, and Decision Curve Analysis (DCA) demonstrated a positive net clinical benefit across clinically relevant threshold probabilities. Conclusions: Preoperative PLR, evaluated as a continuous parameter, provides a statistically stable framework for preoperative risk stratification in endometrioid EC. When integrated with tumor size and age, the proposed nomogram demonstrates promising discriminative performance and potential clinical utility pending external validation for predicting LVSI. However, given the limited number of LVSI-positive events (n = 17), these findings should be regarded as exploratory and hypothesis-generating and require external validation before clinical use.

Postoperative pain management remains a significant challenge in laparoscopic gynecological surgery. Kinesio tape has emerged as a potential non-pharmacolo