As cancer development involves pathological vessel formation, 16 angiogenesis markers were evaluated as potential ovarian cancer (OC) biomarkers. Blood samples collected from 172 patients were divided based on histopathological result: OC (n = 38), borderline ovarian tumours (n = 6), non-malignant ovarian tumours (n = 62), healthy controls (n = 50) and 16 patients were excluded. Sixteen angiogenesis markers were measured using BioPlex Pro Human Cancer Biomarker Panel 1 immunoassay. Additionally, concentrations of cancer antigen 125 (CA125) and human epididymis protein 4 (HE4) were measured in patients with adnexal masses using electrochemiluminescence immunoassay. In the comparison between OC vs. non-OC, osteopontin achieved the highest area under the curve (AUC) of 0.79 (sensitivity 69%, specificity 78%). Multimarker models based on four to six markers (basic fibroblast growth factor—FGF-basic, follistatin, hepatocyte growth factor—HGF, osteopontin, platelet-derived growth factor AB/BB—PDGF-AB/BB, leptin) demonstrated higher discriminatory ability (AUC 0.80–0.81) than a single marker (AUC 0.79). When comparing OC with benign ovarian tumours, six markers had statistically different expression (osteopontin, leptin, follistatin, PDGF-AB/BB, HGF, FGF-basic). Osteopontin was the best single angiogenesis marker (AUC 0.825, sensitivity 72%, specificity 82%). A three-marker panel consisting of osteopontin, CA125 and HE4 better discriminated the groups (AUC 0.958) than HE4 or CA125 alone (AUC 0.941 and 0.932, respectively). Osteopontin should be further investigated as a potential biomarker in OC screening and differential diagnosis of ovarian tumours. Adding osteopontin to a panel of already used biomarkers (CA125 and HE4) significantly improves differential diagnosis between malignant and benign ovarian tumours.

Gestational trophoblastic disease (GTD) is a group of highly aggressive, rare tumors. Human chorionic gonadotropin is a common biomarker used in the diagnosis and monitoring of GTD. To improve our knowledge of the pathology of GTD, we performed protein-peptide profiling on the urine of patients affected with gestational trophoblastic neoplasm (GTN). We analyzed urine samples from patients diagnosed with GTN (n = 26) and from healthy pregnant and non-pregnant controls (n = 17) using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS). Ions were examined in a linear mode over a m/z range of 1000–10,000. All GTN urine samples were analyzed before and after treatment and compared with those of the controls. The statistical analyses included multivariate classification algorithms as well as ROC curves. Urine sample analyses revealed there were significant differences in the composition of the ions between the evaluated groups. Comparing the pre-treatment and group with the pregnant controls, we identified two discriminatory proteins: hemoglobin subunit α (m/z = 1951.81) and complement C4A (m/z = 1895.43). Then, comparing urine samples from the post-treatment cases with those from the non-pregnant controls, we identified the peptides uromodulin fragments (m/z = 1682.34 and 1913.54) and complement C4A (m/z = 1895.43).

Objectives: The purpose of this study was to evaluate the impact of cystocele repair on urinary urge symptoms and to determine the likelihood that urge symptoms are caused by cystocele and therefore cured by cystocele repair. The secondary aim was to assess the impact of baseline cystocele stage POP on the improvement of urge symptoms following surgical treatment of POP. Material and methods: A total of 321 female patients with cystocele stages II, III or IV (POP), who underwent repair surgery for pelvic organ prolapse, were included. A retrospective analysis was performed to determine the presence of urge symptoms in patients with cystocele and to evaluate how many patients were cured from urge symptoms by the cystocele repair. Postoperative data were obtained by interview during a follow-up examination six weeks after surgery. Results: Preoperatively, 52.02% of all patients diagnosed with cystocele stages II, III or IV POP experienced urge symptoms. Urge symptoms were cured in 88.62% of patients with cystocele stages II after POP repair (p < 0.005). 88.60% of patients with cystocele stage II POP and 88.68% of patients with cystocele stages III to IV POP reported improvement in urge symptoms (p < 0.005). Despite cystocele repair, 11.4% of patients with preoperative cystocele stage II POP and 11.32% with preoperative cystocele stages III and IV POP reported persistent urge symptoms. 5.84% of the study group who showed no urge symptoms preoperatively, experienced de novo urge symptoms after following surgery (p < 0.005). Conclusions: Cystocele repair cured urge symptoms in the majority of patients. Therefore, repair of bladder prolapse may help to differentiate urge symptoms from other urinary tract dysfunctions and assist in determining a proper diagnosis and treatment. However, the severity of POP had no significant influence on the improvement in urge symptoms following cystocele repair. Risk of de novo urge symptoms after anatomical repair still needs to be explored. Objectives: The purpose of this study was to evaluate the impact of cystocele repair on urinary urge symptoms and to determine the likelihood that urge symptoms are caused by cystocele and therefore cured by cystocele repair. The secondary aim was to assess the impact of baseline cystocele stage POP on the improvement of urge symptoms following surgical treatment of POP. Material and methods: A total of 321 female patients with cystocele stages II, III or IV (POP), who underwent repair surgery for pelvic organ prolapse, were included. A retrospective analysis was performed to determine the presence of urge symptoms in patients with cystocele and to evaluate how many patients were cured from urge symptoms by the cystocele repair. Postoperative data were obtained by interview during a follow-up examination six weeks after surgery. Results: Preoperatively, 52.02% of all patients diagnosed with cystocele stages II, III or IV POP experienced urge symptoms. Urge symptoms were cured in 88.62% of patients with cystocele stages II after POP repair (p < 0.005). 88.60% of patients with cystocele stage II POP and 88.68% of patients with cystocele stages III to IV POP reported improvement in urge symptoms (p < 0.005). Despite cystocele repair, 11.4% of patients with preoperative cystocele stage II POP and 11.32% with preoperative cystocele stages III and IV POP reported persistent urge symptoms. 5.84% of the study group who showed no urge symptoms preoperatively, experienced de novo urge symptoms after following surgery (p < 0.005). Conclusions: Cystocele repair cured urge symptoms in the majority of patients. Therefore, repair of bladder prolapse may help to differentiate urge symptoms from other urinary tract dysfunctions and assist in determining a proper diagnosis and treatment. However, the severity of POP had no significant influence on the improvement in urge symptoms following cystocele repair. Risk of de novo urge symptoms after anatomical repair still needs to be explored.

Objectives: The early identification of patients who are being treated for low-risk gestational trophoblastic neoplasia (LRGTN) with single-agent chemotherapy, who are at high risk of developing chemoresistance, is of crucial importance. The aim of our research was to evaluate the pretreatment beta subunit of human chorionic gonadotropin (βhCG) concentration and its decrease after the administration of the first course of methotrexate (MTX) in predicting later chemo-resistance to single-agent chemotherapy. Material and methods: A total of 46 patients diagnosed with LRGTN treated with a 5-day methotrexate (MTX) regimen were retrospectively studied. 24 of the patients were successfully cured with only MTX therapy (MTX group). The disease was considered resistant in the remaining 22 patients who, after MTX therapy, required further chemotherapy with an EMA/CO regimen (EMA/CO group). To compare changes in the βhCG concentrations between the two courses of treatment (and the two groups), we calculated the percentage of decline. We determined the specificity and sensitivity of the initial βhCG level and its percentage decline, as a potential predictor of the need for a future EMA/CO regimen. For diagnostic purposes, βhCG levels were measured before the first and second administrations of MTX with a commercial ELISA kit. Results: In the EMA/CO group, we found the initial βhCG level before the first MTX dose was higher (median = 6275 mIU/mL, range: 21.53–192.610.0 mIU/mL) than in the MTX group (median = 532 mIU/mL, range: 56.5 mIU/mL–360.397.0 mIU/mL) (p = 0.034, Mann-Whitney test). The percentage decreases in the βhCG values relative to the initial concentrations were higher in the MTX group (median decrease = 82.7%, range: from 13.3% to 99.9%) than in the EMA/CO group (median de- crease = 71.1%, range: from an increase of 56.1% to a decrease of 97.1%) (p = 0.0079, Mann-Whitney test). An analysis of the ROC curves implied optimal cutoff values for the initial βHCG (6054 IU, sensitivity = 55%, specificity = 86%) and the percentage change in βhCG levels (decrease by 76.5%, sensitivity = 72%, specificity = 71%). Conclusions:  Women with initially higher βhCG levels have a greater risk of developing MTX chemo resistance. It would be advantageous to consider administering an EMA/CO regimen in women with LRGTN when their initial βhCG levels are greater than 6000. Objectives: The early identification of patients who are being treated for low-risk gestational trophoblastic neoplasia (LRGTN) with single-agent chemotherapy, who are at high risk of developing chemoresistance, is of crucial importance. The aim of our research was to evaluate the pretreatment beta subunit of human chorionic gonadotropin (βhCG) concentration and its decrease after the administration of the first course of methotrexate (MTX) in predicting later chemo-resistance to single-agent chemotherapy. Material and methods: A total of 46 patients diagnosed with LRGTN treated with a 5-day methotrexate (MTX) regimen were retrospectively studied. 24 of the patients were successfully cured with only MTX therapy (MTX group). The disease was considered resistant in the remaining 22 patients who, after MTX therapy, required further chemotherapy with an EMA/CO regimen (EMA/CO group). To compare changes in the βhCG concentrations between the two courses of treatment (and the two groups), we calculated the percentage of decline. We determined the specificity and sensitivity of the initial βhCG level and its percentage decline, as a potential predictor of the need for a future EMA/CO regimen. For diagnostic purposes, βhCG levels were measured before the first and second administrations of MTX with a commercial ELISA kit. Results: In the EMA/CO group, we found the initial βhCG level before the first MTX dose was higher (median = 6275 mIU/mL, range: 21.53–192.610.0 mIU/mL) than in the MTX group (median = 532 mIU/mL, range: 56.5 mIU/mL–360.397.0 mIU/mL) (p = 0.034, Mann-Whitney test). The percentage decreases in the βhCG values relative to the initial concentrations were higher in the MTX group (median decrease = 82.7%, range: from 13.3% to 99.9%) than in the EMA/CO group (median de- crease = 71.1%, range: from an increase of 56.1% to a decrease of 97.1%) (p = 0.0079, Mann-Whitney test). An analysis of the ROC curves implied optimal cutoff values for the initial βHCG (6054 IU, sensitivity = 55%, specificity = 86%) and the percentage change in βhCG levels (decrease by 76.5%, sensitivity = 72%, specificity = 71%). Conclusions:  Women with initially higher βhCG levels have a greater risk of developing MTX chemo resistance. It would be advantageous to consider administering an EMA/CO regimen in women with LRGTN when their initial βhCG levels are greater than 6000.