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Serum ischema modified albumin and endometrial cancer; prospective case-control study

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SERUM ISCHEMAA MODIFIED ALBUMIN AND ENDOMETRIAL

CANCER; PROSPECTIVE CASE-CONTROL STUDY

Hanifi Sahin1 , Sevgi Ayhan2 , Mustafa Erkan Sari1 , Selen Yaman1 , Ibrahim Yalcin1 , Tuba Candar3 , Murat Öz1 , Tayfun Güngör3

1 Ankara Zekai Tahir Burak Women’s Health Training and Research Hospital, University of Health Sciences. Department of Gynecologic Oncology

2 Yenimahalle Training and Research Hospital, University of Yıldırım Bayezid Department of Obstetrics and Gynecology

3 Dr.Ridvan Ege Training and Research Hospital, Ufuk University Department of Biochemistry

Objective: To investigate the importance of ischemia modified albumin (IMA) in the

diagnosis and evaluation of endometrioid type endometrial carcinoma

Material-Method: Serum IMA levels of patients with and without endometrioid type

endometrial cancer were measured by the calorimetric assay technique and their absorbance units were compared.

Results: A total of 120 women consisting of 56 endometrial cancer patients and 64 patients as

the control group, were included in the study. The median ages were 58 and 56, respectively. Age, gravida, body mass index, serum albumin levels were not different between the groups (p> 0.05). In the endometrial cancer group, the median serum IMA level was 0.667 and range was 0.57 (0.313- 0.883), while in the control group the median serum IMA level was 0.639 and range was 0.754 (0.178- 0.932). There was no significant difference between the two groups (p = 0.433). IMA levels were similar when myometrial invasion, lymphovascular involvement, grade, tumour size and stage were evaluated (p> 0.05).

Discussion: A prospective or retrospective study that examines the relationship between

gynaecologic tumours and IMA is not available in the literature. Although our study includes a limited number of patients in this aspect, it is the first prospective study in the literature. Ischemia modified albumin (IMA) is an FDA approved marker for use primarily in ischemic heart disease. It is also a marker used in proinflammatory and inflammatory conditions.In recent years, different studies have been conducted describing the relationship between inflammation and cancer. The main purpose of this study is to demonstrate the potential of serum IMA as a diagnostic marker in endometrium cancer, as IMA is an indicator of ischemia and inflammation. There is a limited number of studies on the relationship between serum IMA levels and cancer in the literature. In a prospective study involving 40 colorectal cancer cases, Ellidag et al. found that serum IMA levels were statistically significantly high. In another study of the same group, IMA levels of 40 patients with bladder tumours were investigated and they were found to be significantly elevated. Fidan et al.found statistically significantly higher serum IMA levels in a case-control study involving 52 gastric cancer cases. Stachowicz-Stencel et al. found a significant increase in serum IMA levels in a

prospective study involving 99 paediatric cases of soft tissue sarcoma and neuroblastoma. Da Silveria et al.reported that the increase in serum IMA levels in prostate cancer cases was not

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significant. Radomir et al. reported that the difference between preoperative and postoperative IMA levels in colorectal cancer cases was a valuable marker for predicting the complications. Satoh et al.also reported that the IMA level in the preoperative phase of colorectal cancer patients showed the failure rate of the surgeon.

Conclusions: Although IMA was predominantly used as a cardiac marker only, it was found

to be significantly higher in a limited number of patient studies with some types of cancer. The IMA level does not appear to be an additional predictor of preoperative diagnosis and evaluation of endometrioid type endometrial cancer.

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