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    Assessment of Diagnostic Value of ‘Human Epididymis Factor 4 (HE4)’ in women with adnexal masses
    (Pamukkale University, 2020) Kılıç, Derya; Yetimalar, Mehmet Hakan; Köseoğlu, Mehmet; Sağlam, Gülcan
    Purpose: Human epididymis protein 4 (HE4) is a novel biomarker for ovarian cancers. The aim of this study is to assess the usefulness and efficacy of HE4, in comparison with CA-125 in the differential diagnosis of malignant and benign gynecological diseases in women with adnexal masses. Materials and Methods: 85 patients diagnosed with adnexial mass who were operated at a tertiary referral center between the years of 2012 and 2013 were included in the study. Demographic data, physical examination, results of the laboratory tests, imaging, and pathology were recorded from all subjects. Blood samples were collected before surgery for the evaluation of HE4 and CA-125 levels. Patients were divided into 4 groups according to their histopathologic diagnosis: benign (n:58), malignant (n:17), borderline (n:5) and metastatic (n:5) and serum CA-125 and HE4 levels were compared considering menopausal status. Results: Using 35 U/mL as the cut-off value, CA-125 had a sensitivity of 82.4%, spesificity of 67.2%, a negative predictive value of 92.9%, and a positive predictive value of %42.4%. For the same sensitivity level, specificity was 87.9%, negative predictive value was 94.4%, and the positive predictive value was 66.7% for HE4. Receiver operator characteristic (ROC) area under the curve was higher in both the premenopausal and postmenopausal group for the HE4 curve. Accordingly, sensitivity at set specificity of 90% was 82.4%, and 70.6% for 95% of specificity and 41.1% for 98%. Same sensitivity values for CA-125 were 47.1%, 35.3% and 23.5%, respectively. Conclusion: According to our study, especially in the premenopausal period, HE4 shows higher sensitivity and specificity values than CA-125.
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    Impact of the HALP Score on Long-Term Mortality among Patients Undergoing EVAR
    (Feray Akbaş, 20.11.2024) Altunova, Mehmet; Evsen, Ali; Demir, Yusuf; Aktemur, Tugba; Erdogan, Onur; Atmaca, Sezgin; Köseoğlu, Mehmet; Uzun, Nedim; Sahın, Anıl; Çelik, Ömer
    Introduction: Endovascular aortic repair (EVAR) is commonly used for abdominal aortic aneurysms, but its mortality rate remains high. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, which measures hemoglobin, albumin, lymphocyte, and platelet levels, provides prognostic value by reflecting the nutritional status and systemic inflammation. This study aimed to explore the relationship between the HALP score upon admission and long-term mortality in patients with EVAR. Methods: Consecutive patients with EVAR at our tertiary center from October 2010 to August 2021 were retrospectively analyzed. HALP scores were calculated using the following formula: hemoglobin (g/L) × albumin (g/L) × lymphocyte count (/L)/platelet count (/L). In-hospital and long-term mortality data were extracted. Receiver operating characteristic curve analysis identified predictors of in-hospital mortality. Multivariate Cox regression analysis was performed to examine determinants of long-term mortality. Results: Among the 162 participants (mean age: 69.4±8.2 years, 90.1% male), the HALP score was the most significant predictor of inhospital mortality (area under the curve: 0.752, 95% confidence interval: 0.674-0.830; p<0.001). Multivariate Cox regression analysis revealed HALP (p=0.001) and C-reactive protein (p=0.004) as independent determinants of long-term mortality. Conclusion: This study is the first to investigate the association between the HALP score and in-hospital and long-term mortality in EVAR patients. The HALP score is a robust prognostic tool compared with its components and other parameters in this patient population.
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    Impact of the HALP Score on Long-Term Mortality among Patients Undergoing EVAR
    (Erkan Mor, 20.11.2024) Altunova, Mehmet; Evsen, Ali; Demir, Yusuf; Aktemur, Tugba; Erdogan, Onur; Atmaca, Sezgin; Köseoğlu, Mehmet; Uzun, Nedim; Sahın, Anıl; Çelık, Omer
    Introduction: Endovascular aortic repair (EVAR) is commonly used for abdominal aortic aneurysms, but its mortality rate remains high. The hemoglobin, albumin, lymphocyte, and platelet (HALP) score, which measures hemoglobin, albumin, lymphocyte, and platelet levels, provides prognostic value by reflecting the nutritional status and systemic inflammation. This study aimed to explore the relationship between the HALP score upon admission and long-term mortality in patients with EVAR. Methods: Consecutive patients with EVAR at our tertiary center from October 2010 to August 2021 were retrospectively analyzed. HALP scores were calculated using the following formula: hemoglobin (g/L) × albumin (g/L) × lymphocyte count (/L)/platelet count (/L). In-hospital and long-term mortality data were extracted. Receiver operating characteristic curve analysis identified predictors of in-hospital mortality. Multivariate Cox regression analysis was performed to examine determinants of long-term mortality. Results: Among the 162 participants (mean age: 69.4±8.2 years, 90.1% male), the HALP score was the most significant predictor of inhospital mortality (area under the curve: 0.752, 95% confidence interval: 0.674-0.830; p<0.001). Multivariate Cox regression analysis revealed HALP (p=0.001) and C-reactive protein (p=0.004) as independent determinants of long-term mortality. Conclusion: This study is the first to investigate the association between the HALP score and in-hospital and long-term mortality in EVAR patients. The HALP score is a robust prognostic tool compared with its components and other parameters in this patient population.