Publications by authors named "Daiva Vaitkiene"

13 Publications

  • Page 1 of 1

Performance of the IOTA ADNEX Model on Selected Group of Patients with Borderline Ovarian Tumours.

Medicina (Kaunas) 2020 Dec 11;56(12). Epub 2020 Dec 11.

Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.

ultrasound is considered to be the primary tool for preoperative assessment of ovarian masses; however, the discrimination of borderline ovarian tumours (BOTs) is challenging, and depends highly on the experience of the sonographer. The Assessment of Different NEoplasias in the adneXa (ADNEX) model is considered to be a valuable diagnostic tool for preoperative assessment of ovarian masses; however, its performance for BOTs has not been widely studied, due to the low prevalence of these tumours. The aim of this study was to evaluate the performance of ADNEX model for preoperative diagnosis of BOTs. retrospective analysis of preoperative ultrasound datasets of patients diagnosed with BOTs on the final histology after performed surgery was done at a tertiary oncogynaecology centre during the period of 2012-2018. 85 patients were included in the study. The performance of ADNEX model based on absolute risk (AR) improved with the selection of a more inclusive cut-off value, varying from 47 (60.3%) correctly classified cases of BOTs, with the selected cut-off of 20%, up to 67 (85.9%) correctly classified cases of BOTs with the cut-off value of 3%. When relative risk (RR) was used to classify the tumours, 59 (75.6%) cases were identified correctly. Forty (70.2%) cases of serous and 16 (72.7%) cases of mucinous BOTs were identified when AR with a 10% cut-off value was applied, compared to 44 (77.2%) and 15 (68.2%) cases of serous and mucinous BOTs, correctly classified by RR. The addition of Ca125 improved the performance of ADNEX model for all BOTs in general, and for different subtypes of BOTs. However, the differences were insignificant. The International Ovarian Tumour Analysis (IOTA) ADNEX model performs well in discriminating BOTs from other ovarian tumours irrespective of the subtype. The calculation based on RR or AR with the cut-off value of at least 10% should be used when evaluating for BOTs.
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http://dx.doi.org/10.3390/medicina56120690DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763161PMC
December 2020

Circulating inflammatory markers in cervical cancer patients and healthy controls.

J Immunotoxicol 2020 12;17(1):105-109

Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.

There is increasing evidence that host inflammatory responses play an important role in the development and progression of cancers. There are some data that cancer is associated not only with inflammation at the site of the lesion, but also with dysregulations of the host overall systemic immune response. In the case of cervical cancer, inflammation is an important factor associated with the development, progression, and potential metastasis of the disease. What is unclear still in the potential for modifications of host responses to human papillomaviruses (HPV) - a known causative agent of CC, that could be induced by cigarette smoking. In particular, it remains to be determined how the inflammation induced by HPV infection could impact on CC incidence/severity. In this prospective study, serum levels of 10 cytokines were evaluated using Multiplex and ELISA assays. The samples were the sera of 43 CC patients and 60 healthy (NILM) controls. All outcomes were evaluated in relation to host HPV and to their smoking status. The results in indicated that serum sTREM-1, TNFα, IFNβ, IL-1β, and IL-6 levels were significantly increased in CC (HPV+) patients compared to healthy NILM controls. A similar trend was observed for IL-10 and IL-2 levels. Within the two groups, differences in cytokine levels between smokers and never smokers were not remarkable. The findings here support the hypothesized role of systemic inflammation in the pathophysiology of CC.
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http://dx.doi.org/10.1080/1547691X.2020.1755397DOI Listing
December 2020

Associations among Serum Lipocalin-2 Concentration, Human Papilloma Virus and Clinical Stage of Cervical Cancer.

Medicina (Kaunas) 2019 May 30;55(6). Epub 2019 May 30.

Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, LT 44307 Kaunas, Lithuania.

Lipocalin 2 (LCN2) has an oncogenic role in promoting tumorigenesis through enhancing tumor cell proliferation and the metastatic potential. The aim of our study was to determine whether serum LCN2 could serve as a diagnostic marker of cervical cancer (CC) and to evaluate the correlation between its serum concentration, the clinical stage of the cancer and Human Papilloma Virus HPV infections in women. A total of 33 women with histologically proven cervical cancer (CC), 9 women with high- grade cervical intraepithelial neoplasia (HSIL) and 48 healthy women (NILM) were involved in the study. A concentration of LCN2 was assayed with the Magnetic LuminexR Assay multiplex kit. An HPV genotyping kit was used for the detection and differentiation of 15 high-risk (HR) HPV types in the liquid-based cytology medium (LBCM) and the tissue biopsy. The majority (84.8%) of the women were infected by HPV16 in the CC group, and there was no woman with HPV16 in the control group ( < 0.01). Several types of HR HPV were found more often in the LBCM compared to in the tissue biopsy ( = 0.044). HPV16 was more frequently detected in the tissue biopsy than the LBCM ( < 0.05). The LCN2 level was higher in HPV-positive than in HPV-negative women ( = 0.029). The LCN2 concentration was significantly higher in women with stage IV than those with stage I CC ( = 0.021). Conclusions: Many HR HPV types, together with HPV16/18, can colonize the vagina and cervix, but often HPV16 alone penetrates into the tissue and causes CC. The serum LCN2 concentration was found to be associated not only with HR HPV infection, irrespective of the degree of cervical intraepithelial changes, but also with advanced clinical CC stage. LCN2 could be used to identify patients with advanced disease, who require a more aggressive treatment.
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http://dx.doi.org/10.3390/medicina55060229DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6630730PMC
May 2019

Prevalence of human papillomavirus types 16, 18, and 45 in women with cervical intraepithelial changes: associations with colposcopic and histological findings.

Medicina (Kaunas) 2012 ;48(1):22-30

Department of Obstetrics and Gynecology, Medical Academy, Lithuanian University of Health Sciences, Eivenių 2, 50028 Kaunas, Lithuania.

The aim of the study was to determine the prevalence of human papillomavirus (HPV) types 16, 18, and 45 in women with cervical intraepithelial changes caused by high-risk HPV in relation to colposcopic and histological findings. MATERIAL AND METHODS. A prospective study of 393 women with cervical cytologic changes confirmed by the Papanicolaou test was undertaken from April 3, 2006, to April 3, 2007. The Hybrid Capture 2 assay was performed. HPV-positive women underwent genotyping for types 16, 18, and 45. Colposcopy and biopsy were performed in 317 (80.7%) and 249 women (63.4%), respectively. The results were analyzed by age groups. RESULTS. Of all the women with cervical intraepithelial changes, 59% were positive for HR HPV, and 62% were positive for HPV types 16, 18, and 45. HPV types 16, 18, and 45 were detected in 54.8% of women with ASC-US/AGUS/ASC-H, 50.0% of women with LSIL, and 75.6% of women with HSIL. After confirmation of any histological and colposcopic changes, HPV types 16, 18, and 45 were detected in 68.0% and 69.0% of women, respectively. Moreover, 84.2% of the women with HSIL and high-grade colposcopic changes, and 78.5% of the women with HSIL and CIN 2/CIN 2-3/CIN 3/carcinoma in situ were positive for HPV types 16, 18, and 45. The sensitivity of the Papanicolaou test together with the Hybrid Capture 2 test compared with the Papanicolaou test together with the HPV 16/18/45 test diagnosing CIN 2+ changes did not differ (96.7% vs. 97.1%), but the specificity was higher (40.3% vs. 8.0%). CONCLUSIONS. The majority of the cytologic, colposcopic, and histological changes were caused by HPV types 16, 18, and 45. Despite the high prevalence of HPV types 16, 18, and 45, testing for these genotypes together with the Papanicolaou test did not improve the diagnosis of high-grade cervical intraepithelial lesions.
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May 2012

Long-term results of high-dose-rate brachytherapy and external-beam radiotherapy in the primary treatment of endometrial cancer.

J Radiat Res 2010 ;51(6):675-81

Kaunas University of Medicine, Kaunas, Lithuania.

In this report we update our long-term follow-up results of the prospective study whose aim was to evaluate the efficacy of high-dose-rate (HDR) brachytherapy in combination with external-beam radiotherapy (EBRT) in the treatment of medically inoperable endometrial cancer. Between 1995 and 1998, 29 patients with stages I-III medically inoperable carcinoma of endometrium were treated with definitive irradiation. All patients underwent combined intracavitary HDR brachytherapy and EBRT. The EBRT dose was 50 Gy with midline shield from 16 Gy. The HDR brachytherapy dose was 50 Gy, delivered in 5 fractions in a weekly schedule. Overall survival (OS) at 5 and 10 years was 48.3% and 20.7%, respectively. Disease-specific survival (DSS) at 5 and 10 years was 73.5% and 67.9%, respectively. The 10-year DSS rate was 73.5% for all stages, 85.7% for Stage I disease, 71.4% for Stage II, and 16.7% for stage III disease. Late Grade 1-2 radiation complications were observed in 4 patients (13.8%). Our long-term follow-up confirms that HDR brachytherapy with EBRT appears to be an effective and safe treatment for stage I and II medically inoperable endometrial cancer.
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http://dx.doi.org/10.1269/jrr.10080DOI Listing
March 2011

Lichen sclerosus et atrophicus in pediatric and adult male patients with congenital and acquired phimosis.

Medicina (Kaunas) 2008 ;44(6):460-6

Department of Skin and Venereal Diseases, Kaunas University of Medicine, Eiveniu 2, 50009 Kaunas, Lithuania.

Lichen sclerosus et atrophicus is a chronic inflammatory sclerotic and atrophic disease of unknown cause that predominantly affects male and female genital skin. This study was designed to evaluate histological characteristics of congenital and acquired phimoses among pediatric (n=60) and adult (n=60) male patients who were admitted for circumcision to the Clinics of Urology and Pediatric Surgery of Kaunas University of Medicine Hospital between 2000 and 2003 and to determine the rate of lichen sclerosus et atrophicus and other histological diagnoses among them. This study demonstrates that 45.1% of congenital and 62.3% of acquired phimoses show histological signs of lichen sclerosus et atrophicus. The rate of lichen sclerosus et atrophicus was statistically significantly higher among patients with acquired than congenital phimosis. Boys with acquired narrowing of prepuce were statistically significantly 3.9 times more likely to develop lichen sclerosus et atrophicus than those with congenital phimosis. There were no statistically significant differences between rates of lichen sclerosus et atrophicus and other dermatological diagnoses among pediatric and adult male patients if the type of phimosis (acquired or congenital) was considered. Histological features of lichen sclerosus et atrophicus and other histological diagnoses in boys and men with phimosis were detected with equal frequency irrespective the age of the subjects. The rate of lichen sclerosus et atrophicus was similar among all boys (56.7%) and men (53.3%) treated for phimosis. Only the type of phimosis had a statistically significant influence on the rate of lichen sclerosus et atrophicus and other histological diagnoses.
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October 2008

Fetal middle cerebral artery Doppler velocimetry in cases of rhesus alloimmunization.

J Matern Fetal Neonatal Med 2008 Jun;21(6):361-5

Department of Obstetrics and Gynecology, Hospital of Kaunas University of Medicine, Kaunas, Lithuania.

Objective: To assess fetal middle cerebral artery (MCA) peak systolic velocity (PSV) in cases of rhesus alloimmunization and to establish whether MCA-PSV is valid for the prediction of fetal anemia.

Methods: The study population included 157 pregnant women diagnosed with rhesus alloimmunization. MCA-PSV measurements were obtained within 3 days of blood sampling for estimation of hemoglobin concentration either at delivery or cordocentesis by the same operator and by means of the same ultrasound machine using techniques described previously. To evaluate the measurements of the MCA-PSV as the multiples of median (MoM) for gestation we used original nomograms for various gestational ages derived from a group of 273 normal fetuses between 22 and 40 weeks of gestation, not at risk for anemia. Receiver-operator characteristic (ROC) curves were employed to evaluate the relation of the sensitivity (the true positive rate) and the false positive rate (100% specificity) of different threshold values of the MCA-PSV.

Results: The sensitivity of the MCA-PSV was 94.4% in the case of the subgroup of fetuses with severe anemia. The sensitivity of the MCA-PSV test decreased in less anemic fetuses and was 77.3% in the subgroup with moderate anemia and 32% in the subgroup with mild anemia. According to ROC curves, we selected the optimal MCA-PSV threshold values of 1.15, 1.44, and 1.53 MoM for the prediction of mild, moderate, and severe anemia, respectively.

Conclusions: MCA-PSV is a significant Doppler index valid for the prediction of moderate and severe fetal anemia.
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http://dx.doi.org/10.1080/14767050802037787DOI Listing
June 2008

Puerperal Clostridium perfringens sepsis in a patient with granulocytopenia.

Gynecol Obstet Invest 2008 3;65(1):32-4. Epub 2007 Aug 3.

Department of Obstetrics and Gynecology, Kaunas University of Medicine Hospital, Kaunas, Lithuania.

We present a lethal case of fulminant puerperal sepsis with massive hemolysis after cesarean section in a patient with intermittent granulocytopenia.
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http://dx.doi.org/10.1159/000106763DOI Listing
February 2008

[Disseminated ovarian, bone, and bone marrow metastases from gastric cancer].

Medicina (Kaunas) 2006 ;42(11):923-31

Department of Obstetrics and Gynecology, Kaunas University of Medicine, Eiveniu 2, 50009 Kaunas, Lithuania.

The main cause of death in patients with gastric cancer is disease dissemination. It is not clear why gastric cancer metastasizes to different organs. Early detection and destruction of circulating malignant cells before developing metastases may markedly improve survival of these patients. Krukenberg tumors (metastases of non-gynecological origin in the ovaries) usually are circular cell carcinomas of gastric cancer. Bone metastases of gastric cancer are rare, but if they are diagnosed, patients survive only 2-5 months on the average. Disseminated bone marrow metastases from gastric cancer do not always show the sudden course of the disease, but hematological complications are signs of poor prognosis. Hematological paraneoplastic disorders can be miscellaneous: they usually manifest as anemia of various origin, as leucocytosis in half of the patients, as leukemoid reactions in one-third of the patients, and as hemolysis and thrombocytopenia in half of the patients (often with disseminated intravascular coagulation). Currently, chemotherapy is the most effective treatment for outspread gastric cancer. Unfortunately, there is no exclusively effective scheme for treatment. Lymph node metastases are more sensitive to chemotherapy than primary gastric cancer, while in contrary, hepatic metastases are less sensitive than primary gastric cancer. This article includes a literature review and a rare case of gastric cancer.
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January 2007

[Surgical treatment of advanced epithelial ovarian cancer].

Medicina (Kaunas) 2004 ;40(3):205-15

Clinic of Oncology, Kaunas University of Medicine Hospital, Eiveniu 2, 3007 Kaunas, Lithuania.

Primary cytoreductive surgery remains the standard care in advanced ovarian cancer. Optimal cytoreductive surgery is defined as a residual tumor load less than 1 cm. after operation. The randomized clinical trials showed that interval debulking surgery improved survival in patients who did not undergo optimal primary debulking surgery. The retrospective trials have suggested that the outcome for patients treated with neoadjuvant chemotherapy followed by interval debulking surgery is the same as for patients treated with primary debulking surgery followed by adjuvant chemotherapy. The neoadjuvant chemotherapy should not to be used for clinical practice until the randomized clinical trial carried out by Gynecological Cancer Group of the European Organization for Research and Treatment of Cancer and National Cancer Institute of Canada answers this question. There are no data from randomized trials to show the survival advantage in patients who received second-look operation as compared to those who did not.
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October 2004

Prevalence of Chlamydia trachomatis, Chlamydia psittaci and Chlamydia pneumoniae antibodies in blood donors and attendees of STD clinics.

Clin Microbiol Infect 1996 Jun;1(4):253-260

Institute of Clinical Bacteriology, Uppsala University, Uppsala, Sweden.

OBJECTIVE: To estimate the prevalence of Chlamydia trachomatis, C. psittaci and C. pneumoniae antibodies in sera from altogether 931 blood donors, patients with symptoms of urethritis, assumed salpingitis and sexually acquired reactive arthritis (SARA), and women with fertility problems. METHODS: IgG antibodies to C. trachomatis, C. psittaci and C. pneumoniae were determined by microimmunofluorescence (MIF) tests. All patients were also tested for genital C. trachomatis infection using direct immunofluorescence (DIF) tests. RESULTS: The DIF-positive cases had a significantly (p < 0.0001) higher prevalence of C. trachomatis antibodies than the DIF negatives, i.e. 88.5% versus 14% in men with urethritis, 94.3% versus 36.4% in women with salpingitis, 66.7% versus 16.7% in SARA patients and 90.6% versus 20.8% in women with fertility problems. Antibody reactivity to all three chlamydial species was found significantly (p < 0.0001) more often in the patient groups and in those with a DIF-confirmed genital C. trachomatis infection than in blood donors. CONCLUSIONS: Presence of serum antibodies to C. trachomatis is tightly associated with the presence of chlamydiae in the genital tract, which also influences the cross-reactivities occurring in the MIF tests between chlamydial species.
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http://dx.doi.org/10.1016/s1198-743x(15)60284-1DOI Listing
June 1996
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