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Öğe Analyzing the performance of ChatGPT in answering inquiries about cervical cancer(Wiley, 2025) Yurtcu, Engin; Ozvural, Seyfettin; Keyif, BetulObjective: To analyze the knowledge of ChatGPT about cervical cancer (CC). Methods: Official websites of professional health institutes, and websites created by patients and charities underwent strict screening. Using CC-related keywords, common inquiries by the public and comments about CC were searched in social media applications with these data, a list of frequently asked questions (FAQs) was prepared. When preparing question about CC, the European Society of Gynecological Oncology (ESGO), European Society for Radiotherapy and Oncology (ESTRO), and European Society of Pathology (ESP) guidelines were used. The answers given by ChatGPT were scored according to the Global Quality Score (GQS). Results: When all ChatGPT answers to FAQs about CC were evaluated with regard to GQS, 68 ChatGPT answers were classified as score 5, and none of ChatGPT answers for FAQs were scored as 2 or 1. Moreover, ChatGPT answered 33 of 53 (62.3%) CC-related questions based on ESGO, ESTRO, and ESP guidelines with completely accurate and satisfactory responses (GQS 5). In addition, eight answers (15.1%), seven answers (13.2%), four answers (7.5%), and one answer (1.9%) were categorized as GQS 4, GQS 3, GQS 2, and GQS 1, respectively. The reproducibility rate of ChatGPT answers about CC-related FAQs and responses about those guideline-based questions was 93.2% and 88.7%, respectively. Conclusion: ChatGPT had an accurate and satisfactory response rate for FAQs about CC with regards to GQS. However, the accuracy and quality of ChatGPT answers significantly decreased for questions based on guidelines.Öğe Beyond pelvic pathology: retinal microvascular rarefaction as a systemic marker in endometriosis(Bmc, 2025) Keyif, Betul; Sezer, Taha; Colak, Kubra; Gundogdu, Zulfiye Balkan; Meydan, BayramObjective This study aimed to quantitatively assess retinal microvascular alterations in women with pelvic endometriosis using optical coherence tomography angiography (OCTA), and to explore whether these subclinical findings may reflect early signs of systemic microvascular alterations in this population. Methods In this retrospective cross-sectional study, 100 eyes were analyzed-50 from women with laparoscopically or ultrasonographically confirmed pelvic endometriosis and 50 from age-matched healthy female controls. All participants underwent comprehensive ophthalmic examinations and macular OCTA imaging using the Heidelberg Spectralis system. Quantitative parameters, including vessel area density (VAD), foveal avascular zone (FAZ) metrics (area, perimeter, circularity), and FD-300 values, were extracted from the superficial and deep capillary plexuses using the OCTAVA software. Segmental parafoveal VAD values (nasal, temporal, superior, and inferior) were also assessed. Axial length measurements and endometriosis staging were not available in this retrospective dataset. Hormonal therapy use was not systematically documented. Results Compared to healthy controls, women with endometriosis demonstrated significantly lower total and parafoveal VAD and FD-300 values in both retinal plexuses (p < 0.05 for all). FAZ perimeter showed a modest but statistically significant difference, whereas FAZ area and circularity index remained comparable between groups. No participant in either group exhibited clinically visible retinal pathology. These alterations occurred despite preserved visual acuity and in the absence of systemic comorbidities known to affect microcirculation. Conclusion Although causality cannot be inferred from this cross-sectional design, our findings indicate that pelvic endometriosis is associated with region-specific subclinical reductions in retinal capillary perfusion, particularly within the foveal and parafoveal regions. OCTA-derived metrics, especially FD-300 and parafoveal VAD, may offer insight into microvascular integrity in this patient group. These results support further investigation into the systemic vascular aspects of endometriosis and highlight the potential utility of retinal imaging in exploring such associations.Öğe Boric Acid Suppresses Cell Survival by Triggering Endoplasmic Reticulum Stress-Induced Autophagy in Cervical Cancers(Wiley, 2025) Keyif, Betul; Hacioglu, CeyhanCervical cancer ranks as the fourth most common cancer amongst women globally. This study aimed to investigate boric acid's effects on endoplasmic reticulum (ER) stress and autophagy signalling pathways in cervical cancer cells. We first assessed boric acid's effects on cell viability and proliferation in HUF and HeLa cell lines. Subsequently, we analysed cyclin D1 and CDK4 levels and boric acid-induced nuclear morphology changes. We then examined autophagosome formation and mRNA expression of autophagy/ER stress markers (Beclin1, p62, LC3-I/II, GRP78, p-IRE1 alpha, p-PERK, CHOP and cleaved-caspase-3) in HeLa cells. The findings revealed that boric acid's IC50 was 3.17 mM for HUF cells but significantly lower (641.2 mu M) for HeLa cells, indicating cancer cell sensitivity. In HeLa cells, boric acid-induced a dose-dependent decrease in cyclin D1 and CDK4 levels (associated with G1 phase arrest), which we did not observe in HUF cells. Additionally, boric acid treatment caused nuclear abnormalities in HeLa cells. Boric acid promoted autophagy by enhancing autophagosome formation and upregulating Beclin1, p62, and LC3-I/II expression. Concurrently, it induced ER stress by increasing GRP78, p-IRE1 alpha, p-PERK and CHOP expression. Furthermore, boric acid increased cleaved-caspase-3 expression and apoptotic cell counts. In conclusion, this study underscores boric acid's potential therapeutic effects in cervical cancer through ER stress and autophagy regulation.Öğe Can triglyceride related indices be reliable markers in the assessment of polycystic ovarian syndrome?(Walter De Gruyter Gmbh, 2024) Yavuzcan, Ali; Keyif, Betul; Yavuzcan, Gizem; Goynumer, GokhanObjectives: This study aimed to evaluate the diagnostic utility of the Triglyceride Glucose (TyG), Triglyceride Glucose-Body Mass (TyG-BMI), and Lipid Accumulation Product (LAP) indices for both screening Polycystic Ovary Syndrome (PCOS) and diagnosing insulin resistance (IR) in women diagnosed with PCOS. Methods: Retrospective data from medical records of 124 women were analyzed, with 71 in the PCOS group and 53 in the non-PCOS group. The PCOS diagnosis followed the 2003 Rotterdam criteria. Basic clinical and biochemical parameters were compared. The TyG index was computed using the formula ln [Triglyceride (TG) (mmol/L) x fasting plasma glukose (FPG) (mg/dL)/2]. TyG-BMI value was derived as TyG x BMI. LAP was calculated as (waist circumference (WC-58) x TG (mmol/L). IR was identified if Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) was >2.7. Results: TyG-BMI (AUC=0.62) and LAP indices (AUC=0.61) did not demonstrate statistically significant diagnostic performance for PCOS. Regarding IR in PCOS patients, the highest AUC was for TyG-BMI (0.84, 95 % CI: 0.73-0.93, p<0.001) with a cutoff at 116.15, showing 80 % sensitivity and 86 % specificity. LAP had an AUC of 0.86 with a cutoff of 30.21 (sensitivity 80 %, specificity 81 %), while TyG showed an AUC of 0.78 (95 % CI: 0.67-0.89, p<0.001) with a cutoff of 4.47, demonstrating a sensitivity of 70 % and specificity of 72 %. Conclusions: Numerous biochemical markers have been explored for PCOS detection, however, many are expensive, not universally available, and necessitate specific test kits. TyG, TyG-BMI, and LAP indices might not serve as reliable markers for PCOS screening but could offer utility in identifying IR in Turkish women diagnosed with PCOS.Öğe Comparison of the Efficacies of Sacrospinous Ligament Fixation and Laparoscopic Lateral Suspension in the Treatment of Apical Prolapse: 24-Month Follow-Up Results(Imr Press, 2025) Yurtcu, Engin; Keyif, Betul; Sarigedik, Burcu; Basbug, Alper; Tinelli, AndreaBackground: Pelvic organ prolapse (POP) significantly impacts the quality of life, particularly in older women with a history of vaginal deliveries. Although conservative treatments provide some symptom relief, surgical interventions are more effective for managing POP. This study compares the outcomes and effectiveness of sacrospinous ligament fixation (SSLF) and laparoscopic lateral suspension (LLS) surgeries in the treatment of POP.Methods: This retrospective comparative cohort study included patients with symptomatic stage 2 or higher apical POP, treated at a tertiary hospital in Turkey between April 2021 and June 2022. Patients were treated with either SSLF or LLS surgeries and underwent preoperative and postoperative evaluations using the Prolapse Quality of Life (P-QoL) questionnaire and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). Patients were divided into two groups: SSLF (n = 47) and LLS (n = 44). The primary outcome was the rate of anatomical failure, while secondary outcomes included improvements in functional capability and quality of life.Results: The study found that the rate of postoperative anterior compartment failure was significantly lower in the LLS group compared to the SSLF group (p = 0.005). The success rate of LLS for apical prolapse was 100%, compared to 93.6% for SSLF. In the posterior compartment, SSLF demonstrated a higher success rate (86.2%) than LLS (68.5%). Both procedures improved P-QoL scores and the PISQ-12 subscales; however, a significant improvement in total PISQ-12 scores was observed only in the LLS group (p = 0.009).Conclusions: Both SSLF and LLS are effective in treating POP and enhancing quality of life. However, LLS demonstrated higher success rates for anterior and apical prolapse, while SSLF was more effective in addressing in posterior compartment defects.Öğe Diagnosing Polycystic Ovary Syndrome Using Triglyceride-Related Indices: Is It Possible Without Rotterdam Criteria?(Aras Part Medical Int Press, 2023) Keyif, Betul; Yavuzcan, Ali; Kurdoglu, Mertihan[No abstract available]Öğe An Exploratory Study of Serum Vasorin Levels in Polycystic Ovary Syndrome: A Novel Potential Biomarker for Diagnosis and Pathogenesis(Mdpi, 2025) Keyif, Betul; Yurtcu, Engin; Basbug, Alper; Yavuzcan, Ali; Goynumer, Fikret GokhanObjective: This study aims to investigate the potential role of vasorin as a novel biomarker in the pathogenesis of polycystic ovary syndrome (PCOS) by evaluating serum vasorin levels in women diagnosed with PCOS. Methods: A prospective study was conducted at D & uuml;zce University Faculty of Medicine between March and July 2024, including 92 women with PCOS, diagnosed based on the 2003 Rotterdam criteria, and 68 age- and BMI-matched healthy controls. Serum vasorin levels were measured using an enzyme-linked immunosorbent assay (ELISA) and compared between the two groups. Additionally, correlations between vasorin levels and metabolic, inflammatory, and hormonal parameters were analyzed. Results: Women with PCOS had significantly lower serum vasorin levels (median: 0.70 pg/mL) compared to the control group (median: 2.36 pg/mL, p < 0.001). No significant correlation was found between vasorin and metabolic or hormonal parameters in the PCOS group. However, a weak positive correlation with prolactin was observed in the control group (r = 0.264, p = 0.030). Although vasorin is involved in inflammatory and oxidative-stress pathways, its association with insulin resistance and lipid metabolism remains unclear based on this study. Receiver Operating Characteristic (ROC) curve analysis demonstrated a high diagnostic performance for vasorin in distinguishing PCOS from healthy individuals (AUC = 0.918, p < 0.001, 95% CI: 0.869-0.967). The optimal cutoff value for vasorin (1.285 pg/mL) yielded 92.6% sensitivity and 87.0% specificity. Conclusions: These findings suggest that vasorin may serve as a promising biomarker for PCOS, potentially linking hormonal dysregulation, inflammatory responses, and ovarian dysfunction. However, further validation is required through longitudinal studies, multi-center cohorts, and mechanistic investigations. Additionally, comparative assessments with established biomarkers such as anti-M & uuml;llerian hormone (AMH) and androgen levels are warranted to determine vasorin's diagnostic and prognostic utility in clinical practice.Öğe Exploring the Inflammatory Basis of Endometrial Polyps: Clinical Implications of Hematological Biomarkers in a Retrospective Study(Mdpi, 2025) Keyif, Betul; Yavuzcan, Ali; Yurtcu, Engin; Basbug, Alper; Duzenli, Fatmanur; Keyif, Elif; Goynumer, Fikret GokhanBackground/Objectives: Endometrial polyps (EPs) are common benign endometrial lesions often linked to abnormal uterine bleeding and infertility. While hormonal factors play a key role in their development, recent studies suggest a potential inflammatory component. This retrospective study aimed to assess systemic inflammatory markers, including mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), in EP patients. Methods: A total of 180 patients were classified into three groups: EP (n = 60), chronic endometritis (n = 60), and control (n = 60). Preoperative hematological parameters were retrieved from medical records. Group comparisons were performed using one-way ANOVA, with Tukey's post hoc test applied when significant. Multinomial logistic regression was used to identify independent predictors of EPs. Results: MPV and PLR were significantly higher in the EP group compared to other groups (p = 0.014 and p = 0.015, respectively), while NLR differences were not statistically significant (p = 0.086). Logistic regression identified MPV (p = 0.004) and PLR (p = 0.045) as independent predictors of EPs. Conclusions: These findings suggest that systemic inflammation may contribute to EP development, with MPV and PLR serving as potential inflammatory biomarkers. Further prospective studies with histopathological validation are needed to clarify the role of inflammation in EP pathogenesis.Öğe Predictive Value of Intrapartum Transperineal Ultrasonography in Determining Delivery Mode: A Prospective Study(Duzce Univ, Fac Medicine, 2025) Teberik, Ceren; Keyif, Betul; Yurtcu, Engin; Basbug, Alper; Goynumer, Fikret GokhanObjective: This study aimed to evaluate the usefulness of intrapartum transperineal ultrasonographic (ITU) parameters in predicting delivery mode. Method: This prospective study included 104 pregnant women inAactive labor with ruptured membranes at D & uuml;zce University Health Application and Research Center from April 2023 to April 2024. ITU measured the angle of progression (AoP), head-perineum distance (HPD), and midline angle (MLA). These parameters were compared with digital vaginal examinations and delivery outcomes. Results: Of the participants, 93 (89.4%) had spontaneous vaginal deliveries (SVD), 6 (5.7%) had operative vaginal deliveries (OVD), and 5 (4.8%) had cesarean sections (C/S). AoP1 and AoP2 were significantly higher in the SVD group compared to OVD and C/S groups (p<0.001). The Delta AoP was significantly lower in the OVD group (p=0.044). HPD1 and HPD2 were significantly higher in the C/S group (p=0.031 and p=0.041, Arespectively). MLA1 and MLA2 were significantly lower in the SVD group (p=0.002 and p=0.001, Arespectively). Conclusions: ITU is a valuable tool in predicting delivery mode. AoP, HPD, and MLA measurements provide objective and reliable data to assist clinicians in labor management. Further research with larger sample sizes is needed to validate these findings and establish standardized protocols for clinical use.Öğe Predictive Value of Volumetric Measurements of Fetal Adrenal Glands for Preterm Birth: A Case-Control Study(Imr Press, 2024) Basbug, Alper; Yurtcu, Engin; Keyif, Betul; Kaya, Aski Ellibes; Sungur, Mehmet Ali; Goynumer, Fikret Gokhan; Hatirnaz, SafakBackground: To investigate whether fetal adrenal gland volume (AGV) and fetal zone volume (FZV), important components of the fetal adrenal gland, differ between women who have term and preterm births, and to determine whether these two parameters can be used to predict premature birth. Methods: A total of 238 pregnant women at 24-28 weeks of gestation were included in this case-control study. The fetal AGV and FZV were ultrasonographically evaluated, and corrected AGV (cAGV) and corrected FZV (cFZV) were assessed with adjustments for estimated birth weight. Receiver operating characteristic (ROC) curves were used to assess the ability of AGV, FZV, cAGV, and cFZV to predict preterm birth. Results: Ultrasound exams on 220 term fetuses and 18 preterm fetuses showed that preterm fetuses exhibited higher AGV (p = 0.039), FZV (p = 0.001), cAGV (p = 0.001), and cFVZ (p = 0.001) compared to term fetuses. Conclusions: These results demonstrated that term and preterm fetuses differ in their AGV and FZV within this study population. The data generated by 3D sonography between 24 and 28 weeks of gestation may be beneficial for predicting premature birth. However, larger prospective studies with a larger sample size of preterm births are needed to validate these findings.Öğe The role of incretins in gestational diabetes: a case-control study on the impact of obesity(Bmc, 2024) Yurtcu, Engin; Keyif, Betul; Yilmaz, Gamze; Erkilinc, Selcuk; Akkaya, Hatice; Ozgu-Erdinc, A. SevalBackground This study aimed to evaluate the role of serum Glucagon-Like Peptide-1 (GLP-1), Glucagon-Like Peptide-2 (GLP-2), and Glucose-Dependent Insulinotropic Polypeptide (GIP) levels in relation to obesity and gestational diabetes mellitus (GDM) in pregnancy. Methods A case-control study was conducted, including 96 pregnant women with singleton pregnancies who underwent the Oral Glucose Tolerance Test (OGTT) for GDM diagnosis during the 24th-28th weeks of gestation. Blood samples were collected for measuring GLP-1, GLP-2, GIP, and fasting glucose. Statistical analyses included receiver operating characteristic (ROC) curves and correlation analysis. Results Among the 96 women, no significant difference in age was observed between the groups, but Body Mass Index (BMI) was significantly higher in GDM-O (Gestational Diabetes Mellitus-Obese) and non-GDM-O groups (p < 0.001). GLP-1 had an area under the curve (AUC) of 0.666 (95% CI: 0.553-0.778, p = 0.005) for diagnosing GDM. The optimal GLP-1 cutoff was 815.86 ng/mL, with 65% sensitivity and 77% specificity. A significant correlation was found between GLP-2 and GIP (r = 0.289, p = 0.004), but no significant correlations were observed between GLP-1 and other peptides or gestational age (p > 0.05). Conclusions Impaired secretion of GLP-1, GLP-2, and GIP likely contributes to the pathogenesis of GDM. GLP-1 may serve as a potential biomarker for diagnosing GDM.Öğe Unmasking metabolic clues: adipsin, irisin and osteopontin as biomarkers in polycystic ovary syndrome and their impact on metabolic dynamics: a case-control study(Via Medica, 2025) Duzenli, Fatma Nur; Yurtcu, Engin; Keyif, Betul; Basbug, AlperObjectives: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age, often associated with metabolic alterations.This study assessed serum levels of adipsin, irisin, and osteopontin in patients with PCOS and examined their correlations with metabolic parameters. Material and methods: A case-control studywas conducted involving 96 women with PCOS and 80 healthy controls. Serum levels of adipsin, irisin, and osteopontin were measured; demographic, clinical, and metabolic characteristics were evaluated. Results: Patients with PCOS were significantlyyoungerthan controls (p < 0.001).The PCOS group included a significantly greater proportion of obese individuals (p = 0.013). Patients with PCOS exhibited elevated serum adipsin (p = 0.020) and reduced osteopontin (p < 0.001) levels relative to controls; obesity and age influenced these differences. Osteopontin demonstrated superior predictive power for PCOS diagnosis [area under the curve (AUC) = 0.802] compared with adipsin (AUC = 0.602). A combination of osteopontin and adipsin yielded the highest predictive value (AUC = 0.817) among double or triple biomarker combinations. Conclusions:This study identified potential associations among adipsin, osteopontin, irisin, and PCOS. Further research is warranted to elucidate their roles and clinical implications in PCOS and its metabolic alterations. The findings highlight the impact of age and obesity on these biomarkers and their relationships with PCOS, providing insight into the syndrome's complex pathophysiology.
