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Adam EE, White MC, Townsend JS, Stewart SL. Bilateral Oophorectomy Prevalence Among U.S. Women. J Womens Health (Larchmt) 2024. [PMID: 39011627 DOI: 10.1089/jwh.2023.1134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/17/2024] Open
Abstract
Background: Bilateral oophorectomy has been linked to numerous health outcomes, some of which can have a long latency period. Limited data are available on bilateral oophorectomy prevalence among U.S. women. Methods: The National Health Interview Survey fielded measures of bilateral oophorectomy most recently in 2010 and 2015. We pooled these 2 data years to present bilateral oophorectomy prevalence estimates by age-group, race, ethnicity, geographic region, and hysterectomy status. Results: Our study found bilateral oophorectomy was common among older women. Among women aged 70-79 years, 29% reported a bilateral oophorectomy, compared with <1% for women aged 20-29 years. By geographic region, bilateral oophorectomy prevalence among women 20-84 years was 12.3% in the South, 10.8% in the Midwest, 9.4% in the West, and 8.0% in the Northeast. Small numbers limited our ability to generate age-specific estimates for American Indian and Alaska Native women and subgroups of Asian and Hispanic women. Nearly half of women who had a bilateral oophorectomy reported their procedure occurred more than 20 years ago. Among women aged 20-84 years who reported a hysterectomy, 57% reported they also had both of their ovaries removed. Conclusion: Standard measures of incidence rates for ovarian cancer are not adjusted for oophorectomy status. These findings suggest that ovarian cancer incidence rates may be underestimated among older women. Continued monitoring of bilateral oophorectomy prevalence will be needed to track its potential impact on ovarian cancer incidence and numerous other chronic health outcomes.
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Affiliation(s)
- Emily E Adam
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mary C White
- Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Julie S Townsend
- Comprehensive Cancer Control Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sherri L Stewart
- Comprehensive Cancer Control Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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2
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Silva E. Cancer statistics, 2024: mixed results in gynecologic oncology. Int J Gynecol Cancer 2024; 34:964. [PMID: 38649232 DOI: 10.1136/ijgc-2024-005457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Affiliation(s)
- Elvio Silva
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Guo Y, Li L, Yang K, Song Y, Xu L, Zhao F, Li W. Enhancing prognostic insights: myometrial invasion patterns in endometrial carcinoma, with emphasis on MELF pattern-a comprehensive review and meta-analysis. Eur J Cancer Prev 2024:00008469-990000000-00153. [PMID: 38870068 DOI: 10.1097/cej.0000000000000903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
PURPOSE The microcystic, elongated, and fragmented (MELF) pattern, characterized by myxoid and inflamed stroma, is readily identifiable as a form of myometrial infiltration. This meta-analysis endeavors to assess the prognostic significance of MELF infiltration patterns in patients diagnosed with endometrial cancer. METHODS A comprehensive literature search, spanning until 11 October 2023, across PubMed, Embase, Cochrane, and Web of Science databases, identified 23 relevant studies involving 5199 patients. Data analysis was performed using Stata 16.0. RESULTS Analysis indicates that MELF infiltration predicts a higher risk of lymph node metastasis in endometrial cancer patients [hazard ratios (HR) = 5.05; 95% confidence interval (CI), 3.62-7.05; P < 0.05]. Notably, this association remains consistent across various patient demographics, analytical approaches, study designs, and treatment modalities. However, MELF infiltration does not significantly correlate with recurrence (HR = 1.05; 95% CI, 0.73-1.52; P > 0.05), overall survival (HR = 1.24; 95% CI, 0.91-1.68; P > 0.05), or disease-free survival (HR = 1.40; 95% CI, 0.85-2.28; P > 0.05). CONCLUSION While MELF infiltration heightens the risk of lymph node metastasis in endometrial cancer, its impact on recurrence, overall survival, and disease-free survival remains statistically insignificant.
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Affiliation(s)
| | - Luying Li
- School of Medicine, Shihezi University
| | | | | | - Lu Xu
- School of Medicine, Shihezi University
| | | | - Wenting Li
- School of Medicine, Shihezi University
- Department of Gynaecology, The First Affiliated Hospital of Shihezi University, Shihezi, China
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Stephens AN, Hobbs SJ, Kang SW, Oehler MK, Jobling TW, Allman R. Utility of a Multi-Marker Panel with Ultrasound for Enhanced Classification of Adnexal Mass. Cancers (Basel) 2024; 16:2048. [PMID: 38893167 PMCID: PMC11171301 DOI: 10.3390/cancers16112048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/24/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024] Open
Abstract
Pre-surgical clinical assessment of an adnexal mass typically relies on transvaginal ultrasound for comprehensive morphological assessment, with further support provided by biomarker measurements and clinical evaluation. Whilst effective for masses that are obviously benign or malignant, a large proportion of masses remain sonographically indeterminate at surgical referral. As a consequence, post-surgical diagnoses of benign disease can outnumber malignancies up to 9-fold, while less than 50% of cancer cases receive a primary referral to a gynecological oncology specialist. We recently described a blood biomarker signature (multi-marker panel-MMP) that differentiated patients with benign from malignant ovarian disease with high accuracy. In this study, we have examined the use of the MMP, both individually and in combination with transvaginal ultrasound, as an alternative tool to CA-125 for enhanced decision making in the pre-surgical referral process.
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Affiliation(s)
- Andrew N. Stephens
- Cleo Diagnostics Ltd., Melbourne 3000, Australia; (S.J.H.); (R.A.)
- Hudson Institute of Medical Research, Clayton 3168, Australia;
- Department of Molecular and Translational Sciences, Monash University, Clayton 3168, Australia
| | - Simon J. Hobbs
- Cleo Diagnostics Ltd., Melbourne 3000, Australia; (S.J.H.); (R.A.)
| | - Sung-Woog Kang
- Hudson Institute of Medical Research, Clayton 3168, Australia;
- Department of Molecular and Translational Sciences, Monash University, Clayton 3168, Australia
| | - Martin K. Oehler
- Department of Gynecological Oncology, Royal Adelaide Hospital, Adelaide 5000, Australia;
- Robinson Institute, University of Adelaide, Adelaide 5000, Australia
| | - Tom W. Jobling
- Department of Gynecological Oncology, Monash Medical Centre, Bentleigh East 3165, Australia;
| | - Richard Allman
- Cleo Diagnostics Ltd., Melbourne 3000, Australia; (S.J.H.); (R.A.)
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5
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Allen I, Hassan H, Joko-Fru WY, Huntley C, Loong L, Rahman T, Torr B, Bacon A, Knott C, Jose S, Vernon S, Lüchtenborg M, Pethick J, Lavelle K, McRonald F, Eccles D, Morris EJ, Hardy S, Turnbull C, Tischkowitz M, Pharoah P, Antoniou AC. Risks of second primary cancers among 584,965 female and male breast cancer survivors in England: a 25-year retrospective cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2024; 40:100903. [PMID: 38745989 PMCID: PMC11092881 DOI: 10.1016/j.lanepe.2024.100903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 05/16/2024]
Abstract
Background Second primary cancers (SPCs) after breast cancer (BC) present an increasing public health burden, with little existing research on socio-demographic, tumour, and treatment effects. We addressed this in the largest BC survivor cohort to date, using a novel linkage of National Disease Registration Service datasets. Methods The cohort included 581,403 female and 3562 male BC survivors diagnosed between 1995 and 2019. We estimated standardized incidence ratios (SIRs) for combined and site-specific SPCs using incidences for England, overall and by age at BC and socioeconomic status. We estimated incidences and Kaplan-Meier cumulative risks stratified by age at BC, and assessed risk variation by socio-demographic, tumour, and treatment characteristics using Cox regression. Findings Both genders were at elevated contralateral breast (SIR: 2.02 (95% CI: 1.99-2.06) females; 55.4 (35.5-82.4) males) and non-breast (1.10 (1.09-1.11) females, 1.10 (1.00-1.20) males) SPC risks. Non-breast SPC risks were higher for females younger at BC diagnosis (SIR: 1.34 (1.31-1.38) <50 y, 1.07 (1.06-1.09) ≥50 y) and more socioeconomically deprived (SIR: 1.00 (0.98-1.02) least deprived quintile, 1.34 (1.30-1.37) most). Interpretation Enhanced SPC surveillance may benefit BC survivors, although specific recommendations require more detailed multifactorial risk and cost-benefit analyses. The associations between deprivation and SPC risks could provide clinical management insights. Funding CRUK Catalyst Award CanGene-CanVar (C61296/A27223). Cancer Research UK grant: PPRPGM-Nov 20∖100,002. This work was supported by core funding from the NIHR Cambridge Biomedical Research Centre (NIHR203312)]. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.
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Affiliation(s)
- Isaac Allen
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Hend Hassan
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Walburga Yvonne Joko-Fru
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
| | - Catherine Huntley
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom
| | - Lucy Loong
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom
| | - Tameera Rahman
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Health Data Insight CIC, Cambridge, United Kingdom
| | - Bethany Torr
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom
| | - Andrew Bacon
- National Disease Registration Service, National Health Service England, London, United Kingdom
| | - Craig Knott
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Health Data Insight CIC, Cambridge, United Kingdom
| | - Sophie Jose
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Health Data Insight CIC, Cambridge, United Kingdom
| | - Sally Vernon
- National Disease Registration Service, National Health Service England, London, United Kingdom
| | - Margreet Lüchtenborg
- National Disease Registration Service, National Health Service England, London, United Kingdom
- Centre for Cancer, Society and Public Health, Comprehensive Cancer Centre, School of Cancer and Pharmaceutical Sciences, King's College London, London, United Kingdom
| | - Joanna Pethick
- National Disease Registration Service, National Health Service England, London, United Kingdom
| | - Katrina Lavelle
- National Disease Registration Service, National Health Service England, London, United Kingdom
| | - Fiona McRonald
- National Disease Registration Service, National Health Service England, London, United Kingdom
| | - Diana Eccles
- Department of Cancer Sciences, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Eva J.A Morris
- Applied Health Research Unit, Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Steven Hardy
- National Disease Registration Service, National Health Service England, London, United Kingdom
| | - Clare Turnbull
- Division of Genetics and Epidemiology, Institute of Cancer Research, Sutton, United Kingdom
| | - Marc Tischkowitz
- Department of Medical Genetics, Cambridge Biomedical Research Centre, National Institute for Health Research, University of Cambridge, Cambridge, United Kingdom
| | - Paul Pharoah
- Department of Computational Biomedicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Antonis C. Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
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Stephens AN, Hobbs SJ, Kang SW, Oehler MK, Jobling TW, Allman R. ReClassification of Patients with Ambiguous CA125 for Optimised Pre-Surgical Triage. Diagnostics (Basel) 2024; 14:671. [PMID: 38611584 PMCID: PMC11011550 DOI: 10.3390/diagnostics14070671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/07/2024] [Accepted: 03/19/2024] [Indexed: 04/14/2024] Open
Abstract
Pre-surgical clinical assessment of an adnexal mass is a complex process, and ideally requires accurate and rapid identification of disease status. Gold standard biomarker CA125 is extensively used off-label for this purpose; however its performance is typically inadequate, particularly for the detection of early stage disease and discrimination between benign versus malignant status. We recently described a multi-marker panel (MMP) and associated risk index for the differentiation of benign from malignant ovarian disease. In this study we applied a net reclassification approach to assess the use of MMP index to rescue those cases where low CA125 incorrectly excludes cancer diagnoses, or where benign disease is incorrectly assessed as "high risk" due to elevated CA125. Reclassification of such patients is of significant value to assist in the timely and accurate referral for patients where CA125 titer is uninformative.
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Affiliation(s)
- Andrew N. Stephens
- Hudson Institute of Medical Research, Clayton 3168, Australia;
- Department of Molecular and Translational Sciences, Monash University, Clayton 3168, Australia
- Cleo Diagnostics Ltd., Melbourne 3000, Australia; (S.J.H.); (R.A.)
| | - Simon J. Hobbs
- Cleo Diagnostics Ltd., Melbourne 3000, Australia; (S.J.H.); (R.A.)
| | - Sung-Woog Kang
- Hudson Institute of Medical Research, Clayton 3168, Australia;
- Department of Molecular and Translational Sciences, Monash University, Clayton 3168, Australia
| | - Martin K. Oehler
- Department of Gynecological Oncology, Royal Adelaide Hospital, Adelaide 5000, Australia;
- Robinson Institute, University of Adelaide, Adelaide 5000, Australia
| | - Tom W. Jobling
- Department of Gynecological Oncology, Monash Medical Centre, Bentleigh East 3165, Australia;
| | - Richard Allman
- Cleo Diagnostics Ltd., Melbourne 3000, Australia; (S.J.H.); (R.A.)
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Chi H, Sun Y, Lin P, Zhou J, Zhang J, Yang Y, Qiao Y, Liu D. Glucose Fluctuation Inhibits Nrf2 Signaling Pathway in Hippocampal Tissues and Exacerbates Cognitive Impairment in Streptozotocin-Induced Diabetic Rats. J Diabetes Res 2024; 2024:5584761. [PMID: 38282656 PMCID: PMC10817812 DOI: 10.1155/2024/5584761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 12/25/2023] [Accepted: 01/09/2024] [Indexed: 01/30/2024] Open
Abstract
Background This research investigated whether glucose fluctuation (GF) can exacerbate cognitive impairment in streptozotocin-induced diabetic rats and explored the related mechanism. Methods After 4 weeks of feeding with diets containing high fats plus sugar, the rat model of diabetes mellitus (DM) was established by intraperitoneal injection of streptozotocin (STZ). Then, GF was triggered by means of alternating satiety and starvation for 24 h. The weight, blood glucose level, and water intake of the rats were recorded. The Morris water maze (MWM) test was carried out to appraise the cognitive function at the end of week 12. Moreover, the morphological structure of hippocampal neurons was viewed through HE and Nissl staining, and transmission electron microscopy (TEM) was performed for ultrastructure observation. The protein expression levels of Nrf2, HO-1, NQO-1, Bax, Bcl-2, and Caspase-3 in the hippocampal tissues of rats were measured via Western blotting, and the mRNA expressions of Nrf2, HO-1, and NQO-1 were examined using qRT-PCR. Finally, Western blotting and immunohistochemistry were conducted to detect BDNF levels. Results It was manifested that GF not only aggravated the impairment of spatial memory in rats with STZ-induced type 2 DM but also stimulated the loss, shrinkage, and apoptosis of hippocampal neurons. Regarding the expressions in murine hippocampal tissues, GF depressed Nrf2, HO-1, NQO-1, Bcl-2, and BDNF but boosted Caspase-3 and Bax. Conclusions GF aggravates cognitive impairment by inhibiting the Nrf2 signaling pathway and inducing oxidative stress and apoptosis in the hippocampal tissues.
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Affiliation(s)
- Haiyan Chi
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
- Department of Endocrinology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Yujing Sun
- Department of Traditional Chinese Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Peng Lin
- Department of Traditional Chinese Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Junyu Zhou
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Jinbiao Zhang
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Yachao Yang
- Department of Endocrinology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Yun Qiao
- Department of Traditional Chinese Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Deshan Liu
- Department of Traditional Chinese Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
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Stephens AN, Hobbs SJ, Kang SW, Bilandzic M, Rainczuk A, Oehler MK, Jobling TW, Plebanski M, Allman R. A Novel Predictive Multi-Marker Test for the Pre-Surgical Identification of Ovarian Cancer. Cancers (Basel) 2023; 15:5267. [PMID: 37958440 PMCID: PMC10650329 DOI: 10.3390/cancers15215267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 10/27/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023] Open
Abstract
Ovarian cancer remains the most lethal of gynecological malignancies, with the 5-year survival below 50%. Currently there is no simple and effective pre-surgical diagnosis or triage for patients with malignancy, particularly those with early-stage or low-volume tumors. Recently we discovered that CXCL10 can be processed to an inactive form in ovarian cancers and that its measurement has diagnostic significance. In this study we evaluated the addition of processed CXCL10 to a biomarker panel for the discrimination of benign from malignant disease. Multiple biomarkers were measured in retrospectively collected plasma samples (n = 334) from patients diagnosed with benign or malignant disease, and a classifier model was developed using CA125, HE4, Il6 and CXCL10 (active and total). The model provided 95% sensitivity/95% specificity for discrimination of benign from malignant disease. Positive predictive performance exceeded that of "gold standard" scoring systems including CA125, RMI and ROMA% and was independent of menopausal status. In addition, 80% of stage I-II cancers in the cohort were correctly identified using the multi-marker scoring system. Our data suggest the multi-marker panel and associated scoring algorithm provides a useful measurement to assist in pre-surgical diagnosis and triage of patients with suspected ovarian cancer.
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Affiliation(s)
- Andrew N. Stephens
- Hudson Institute of Medical Research, Clayton 3168, Australia; (S.-W.K.); (M.B.); (A.R.)
- Department of Molecular and Translational Sciences, Monash University, Clayton 3168, Australia
- Cleo Diagnostics Ltd., Melbourne 3000, Australia; (S.J.H.); (R.A.)
| | - Simon J. Hobbs
- Cleo Diagnostics Ltd., Melbourne 3000, Australia; (S.J.H.); (R.A.)
| | - Sung-Woon Kang
- Hudson Institute of Medical Research, Clayton 3168, Australia; (S.-W.K.); (M.B.); (A.R.)
- Department of Molecular and Translational Sciences, Monash University, Clayton 3168, Australia
| | - Maree Bilandzic
- Hudson Institute of Medical Research, Clayton 3168, Australia; (S.-W.K.); (M.B.); (A.R.)
- Department of Molecular and Translational Sciences, Monash University, Clayton 3168, Australia
| | - Adam Rainczuk
- Hudson Institute of Medical Research, Clayton 3168, Australia; (S.-W.K.); (M.B.); (A.R.)
- Department of Molecular and Translational Sciences, Monash University, Clayton 3168, Australia
- Bruker Pty Ltd., Preston 3072, Australia
| | - Martin K. Oehler
- Department of Gynecological Oncology, Royal Adelaide Hospital, Adelaide 5000, Australia;
- Robinson Institute, University of Adelaide, Adelaide 5000, Australia
| | - Tom W. Jobling
- Department of Gynecology Oncology, Monash Medical Centre, Bentleigh East 3165, Australia;
| | - Magdalena Plebanski
- School of Health and Biomedical Sciences, RMIT University, Bundoora 3083, Australia;
| | - Richard Allman
- Cleo Diagnostics Ltd., Melbourne 3000, Australia; (S.J.H.); (R.A.)
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