Exploring the role of serum sestrin 2 in patients with endometrial polyps and uterine leiomyomas: implications for early diagnosis and pathophysiology

Selim Akkaya; Teymur Bornaun; Hamit Zafer Güven

doi:10.18621/eurj.1468149

Review

Exploring the role of serum sestrin 2 in patients with endometrial polyps and uterine leiomyomas: implications for early diagnosis and pathophysiology

Year 2024, , 634 - 643, 04.11.2024

Selim Akkaya , Teymur Bornaun , Hamit Zafer Güven

https://doi.org/10.18621/eurj.1468149

Abstract

Endometrial polyps and uterine leiomyomas are common gynecological conditions that significantly affect women's health. Recent studies have begun to explore potential biomarkers that could assist in the early diagnosis and understanding of the pathophysiology of these conditions. One such biomarker is Serum Sestrin 2 (SESN2), a protein involved in cellular stress response. This review aims to synthesize research findings on the relationship between serum SESN2 levels and the presence of endometrial polyps and uterine leiomyomas. It examines the potential of SESN2 as a diagnostic tool and its role in the underlying mechanisms of these conditions. Studies suggest that SESN2 levels are elevated in patients with these conditions compared to controls, indicating its involvement in their pathophysiology. Furthermore, the review discusses the implications of these findings for clinical practice, particularly in terms of early detection and targeted therapies. Future research directions and the need for large-scale studies to validate SESN2 as a clinical marker are also addressed. This review highlights the importance of biomarkers like SESN2 in enhancing our understanding and management of gynecological disorders.

Keywords

Sestrin 2, endometrial polyp, uterine leiomyoma, biomarkers

References

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5. Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003;188(1):100-107. doi: 10.1067/mob.2003.99.
6. Protic O, Toti P, Islam MS, et al. Possible involvement of inflammatory/reparative processes in the development of uterine fibroids. Cell Tissue Res. 2016;364(2):415-427. doi: 10.1007/s00441-015-2324-3.
7. Santulli P, Borghese B, Lemaréchal H, et al. Increased serum oxidative stress markers in women with uterine leiomyoma. PLoS One. 2013;8(8):e72069. doi: 10.1371/journal.pone.0072069.
8. Özcan O, Erdal H, Çakırca G, Yönden Z. [Oxidative stress and its impacts on intracellular lipids, proteins and DNA]. J Clin Exp Invest. 2015;6(3):331-336. doi: 10.5799/ahinjs.01.2015.03.0545. [Article in Turkish]
9. Maeda H, Akaike T. Nitric oxide and oxygen radicals in infection, inflammation, and cancer. Biochemistry (Mosc). 1998;63(7):854-865. doi: 10.1007/978-1-4615-5081-5_18.
10. Toyokuni S, Okamoto K, Yodoi J, Hiai H. Persistent oxidative stress in cancer. FEBS Lett. 1995;358(1):1-3. doi: 10.1016/0014-5793(94)01368-B.
11. Pejic S, Kasapovic J, Todorovic A, Stojiljkovic V, Pajovic SB. Lipid peroxidation and antioxidant status in blood of patients with uterine myoma, endometrial polypus, hyperplastic and malignant endometrium. Biol Res. 2006;39(4):619-629. doi: 10.4067/S0716-97602006000500005.
12. Gong L, Wang Z, Wang Z, Zhang Z. Sestrin2 as a potential target for regulating metabolic-related diseases. Front Endocrinol (Lausanne). 2021;12:751020. doi: 10.3389/fendo.2021.751020.
13. Yang JH, Kim KM, Kim MG, et al. Role of sestrin2 in the regulation of proinflammatory signaling in macrophages. Free Radic Biol Med. 2015;78:156-167. doi: 10.1016/j.freeradbiomed.2014.11.002.
14. Yi L, Li F, Yong Y, et al. Upregulation of sestrin-2 expression protects against endothelial toxicity of angiotensin II. Cell Biol Toxicol. 2014;30(3):147-156. doi: 10.1007/s10565-014-9276-3.
15. Shin J, Bae J, Park S, et al. mTOR-Dependent Role of Sestrin2 in Regulating Tumor Progression of Human Endometrial Cancer. Cancers (Basel). 2020;12(9):2515. doi: 10.3390/cancers12092515.
16. Lu C, Jiang Y, Xu W, Bao X. Sestrin2: multifaceted functions, molecular basis, and its implications in liver diseases. Cell Death Dis. 2023;14(2):160. doi: 10.1038/s41419-023-05669-4.
17. Xu L, Liu Z, Wang H, et al. SESN2 Could Be a Potential Marker for Diagnosis and Prognosis in Glioma. Genes (Basel). 2023;14(3):701. doi: 10.3390/genes14030701.
18. Ala M. Sestrin2 in cancer: a foe or a friend? Biomark Res. 2022;10(1):29. doi: 10.1186/s40364-022-00380-6.
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21. Hamani Y, Eldar I, Sela HY, Voss E, Haimov-Kochman R. The clinical significance of small endometrial polyps. Eur J Obstet Gynecol Reprod Biol. 2013;170(2):497-500. doi: 10.1016/j.ejogrb.2013.07.011.
22. Peterson WF, Novak ER. Endometrial polyps. Obstet Gynecol. 1956;8(1):40-49.
23. Jovanovic AS, Boynton KA, Mutter GL. Uteri of women with endometrial carcinoma contain a histopathological spectrum of monoclonal putative precancers, some with microsatellite instability. Cancer Res. 1996;56(8):1917-1921.
24. Pal L, Niklaus AL, Kim M, Pollack S, Santoro N. Heterogeneity in endometrial expression of aromatase in polyp-bearing uteri. Hum Reprod. 2008;23(1):80-84. doi:.1093/humrep/dem346.
25. Maia H, Pimentel K, Silva TMC, et al. Aromatase and cyclooxygenase-2 expression in endometrial polyps during the menstrual cycle. Gynecol Endocrinol. 2006;22(4):219-224. doi: 10.1080/09513590600585955.
26. Nogueira AA, Sant’Ana de Almeida EC, Poli Neto OB, Zambelli Ramalho LN, Rosa e Silva JC, Candido dos Reis FJ. Immunohistochemical expression of p63 in endometrial polyps: evidence that a basal cell immunophenotype is maintained. Menopause. 2006;13(5):826-830. doi: 10.1097/01.gme.0000242274.32278.a2.
27. Dal Cin P, Vanni R, Marras S, et al. Four cytogenetic subgroups can be identified in endometrial polyps. Cancer Res. 1995;55(7):1565-1568. doi: 10.1016/0165-4608(96)85299-X.
28. Tanos V, Berry KE, Seikkula J, et al. The management of polyps in female reproductive organs. Int J Surg. 2017;43:7-16. doi: 10.1016/j.ijsu.2017.05.012.
29. McLennan CE, Rydell AH. Extent of endometrial shedding during normal menstruation. Obstet Gynecol. 1965;26(5):605-621.
30. Altaner S, Gucer F, Tokatli F, et al. Expression of Bcl-2 and Ki-67 in Tamoxifen-Associated Endometrial Polyps: Comparison with Postmenopausal Polyps. Oncol Res Treat. 2006;29(8-9):376-380. doi: 10.1159/000094443.
31. Banas T, Pitynski K, Mikos M, Cielecka-Kuszyk J, Cielecka D. Endometrial Polyps and Benign Endometrial Hyperplasia Have Increased Prevalence of DNA Fragmentation Factors 40 and 45 (DFF40 and DFF45) Together With the Antiapoptotic B-Cell Lymphoma (Bcl-2) Protein Compared With Normal Human Endometria. Int J Gynecol Pathol. 2018;37(5):431-440. doi: 10.1097/PGP.0000000000000442.
32. Dreisler E, Stampe Sorensen S, Ibsen PH, Lose G. Prevalence of endometrial polyps and abnormal uterine bleeding in a Danish population aged 20-74 years. Ultrasound Obstet Gynecol. 2009;33(1):102-108. doi: 10.1002/uog.6259.
33. Annan JJ, Aquilina J, Ball E. The management of endometrial polyps in the 21st century. Obstetr Gynaecol. 2012;14(1):33-38. doi: 10.1111/j.1744-4667.2011.00091.x.
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35. Sasaki LMP, Andrade KRC, Figueiredo ACMG, Wanderley M da S, Pereira MG. Factors Associated with Malignancy in Hysteroscopically Resected Endometrial Polyps: A Systematic Review and Meta-Analysis. J Minim Invasive Gynecol. 2018;25(5):777-785. doi: 10.1016/j.jmig.2018.02.004.
36. Runowicz CD, Costantino JP, Wickerham DL, et al. Gynecologic conditions in participants in the NSABP breast cancer prevention study of tamoxifen and raloxifene (STAR). Am J Obstet Gynecol. 2011;205(6):535.e1-535.e5. doi: 10.1016/j.ajog.2011.06.067.
37. Lee JH, Budanov AV, Park EJ, et al. Sestrin as a feedback inhibitor of TOR that prevents age-related pathologies. Science. 2010;327(5970):1223-1228. doi: 10.1126/science.1182228.
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39. Ryu D, Jo YS, Lo Sasso G, et al. A metabolic role for mitochondria in palmitate-induced cardiac myocyte apoptosis. Diabetologia. 2010;53(11):2435-2445. doi: 10.1152/ajpheart.2000.279.5.H2124.
40. Hu X, Xu Q, Wan H, et al. Sestrin2 protects against acute myocardial infarction by enhancing autophagy and reducing oxidative stress. Redox Biol. 2020;32:101504. doi: 10.1016/j.jphs.2020.11.012.
41. Zhong Z, Sanchez-Lopez E, Karin M. More than an antioxidant: the role of sestrin2 in regulating metabolism and preventing disease. J Hepatol. 2020;72(1):173-181. doi: 10.3390/ijms21134714.
42. Choi AMK, Ryter SW, Levine B. Autophagy in human health and disease. N Engl J Med. 2013;368(15):1845-1846. doi: 10.1056/NEJMra1205406.
43. Park HW, Park H, Ro SH, et al. Hepatic expression of detoxifying enzymes is decreased in human subjects with nonalcoholic fatty liver disease and in mice with diet-induced steatosis. J Hepatol. 2012;57(2):780-787. doi: 10.1016/j.jphs.2020.11.012.
44. Li X, Guo J, Jiang X, et al. Involvement of sestrin2 in the regulation of endoplasmic reticulum stress in diabetes. Diabetes Res Clin Pract. 2019;156:107834. doi: 10.18632/oncotarget.7601.
45. Sun Y, Chen X, Zhang X, Shen X, Wang M, Wang X. Protective effects of sestrin2 in cardiovascular diseases: Promising therapeutic potential. Rev Cardiovasc Med. 2021;22(1):275-285. doi: 10.1016/j.heliyon.2024.e27110.
46. Zhang J, Li Y, Jiang S, Yu H, An W. Role of sestrin2 in the regulation of proinflammatory signaling in macrophages. Free Radic Biol Med. 2015;78:156-167. doi: 10.1016/j.freeradbiomed.2014.11.002.
47. Suh JH, Kim K, Choi JH, Paik SR, Kim H. Sestrin2 is crucial for the survival of human pancreatic beta cells under oxidative stress. Diabetes Metab Res Rev. 2018;34(2). doi: 10.1016/j.mad.2020.111379.
48. Liang Y, Zhu J, Huang H, et al. SESN2/sestrin 2 induction-mediated autophagy and inhibitory effect of isorhapontigenin (ISO) on human bladder cancers. Autophagy. 2016;12(8):1229-1239. doi: 10.1080/15548627.2016.1179403.
49. Chen KB, Xuan Y, Shi WJ, Chi F, Xing R, Zeng YC. Sestrin2 expression is a favorable prognostic factor in patients with non-small cell lung cancer. Am J Transl Res. 2016;8(4):1903-1909.
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Year 2024, , 634 - 643, 04.11.2024

Selim Akkaya , Teymur Bornaun , Hamit Zafer Güven

https://doi.org/10.18621/eurj.1468149

Abstract

References

1. Nijkang NP, Anderson L, Markham R, Manconi F. Endometrial polyps: Pathogenesis, sequelae and treatment. SAGE Open Med. 2019;7. doi: 10.1177/2050312119848247.
2. Salim S, Won H, Nesbitt-Hawes E, Campbell N, Abbott J. Diagnosis and management of endometrial polyps: A critical review of the literature. J Minim Invasive Gynecol. 2011;18(5):569-581. doi: 10.1016/j.jmig.2011.05.018.
3. Shokeir TA, Shalan HM, El-Shafei MM. Significance of endometrial polyps detected hysteroscopically in eumenorrheic infertile women. J Obstet Gynaecol Res. 2004;30(2):84-89. doi: 10.1111/j.1447-0756.2003.00163.x.
4. Indraccolo U, Di Iorio R, Matteo M, Corona G, Greco P, Indraccolo SR. The pathogenesis of endometrial polyps: a systematic semi-quantitative review. Eur J Gynaecol Oncol. 2013;34(1):5-22. doi: 10.12892/ejgo340101.
5. Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003;188(1):100-107. doi: 10.1067/mob.2003.99.
6. Protic O, Toti P, Islam MS, et al. Possible involvement of inflammatory/reparative processes in the development of uterine fibroids. Cell Tissue Res. 2016;364(2):415-427. doi: 10.1007/s00441-015-2324-3.
7. Santulli P, Borghese B, Lemaréchal H, et al. Increased serum oxidative stress markers in women with uterine leiomyoma. PLoS One. 2013;8(8):e72069. doi: 10.1371/journal.pone.0072069.
8. Özcan O, Erdal H, Çakırca G, Yönden Z. [Oxidative stress and its impacts on intracellular lipids, proteins and DNA]. J Clin Exp Invest. 2015;6(3):331-336. doi: 10.5799/ahinjs.01.2015.03.0545. [Article in Turkish]
9. Maeda H, Akaike T. Nitric oxide and oxygen radicals in infection, inflammation, and cancer. Biochemistry (Mosc). 1998;63(7):854-865. doi: 10.1007/978-1-4615-5081-5_18.
10. Toyokuni S, Okamoto K, Yodoi J, Hiai H. Persistent oxidative stress in cancer. FEBS Lett. 1995;358(1):1-3. doi: 10.1016/0014-5793(94)01368-B.
11. Pejic S, Kasapovic J, Todorovic A, Stojiljkovic V, Pajovic SB. Lipid peroxidation and antioxidant status in blood of patients with uterine myoma, endometrial polypus, hyperplastic and malignant endometrium. Biol Res. 2006;39(4):619-629. doi: 10.4067/S0716-97602006000500005.
12. Gong L, Wang Z, Wang Z, Zhang Z. Sestrin2 as a potential target for regulating metabolic-related diseases. Front Endocrinol (Lausanne). 2021;12:751020. doi: 10.3389/fendo.2021.751020.
13. Yang JH, Kim KM, Kim MG, et al. Role of sestrin2 in the regulation of proinflammatory signaling in macrophages. Free Radic Biol Med. 2015;78:156-167. doi: 10.1016/j.freeradbiomed.2014.11.002.
14. Yi L, Li F, Yong Y, et al. Upregulation of sestrin-2 expression protects against endothelial toxicity of angiotensin II. Cell Biol Toxicol. 2014;30(3):147-156. doi: 10.1007/s10565-014-9276-3.
15. Shin J, Bae J, Park S, et al. mTOR-Dependent Role of Sestrin2 in Regulating Tumor Progression of Human Endometrial Cancer. Cancers (Basel). 2020;12(9):2515. doi: 10.3390/cancers12092515.
16. Lu C, Jiang Y, Xu W, Bao X. Sestrin2: multifaceted functions, molecular basis, and its implications in liver diseases. Cell Death Dis. 2023;14(2):160. doi: 10.1038/s41419-023-05669-4.
17. Xu L, Liu Z, Wang H, et al. SESN2 Could Be a Potential Marker for Diagnosis and Prognosis in Glioma. Genes (Basel). 2023;14(3):701. doi: 10.3390/genes14030701.
18. Ala M. Sestrin2 in cancer: a foe or a friend? Biomark Res. 2022;10(1):29. doi: 10.1186/s40364-022-00380-6.
19. Kim KR, Peng R, Ro JY, Robboy SJ. A diagnostically useful histopathologic feature of endometrial polyp: the long axis of endometrial glands arranged parallel to surface epithelium. Am J Surg Pathol. 2004;28(8):1057-1062. doi: 10.1097/01.pas.0000128659.73944.f3.
20. Salim S, Won H, Nesbitt-Hawes E, Campbell N, Abbott J. Diagnosis and management of endometrial polyps: a critical review of the literature. J Minim Invasive Gynecol. 2011;18(5):569-581. doi: 10.1016/j.jmig.2011.05.018.
21. Hamani Y, Eldar I, Sela HY, Voss E, Haimov-Kochman R. The clinical significance of small endometrial polyps. Eur J Obstet Gynecol Reprod Biol. 2013;170(2):497-500. doi: 10.1016/j.ejogrb.2013.07.011.
22. Peterson WF, Novak ER. Endometrial polyps. Obstet Gynecol. 1956;8(1):40-49.
23. Jovanovic AS, Boynton KA, Mutter GL. Uteri of women with endometrial carcinoma contain a histopathological spectrum of monoclonal putative precancers, some with microsatellite instability. Cancer Res. 1996;56(8):1917-1921.
24. Pal L, Niklaus AL, Kim M, Pollack S, Santoro N. Heterogeneity in endometrial expression of aromatase in polyp-bearing uteri. Hum Reprod. 2008;23(1):80-84. doi:.1093/humrep/dem346.
25. Maia H, Pimentel K, Silva TMC, et al. Aromatase and cyclooxygenase-2 expression in endometrial polyps during the menstrual cycle. Gynecol Endocrinol. 2006;22(4):219-224. doi: 10.1080/09513590600585955.
26. Nogueira AA, Sant’Ana de Almeida EC, Poli Neto OB, Zambelli Ramalho LN, Rosa e Silva JC, Candido dos Reis FJ. Immunohistochemical expression of p63 in endometrial polyps: evidence that a basal cell immunophenotype is maintained. Menopause. 2006;13(5):826-830. doi: 10.1097/01.gme.0000242274.32278.a2.
27. Dal Cin P, Vanni R, Marras S, et al. Four cytogenetic subgroups can be identified in endometrial polyps. Cancer Res. 1995;55(7):1565-1568. doi: 10.1016/0165-4608(96)85299-X.
28. Tanos V, Berry KE, Seikkula J, et al. The management of polyps in female reproductive organs. Int J Surg. 2017;43:7-16. doi: 10.1016/j.ijsu.2017.05.012.
29. McLennan CE, Rydell AH. Extent of endometrial shedding during normal menstruation. Obstet Gynecol. 1965;26(5):605-621.
30. Altaner S, Gucer F, Tokatli F, et al. Expression of Bcl-2 and Ki-67 in Tamoxifen-Associated Endometrial Polyps: Comparison with Postmenopausal Polyps. Oncol Res Treat. 2006;29(8-9):376-380. doi: 10.1159/000094443.
31. Banas T, Pitynski K, Mikos M, Cielecka-Kuszyk J, Cielecka D. Endometrial Polyps and Benign Endometrial Hyperplasia Have Increased Prevalence of DNA Fragmentation Factors 40 and 45 (DFF40 and DFF45) Together With the Antiapoptotic B-Cell Lymphoma (Bcl-2) Protein Compared With Normal Human Endometria. Int J Gynecol Pathol. 2018;37(5):431-440. doi: 10.1097/PGP.0000000000000442.
32. Dreisler E, Stampe Sorensen S, Ibsen PH, Lose G. Prevalence of endometrial polyps and abnormal uterine bleeding in a Danish population aged 20-74 years. Ultrasound Obstet Gynecol. 2009;33(1):102-108. doi: 10.1002/uog.6259.
33. Annan JJ, Aquilina J, Ball E. The management of endometrial polyps in the 21st century. Obstetr Gynaecol. 2012;14(1):33-38. doi: 10.1111/j.1744-4667.2011.00091.x.
34. Vitale SG, Haimovich S, Laganà AS, et al. Endometrial polyps. An evidence-based diagnosis and management guide. Eur J Obstet Gynecol Reprod Biol. 2021;260:70-77. doi: 10.1016/j.ejogrb.2021.03.017.
35. Sasaki LMP, Andrade KRC, Figueiredo ACMG, Wanderley M da S, Pereira MG. Factors Associated with Malignancy in Hysteroscopically Resected Endometrial Polyps: A Systematic Review and Meta-Analysis. J Minim Invasive Gynecol. 2018;25(5):777-785. doi: 10.1016/j.jmig.2018.02.004.
36. Runowicz CD, Costantino JP, Wickerham DL, et al. Gynecologic conditions in participants in the NSABP breast cancer prevention study of tamoxifen and raloxifene (STAR). Am J Obstet Gynecol. 2011;205(6):535.e1-535.e5. doi: 10.1016/j.ajog.2011.06.067.
37. Lee JH, Budanov AV, Park EJ, et al. Sestrin as a feedback inhibitor of TOR that prevents age-related pathologies. Science. 2010;327(5970):1223-1228. doi: 10.1126/science.1182228.
38. Ro SH, Fay J, Cyuzuzo CI, et al. SESTRINs: Emerging Dynamic Stress-Sensors in Metabolic and Environmental Health. Front Cell Dev Biol. 2020;8:603421. doi: 10.3389/fcell.2020.603421.
39. Ryu D, Jo YS, Lo Sasso G, et al. A metabolic role for mitochondria in palmitate-induced cardiac myocyte apoptosis. Diabetologia. 2010;53(11):2435-2445. doi: 10.1152/ajpheart.2000.279.5.H2124.
40. Hu X, Xu Q, Wan H, et al. Sestrin2 protects against acute myocardial infarction by enhancing autophagy and reducing oxidative stress. Redox Biol. 2020;32:101504. doi: 10.1016/j.jphs.2020.11.012.
41. Zhong Z, Sanchez-Lopez E, Karin M. More than an antioxidant: the role of sestrin2 in regulating metabolism and preventing disease. J Hepatol. 2020;72(1):173-181. doi: 10.3390/ijms21134714.
42. Choi AMK, Ryter SW, Levine B. Autophagy in human health and disease. N Engl J Med. 2013;368(15):1845-1846. doi: 10.1056/NEJMra1205406.
43. Park HW, Park H, Ro SH, et al. Hepatic expression of detoxifying enzymes is decreased in human subjects with nonalcoholic fatty liver disease and in mice with diet-induced steatosis. J Hepatol. 2012;57(2):780-787. doi: 10.1016/j.jphs.2020.11.012.
44. Li X, Guo J, Jiang X, et al. Involvement of sestrin2 in the regulation of endoplasmic reticulum stress in diabetes. Diabetes Res Clin Pract. 2019;156:107834. doi: 10.18632/oncotarget.7601.
45. Sun Y, Chen X, Zhang X, Shen X, Wang M, Wang X. Protective effects of sestrin2 in cardiovascular diseases: Promising therapeutic potential. Rev Cardiovasc Med. 2021;22(1):275-285. doi: 10.1016/j.heliyon.2024.e27110.
46. Zhang J, Li Y, Jiang S, Yu H, An W. Role of sestrin2 in the regulation of proinflammatory signaling in macrophages. Free Radic Biol Med. 2015;78:156-167. doi: 10.1016/j.freeradbiomed.2014.11.002.
47. Suh JH, Kim K, Choi JH, Paik SR, Kim H. Sestrin2 is crucial for the survival of human pancreatic beta cells under oxidative stress. Diabetes Metab Res Rev. 2018;34(2). doi: 10.1016/j.mad.2020.111379.
48. Liang Y, Zhu J, Huang H, et al. SESN2/sestrin 2 induction-mediated autophagy and inhibitory effect of isorhapontigenin (ISO) on human bladder cancers. Autophagy. 2016;12(8):1229-1239. doi: 10.1080/15548627.2016.1179403.
49. Chen KB, Xuan Y, Shi WJ, Chi F, Xing R, Zeng YC. Sestrin2 expression is a favorable prognostic factor in patients with non-small cell lung cancer. Am J Transl Res. 2016;8(4):1903-1909.
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Details

Primary Language	English
Subjects	Obstetrics and Gynaecology
Journal Section	Reviews
Authors	Selim Akkaya 0000-0001-8344-5125 Teymur Bornaun 0009-0007-8081-8003 Hamit Zafer Güven 0009-0002-7217-7318
Early Pub Date	July 15, 2024
Publication Date	November 4, 2024
Submission Date	April 14, 2024
Acceptance Date	June 25, 2024
Published in Issue	Year 2024

Cite

AMA	Akkaya S, Bornaun T, Güven HZ. Exploring the role of serum sestrin 2 in patients with endometrial polyps and uterine leiomyomas: implications for early diagnosis and pathophysiology. Eur Res J. November 2024;10(6):634-643. doi:10.18621/eurj.1468149

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