Platelet RNA enables accurate detection of ovarian cancer: an intercontinental, biomarker identification study

Platelets are reprogrammed by cancer via a process called education, which favors cancer development. The transcriptional profile of tumor-educated platelets (TEPs) is skewed and therefore practicable for cancer detection. This intercontinental, hospital-based, diagnostic study included 761 treatment-naïve inpatients with histologically confirmed adnexal masses and 167 healthy controls from nine medical centers (China, n = 3; Netherlands, n = 5; Poland, n = 1) between September 2016 and May 2019. The main outcomes were the performance of TEPs and their combination with CA125 in two Chinese (VC1 and VC2) and the European (VC3) validation cohorts collectively and independently. Exploratory outcome was the value of TEPs in public pan-cancer platelet transcriptome datasets. The AUCs for TEPs in the combined validation cohort, VC1, VC2, and VC3 were 0.918 (95% CI 0.889-0.948), 0.923 (0.855-0.990), 0.918 (0.872-0.963), and 0.887 (0.813-0.960), respectively. Combination of TEPs and CA125 demonstrated an AUC of 0.922 (0.889-0.955) in the combined validation cohort; 0.955 (0.912-0.997) in VC1; 0.939 (0.901-0.977) in VC2; 0.917 (0.824-1.000) in VC3. For subgroup analysis, TEPs exhibited an AUC of 0.858, 0.859, and 0.920 to detect early-stage, borderline, non-epithelial diseases and 0.899 to discriminate ovarian cancer from endometriosis. TEPs had robustness, compatibility, and universality for preoperative diagnosis of ovarian cancer since it withstood validations in populations of different ethnicities, heterogeneous histological subtypes, and early-stage ovarian cancer. However, these observations warrant prospective validations in a larger population before clinical utilities.

Correlation analysis between multi-slice CT perfusion imaging and microvessel density in ovarian tumors / 南方医科大学学报

<p><b>OBJECTIVE</b>To analyze the correlation between the perfusion data and microvessel density (MVD) in ovarian tumors, and investigate the hemodynamic features of the tumors in terms of anatomy and functional CT imaging.</p><p><b>METHODS</b>Six patients with surgically confirmed benign ovarian tumors and 6 with malignant ovarian tumors underwent multi-slice CT perfusion imaging to acquire the perfusion parameters including perfusion, PEI, TTP, BV peak enhancement image(PEI), time to peak(TTP) and blood volume(BV). The tumors were stained and counted by Immunohistochemical staining of the microvessels in the tumor was performed to detect the MVD.</p><p><b>RESULTS</b>s The time-density curves of the benign ovarian tumors increased slowly, reaching the peak at 40 s; the curves of the malignant tumors rose rapidly and continuously and reached the peak at 25 s. The differences in the perfusion data (PEI, TTP, BV) were statistically significant between the benign and malignant tumors (P<0.05). The MVD of the malignant tumors was significantly greater than that of the benign tumors (P<0.05). The mean BV of the malignant ovarian tumor was positively correlated to MVD (r=0.786, P<0.05).</p><p><b>CONCLUSION</b>Multi-slice spiral CT perfusion imaging can provide accurate enhancement data of the ovarian tumors and helps in the diagnosis and differential diagnosis of the ovarian tumors by presenting the changes of the hemodynamic features in the tumors.</p>

Atypical magnetic resonance imaging vs pathological findings of leiomyoma in the female reproductive system / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate magnetic resonance imaging (MRI) findings of the atypical leiomyoma in the female reproductive system in comparison with the pathological features of the neoplasms.</p><p><b>METHODS</b>A retrospective analysis of the MRI findings and the pathological features was conducted in 24 cases of atypical leiomyoma involving the female reproductive system.</p><p><b>RESULTS</b>Atypical leiomyomas were displayed by MRI as solid tumor mass surrounded by cystic degeneration, pseudotumors, or solid mass with homogeneous signal intensity. Intrauterine lesions were found in 19 cases, involving the subserosal layer (n=11), intramural region (n=4), broad ligament (n=3), cervix (n=2), submucous layer (n=2), vagina (n=1), and the ovary (n=1). Except for two cases with submucous lesions shown as solid mass, all the cases had lesions appearing as solid cystic mass, whose solid part showed hypo or isointense signals on T1WI and moderate hyperintense signals on T2WI, with heterogeneous enhancement after contrast agent injection. Tumor cell and interstitial cell swelling, vascular hyalinosis, hyalinosis, myxoedema, cystic degeneration, and hemorrhage were found in the lesions.</p><p><b>CONCLUSION</b>Leiomyoma can occur at almost any site in the female reproductive system, and atypical leiomyoma usually are shown as solid cystic mixed mass in the pelvic cavity. Evaluation of the relationship between the solid mass and cystic portion and observation for the presence of low signal on T2WI may help in the diagnosis of atypical leiomyoma.</p>