ABSTRACT
Background: Clear cell and mucinous types of epithelial ovarian cancers are relatively chemo resistant and have a poorer prognosis compared to other histologies. Aim of the study was to study the biochemical and histopathological response and surgical outcome of various histologies to standard platin based chemotherapy.Methods: All 42 cases of locally advanced carcinoma ovary who received several cycles of neoadjuvant chemotherapy (NACT) followed by, interval cytoreductive surgery (ICS) were included in this study. Serum CA125 levels before and after neoadjuvant chemotherapy, the ability to achieve optimal cytoreduction and the presence of residual tumour in the surgical specimen were the parameters measured. Continuous variables were compared by one-way ANOVA. Categorical variables were compared by the Pearson chi-square test. Significance was defined by p values less than 0.05. Survival analysis was done using Kaplan-Meier estimation.Results: There was a 95,84% reduction in serum CA125 levels for papillary serous carcinoma compared to clear cell and mucinous varieties, which had 81.2% and 78.5% reduction, respectively. More number of papillary serous tumours were able to achieve optimal cytoreduction (72%) compared to mucinous variety (25%). Residual tumour was present in 68% of serous papillary tumours compared to 87.5% in mucinous and 80% in clear cell histology.Conclusions: Our study concludes that mucinous and clear cell types of EOC are relatively chemo resistant compared to the serous subtype. We recommend more aggressive surgery especially for mucinous tumours. In the case of ovarian cancer, we observed that the mucinous and clear cell types of EOC are relatively chemoresistant compared to the serous subtype. From the results, we recommend the more aggressive strategy of surgery as a preliminary choice of treatment especially for mucinous tumours rather than chemotherapy in patients with EOC.
ABSTRACT
Objective To evaluate the value of multislice spiral computed tomography angiography (MSCTA) in differential diagnosis between epithelial ovarian carcinoma (EOC) and borderline epithelial ovarian tumor (BOT).Methods The MSCTA images of 39 EOC patients and 23 BOT patients confirmed by surgical pathology were reviewed retrospectively.Main characteristics of tumor vessels were analyzed: the number of feeding arteries, the existence of dilated draining veins, whether the tumor vessels were tortuous, whether the distribution of tumor vessels were disturbed, and whether there were accompanying microaneurysms or arteriovenous malformations (AVMs).Results Two or more feeding arteries of the EOCs and BOTs were 89.7% (35/39) and 8.7% (2/23), respectively.Dilated draining veins were observed in 87.2% (34/39) of the EOCs and 4.3% (1/23) of the BOTs.The tortuosity of tumor vessels was observed in 97.4% (38/39) of the EOCs and 13.0% (3/23) of the BOTs.79.5% (31/39) of the EOCs and 8.7% (2/23) of the BOTs were complicated by microaneurysms, and 74.4% (29/39) of the EOCs and 4.3% (1/23) of the BOTs were complicated by AVMs.The characteristics of tumor vessels were significantly different between the two groups (P<0.01), with relatively high sensitivity and specificity.Conclusion MSCTA can better show the distribution, number and pattern of tumor vessels and is of great value in differential diagnosis between EOC and BOT.
ABSTRACT
Objective To investigate the expressions of apoptosis associated protein 3 (APR3) and nuclear factor 3 of activated T-cell (NFAT3) in the tissue of epithelial ovarian tumors and its correlation with the clinicopathological features.Methods 92 patients with epithelial ovarian tumor were collected,23 cases with malignant tumor,24 cases with borderline tumor,45 cases with benign tumor.The expressions of APR3 and NFAT3 were detected by immunohistochemical methods,and the differences of different types of epithelial ovarian tumor were compared.The correlation of the expressions of APR3 and NFAT3 with the clinicopathological features of epithelial ovarian tumor was analyzed.The correlation of the expressions of APR3 with the expressions of NFAT3 in epithelial ovarian tumor was analyzed.Results The positive expression rate of APR3 in patients with malignant epithelial ovarian tumors (78.26％) was significantly higher than borderline tumors (41.67 ％) and benign tumors (22.22 ％),the differences were statistically significant (x2 =5.864,7.632,all P ＜ 0.05).The expression of APR3 in patients with malignant epithelial ovarian tumors was significantly correlated with differentiation,clinical stage,lymph node and abdominal organs metastasis and ascites (x2 =7.425,7.262,8.421,5.031,all P ＜ 0.05).The positive expression rate of NFAT3 in patients with malignant epithelial ovarian tumors (56.52％) was significantly higher than borderline tumors (29.17％) and benign tumors(17.78％),the differences were statistically significant (x2 =6.829,7.547,all P ＜0.05).The expression of NFAT3 in patients with malignant epithelial ovarian tumors was significantly correlated with differentiation,clinical stage,lymph node and abdominal organs metastasis (x2 =5.253,6.367,8.021,all P ＜ 0.05).The expressions of APR3 and NFAT3 in patients with malignant epithelial ovarian tumors were positively correlated (r =0.032,P ＜ 0.05).Conclusion The expressions of APR3 and NFAT3 in the tissue of malignant epithelial ovarian tumor obviously increase,are significantly correlated with differentiation,clinical stage,lymph node and abdominal organs metastasis and are positively correlated,and it may be correlated with the development and progression of malignant epithelial ovarian tumor.
ABSTRACT
OBJECTIVE:To observe clinical efficacy and safety of Xiaoaiping injection with rectum administration combined with conventional chemotherapy in the treatment of epithelial ovarian tumor. METHODS:60 patients diagnosed as epithelial ovari-an tumor were divided into observation group and control group according to the actual order,with 30 cases in each group. AU pa-tients received TC chemotherapy,4-6 cycles in total;And patients in control group received TC chemotherapy for 3 weeks,i.e. pa-clitaxel 175 mg/m2,3 h,i.v.+carboplatin AUC=5-7.5,1 h,i.v.. Based on this,observation group was additionally given Xiaoaip-ing injection with rectum administration,20-30 ml each time,once a day,2 weeks as a treatment course. Clinical effective rate, 1-year progression-free survival rate and median progression free survival and the incidence of adverse events were compared be-tween 2 groups. RESULTS:Effective rate of observation group was 83.33%,and higher than that of control group (53.33%);there was statistically significant difference (χ2=13.20,P<0.05);1-year progression-free survival rate of observation group was 86.67%,and median progression free survival was 11.3 months;those of control group were 63.33% and 7.2 months;there was statistically significant difference between 2 groups (P<0.01 or P<0.05). There was no significant difference in the incidence of ADR between 2 groups(χ2=0.53,P=0.47). CONCLUSIONS:Xiaoaiping injection with rectum administration combined with con-ventional chemotherapy in the treatment of epithelial ovarian cancer show good curative effect and safety,high 1-year progres-sion-free survival rate and long median progression-free survival.
ABSTRACT
Objective To investigate the expression and the clinical significance of Lewis y antigen and Mucin 1 (MUC1),as well as to evaluate the correlation between them in epithelial ovarian tumor.Methods The expression of Lewis y antigen and MUC1 in 60 cases of epithelial ovarian malignant tumors,30 cases of borderline ovarian tumors,30 cases of benign ovarian tumors and 20 cases of normal ovarian tissues were detected by immunohistochemical staining.The relationship between Lewis y antigen and MUC1,and their relationship with biology characteristic of ovarian carcinoma were analyzed.An immunofluorescence double labeling methods was performed to detect the correlation between Lewis y antigen and MUC1.Results In malignant epithelial ovarian tumors,the positive rates of Lewis y antigen was 88.33％,which was significantly higher than the positive rates in borderline(60.00％,x2 =9.6405,P ＜0.01) and benign ovarian tumors(33.33％,x2 =28.8095,P ＜0.01) and normal ovarian samples (0,x2 =52.3457,P ＜ 0.01).The positive rates of Lewis y antigen had nothing to do with the clinical pathological parameters of ovarian tumor,but the expression intensity of Lewis yantigen was increased with the development of the malignant degree(P ＜ 0.05).The positive rates of MUC1 in malignant epithelial ovarian tumors was also significantly higher than that in borderline,benign ovarian tumors and normal ovarian samples (86.67％ vs 53.33％,30.00％,25.00％,x2 =12.0321,29.4064,27.8464 ; P ＜0.01).And the expression intensity of MUC1 also increased with the development of clinical stage(P ＜0.01),but had nothing to do with the lymph node metastasis and histological grade(P ＞ 0.05).In ovarian cancer,both Lewis y antigen and MUC1 were highly expressed,and their expression levels were positively correlated (r =0.707,P ＜0.01),and Lewis y antigen colocalized with MUC1.Conclusion Both Lewis y antigen and MUC1 are associated with the occurrence and development of ovarian cancer.Lewis y antigen and MUC1 might be a sigh of biological behavior in ovarian cancers,and this study provides theoretical evidence of ovarian cancer biological treatment.
ABSTRACT
OBJECTIVE: To assess the expression pattern of all six Prxs in normal ovarian tissue and epithelial ovarian tumor cell using immunohistochemical staining. METHODS: Patients were retrieved from those who had undertaken operation in Obstetrics and Gynecology of our hospital from January 1995 to June 2005. According to the pathologic result, five patients were allocated randomly in each group of malignant serous, malignant mucinous, benign serous and benign mucinous ovarian tumor. And another five with normal ovarian epithelial cell were included for the comparison. Immunohistochemical staining was performed with Prx I to VI antibodies. Using microscopy, we evaluated the immunoreactivities of nucleus and cytoplasm semiquantitatively by dividing into four categories : -; no immunoactivity present, +; weak, ++; moderate, +++; strong staining. RESULTS: The immunopositivity of Prx III in cytoplasm shows weak to moderate and Prx VI moderate to strong in normal ovarian tissue. In mucinous epithelial ovarian tumor cell, cytoplasmic Prx IV shows stronger activity than in normal epithelial cell or serous tumor cell. In malignant epithelial cell, Prx V shows stronger activity in cytoplasm than normal epithelial cell. It shows characteristically granular pattern. Prx VI shows stronger activity in the nucleus of malignant epithelial cell compared to normal epithelial cell or benign tumor epithelial cell. CONCLUSION: Normal ovarian tissue showed higher affinity for Prx III and VI. In epithelial ovarian tumor, cytosolic Prx IV in mucinous tumor, cytosolic Prx V and nuclear Prx VI in malignant tumor were overexpressed.
Subject(s)
Female , Humans , Antibodies , Cytoplasm , Cytosol , Epithelial Cells , Gynecology , Microscopy , Mucins , Obstetrics , Ovary , Peroxiredoxins , Protein IsoformsABSTRACT
OBJECTIVE: Some genetic alterations are involved in ovarian carcinogenesis. Since some benign and borderline tumors may represent early steps in ovarian carcinogenesis, analysis of precursor lesions could provide evidence that an accumulation of genetic events is required in order for normal ovarian epithelium to generate benign, borderline, malignant tumors. Few pre-invasive ovarian tumors have been studied so far. METHODS: 60 cases of ovarian epithelial tumors, including benign, borderline, and malignant tumors, were analyzed for microsatellite instability (MSI) by gel analysis of paired germ line and tumor DNA. PCR amplification was performed using the panel of 5 microsatellite markers recommended by the NCI (BAT25, BAT26, D2S123, D5S346, D17S250) and 6 additional markers (D1S160, D1S162, D7S522, D11S860, D17S855, D17S932). RESULTS: In this study, D2S123 and D5S346 were the most frequently altered markers in malignant ovarian tumors and D11S860 locus showed MSI in 4 adenomas, 4 boderline tomors, and 10 malignant tumors. Other markers displayed instability with only one or two tumors showing MSI. On the basis of NCI criteria, most benign tumors demonstrat microsatellite stable (MSS). In the borderline tumors, 10 tumors revealed MSS, 8 tumors had low-frequency MSI (MSI-L), and two tumors had high frequency MSI (MSI-H). In the malignant tumors, 6 tumors revealed MSS, 2 tumors had MSI-L, and 12 tumors had high MSI-H. CONCLUSION: According to the results, MSL-H is more frequently seen in the malignant tumors. D2S123 and D5S346 were the most frequently altered markers in the malignant tumors, and D11S860 locus may be involved in early step of carcinogenesis.
Subject(s)
Adenoma , Carcinogenesis , DNA , Epithelium , Germ Cells , Microsatellite Instability , Microsatellite Repeats , Polymerase Chain ReactionABSTRACT
OBJECTIVE: To determine the CD44S expression in the development and progression of serous ovarian tumor. METHODS: An immunohistochemical stain was undertaken of a series of 12 cases of benign, 15 cases of borderline, 30 cases of malignant serous ovarian tumors. Then, we analyzed the expression of CD44S to see whether expression of this adhesion molecule by tumor cells correlated with clinicopathological factors. RESULTS: In twelve benign tumors, CD44S was not expressed. Four of fifteen (27%) borderline tumors were positive for CD44S. Twelve of thirty (40%) malignant tumors were positive for CD44S. CD44S expression rate was significantly associated with non-benign tumors (P=0.003). But, there was no significant correlation between CD44S expression and stage, grade, peritoneal seeding or lymph node metastasis. CONCLUSION: Since benign ovarian tumors show negative CD44S, positive CD44S can provide partial diagnostic aid in ovarian malignant tumor.
Subject(s)
Lymph Nodes , Neoplasm MetastasisABSTRACT
Borderline epithelial ovarian tumor is a special entity of ovarian tumor. Compared with invasive epithelial ovarian cancer, borderline tumors have a much more favorable prognosis. Several issues remain unclear in the management of patients with borderline ovarian tumor. Objective : To review the clinical features, treatment and survival status of patients with borderline epithelial ovarian tumors. Materials and methods : A retrospective review of the records of 48 patients with borderline epithelial ovarian tumors registered at the Gynaecologic Oncology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University from January 1, 1986 - December 31, 1998 was performed. Results : Ninety percent of the patients had stage I disease. Mucinous cell type was found in 77.1% and serous cell type was found in 22.9%. All the patients received surgery and most of the patients received adjuvant chemotherapy. Mean follow up time was 38.94 months and the 10 - year survival rate was 97.92%. Three patients had recurrence of disease. All patients with recurrence did so within 12 months. Conclusion : The prognosis of patients with borderline epithelial ovarian tumor is good. Conservative surgery should be performed for stage I patients who wish to remain fertile.
ABSTRACT
The author examined expression of tumor-related antigens, such as p53 tumor supressor protein, c-myc, TGF-alpha, and TGF-beta proteins in 75 cases of surgically resected epithelial ovarian tumors. Peroxidase immunohistochemistry was used to determine the frequency of expression, the relationship among expression of these antigens and histopathological spectrums, and clinical stage, and their potential prognostic significance. The results are summarized as follows. A positive correlation was found between expression of p53(P=0.02), c-myc(P=0.03), and TGF-alpha(P=0.001) and histological degrees of malignancy(benign, borderline, or malignant) in epithelial ovarian tumors. A significant correlation was found between expression of p53 and histological degrees of malignancy in serous ovarian tumors(P=0.003) and mucinous tumors (P=0.049). A significant correlation was also found between expression of c-myc and the histological grade of serous carcinomas(P=0.02). A correlation between expression of these antigenic proteins and clinical stage of epithelial ovarian tumors was not demonstrated. Expression of p53 and c-myc was closely correlated with expression of TGF-alpha irrespective of the histological degrees of malignancy and type of epithelial ovarian tumors(0.4 < or = K < or = 0.7). The results of this study support the ideas that expression of c-myc and TGF-alpha might be a useful prognostic indicator in human ovarian carcinomas, and expression of p53 could be another indicator of prognosis, as the expression of p53 is characteristic in that the expression is mostly seen in invasive ovarian carcinomas.