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Context: The concept of epithelial–mesenchymal transition (EMT) in cancer origin, progression, and metastasis is of recent origin and not fully understood. So far, many cell culture studies have been done to investigate the role of EMT in epithelial ovarian cancer, but only a few human studies have been conducted. Aims: The aim of the study is to study the expression of E-cadherin and vimentin in serous and mucinous tumors of the ovary and to compare their expression in benign and malignant serous and mucinous ovarian tumors. Methods: This study was a prospective study done on 60 patients with a histological diagnosis of serous and mucinous ovarian malignancy. The study was conducted in the Department of Pathology and Department of Obstetrics and Gynaecology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi. The expression of epithelial marker E-cadherin and mesenchymal marker vimentin was studied in each of the tumors. Statistical Analysis: Unpaired t-test/Mann–Whitney test, Chi-Square test/Fisher's exact test, and Kolmogorov–Smirnov test were used. Results: Of the total 60 cases included in the study, 30 benign and 30 malignant cases of serous and mucinous tumors were taken. Of the 30 benign cases, 22 cases (73.3%) were that of serous cystadenomas, whereas 8 (26.67%) cases were of mucinous cystadenomas. Among the malignant cases, 21 cases (70%) were serous surface epithelial ovarian carcinoma, whereas 9 (30%) were mucinous surface epithelial ovarian carcinoma. Subsequently, the malignant cases were graded according to their glandular differentiation. Immunohistochemistry was performed in each of the 60 cases. Conclusion: In the malignant cases with increasing grade of the tumor, a reduced expression of E-cadherin and an increased expression of vimentin were seen in the epithelial cells
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Background and purpose:The ovarian mucinous tumor is one of the major subtypes of the ovari-an epithelial cancer. Ubiquitination is one of the main post-translational modifications, which has proven to be involved in tumorigenicity. Deubiquitinase is the protein enzyme that could reverse the process of ubiquitination to affect the initiation and progression of malignancies. This study aimed to analyze the expression and clinical application of deubiquitinase OTUB1 (OTU deubiquitinase, ubiquitin aldehyde binding 1) in ovarian primary mucinous tumors. Methods:This study collected 90 cases of ovarian primary mucinous tumors during 2010-2015 in Obstetrics and Gynecology Hospital of Fudan University, and then collected the clinicopathological information and performed the immunochemistry.Results:Fourteen out of 90 cases were ovarian primary mucinous cystadenoma, 17 were borderline mucinous tumor (intestinal type and intraepithelial carcinoma), and 59 were ovarian primary mucinous carcinoma. The expression rate and intensity of OTUB1 were much higher in malignant cases than those in benign ones (P<0.05). The expression rate and intensity of OTUB1 were much higher in cases with mucinous intraepithelial carcinoma than those in cases with intestinal type borderline mucinous tumor (P<0.05). The expression rate and intensity of OTUB1 increased with the advance of FIGO staging (P<0.05). The expression rate and intensity of OTUB1 were much higher in cases with involved fallopian tubes than those in cases without involved fallopian tubes (P<0.05). The expression rate and intensity of OTUB1were much higher in cases with involved uterus and omentum than those in cases with-out involvement (P<0.05). The expression rate and intensity of OTUB1were much higher in cases with lymph node metastasis than those in cases without involvement (P<0.05).Conclusion:There is significant difference in OTUB1 expression between ovarian primary mucinous carcinoma and benign mucinous cystadenoma. It is highly correlated to FIGO staging and invasion and metastasis of tumor. OTUB1 could be used in differential diagnosis and in monitoring the tumor initiation and progression in ovarian mucinous carcinoma.
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Objective To analyze the CT manifestation and clinical characteristics of appendiceal mucinous tumor for improving the diagnostic and therapeutic level. Methods The CT and clinical data of 7 patients with appendiceal mucinous tumor verified by histopathology were retrospectively analyzed. Results Among the 7 cases, mucinous cystadenomas was in 6 cases, and mucinous cystadenocarcinoma was in 1 case. One case had no obvious discomfort;3 cases visited because of pain on right hypogastrium and fever;3 cases had the medical history ofchronic appendicitis, among whom 2 cases had the mass on right hypogastrium which had existed for 1 day or 2 years. The unenhanced CT showed that all of 7 cases had the cystic tumors on right hypogastrium near the cecum, and the maximum traverse diameter was 25-208 (67 ± 27) mm. The cyst walls of mucinous cystadenoma in 6 cases were flimsy, symmetrical, 2.3-3.5 mm thickness and smooth. Three cases had cyst walls calcification; the cyst wall of mucinous cystadenocarcinoma was thick and asymmetrical, and the thickness of cyst wall was 3.5-5.7 mm. Small nodes could be found inside the walls. 7 cases had much mucilage, with CT value 14.0-33.5 HU. Four cases had slight septa. The enhanced CT showed that the cyst walls of mucinous cystadenoma in 6 cases were mild to moderate continuous enhancement during venous phase; the cyst wall and nodes mucinous cystadenocarcinoma was obvious and continuous enhancement. Four cases showed clear boundary, while 3 cases accompanied with acute inflammation showed dim edge. The enlargement of lymphatic nodes could be seen near mesentery in 1 case. All the 7 cases were treated by surgical treatment. One patient who survived after 26 months showed the metastasis of peritoneal pseudomyxoma after 20 months. The 6 patients with mucinous cystadenoma were followed up for 18 - 36 months, they did not had metastasis or recurrence by CT review. Conclusions Appendiceal mucinous tumor is often short of characteristic in clinical symptom and physical sign, but has favourable prognosis. CT is a vital tool for its diagnosis and identification.
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Los tumores de ovario de bajo grado de malignidad o "borderline", se originan del epitelio de este órgano y tienen un comportamiento biológico intermedio entre las lesiones malignas y benignas del ovario. El estudio se realizó con el objetivo de profundizar en el diagnóstico y la conducta terapéutica de esta infrecuente afección nosológica. Se presenta un caso clínico atendido en el servicio de Cirugía General del Hospital General Docente "Leopoldito Martínez", en San José de las Lajas, provincia Mayabeque. No se identificaron signos patológicos. Se identificó vulva y vagina sin alteraciones. El diagnóstico se estableció por el examen histopatológico y el tratamiento quirúrgico fue radical...
Ovarian tumors of low malignant potential or "borderline" originate from the epithelium of this body and they have an intermediate biological behavior between malignant and benign ovarian lesions. This study aims to deepen the diagnosis and therapeutic management of this uncommon nosological condition. A clinical case is presented here. This patient was treated at the Department of General Surgery, at Leopoldito Martinez General Teaching Hospital in San José de las Lajas, Mayabeque province. No pathological signs were identified. Vulva and vagina had no alterations. The diagnosis was established by histopathological examination and surgical treatment was radical...
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Objective: To discuss the feasibility of distinguishing benign from malignant intraductal papillary mucinous tumors (IPMT) of the pancreas preoperatively based on the clinical and radiological characteristics. Methods: The clinical data of 40 patients with IPMT treated between July 1996 and March 2007 were analyzed. The diagnoses of all patients were confirmed pathologically after surgical resections. Among the 40 patients, there were 17 benign cases and 23 malignant ones. Results: Malignant IPMT patients had a higher frequency of upper abdominal pain and jaundice than benign patients (P<0.05). The sex difference in incidence of IPMT, time of onset, and loss of body mass were not significantly different between the 2 groups. Radiological results demonstrated that the size of tumor and mural nodules in the lesions were larger in the malignant cases than in the benign cases (P<0.05); besides, the malignant cases also had a more dilated main pancreatic duct (MPD) (P<0.05). Mural nodules and thick irregular septum in the cystic lesions were more frequently seen in malignant cases (P<0.05). There was no significant difference in the site preference between the 2 groups. Conclusion: Benign and malignant IPMT have significant differences in their clinical and radiological characteristics, which provides an important evidence for differentiating the biological types of IPMT and helps surgeons on their decision of surgical planning.
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Objective: To evaluate the value of intraductal ultrasonography (IDUS) in diagnosis of pancreatic diseases. Methods: We retrospectively reviewed the imaging data of 63 patients with pancreatic diseases who underwent IDUS from February 2005 to February 2010. A 20 MHz over-the-guidewire intraductal US catheter probe was used during endoscopic retrograde cholangio- pancreatography(ERCP) for further examination of the pancreas. We also compared the results of CT, magnetic resonance imaging (MRI), endoscopic ultrasonography (EUS) and abdominal ultrasonography in diagnosis of pancreatic diseases, so as to further evaluate the value of IDUS in the clinical diagnosis of pancreatic diseases. Results: The accuracies of IDUS in diagnosis of chronic pancreatitis (23 cases), pancreatic cancer (10 cases), intraductal papillary mucinous tumors (IPMT, 25 cases), and pancreatic adenoma (4 cases) were 93. 7% (59/63), 100.0% (63/63), 90.5% (57/63), and 96.8% (61/63), and the Kappa values were 0.854, 1.00, 0.898, and 0.848, respectively. The diagnostic accuracies and Kappa test values of IDUS were better than those of the other four methods. IDUS correctly diagnosed the pancreatic cystadenocarcinoma in one patient before operation. Conclusion: IDUS has a high diagnostic value for pancreatic diseases.
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Objective To summarize the clinical features of intraductal papillary mucinous tumors (IPMT) of the pancreas to improve the diagnosis and treatment of IPMT.Methods The clinical features,imaging features and clinicopatholagic characteristics of 49 IPMT patients,who underwent operations in our department from March 1996 to September 2008,were retrospectively analyzed.The clinical features of benign,borderline and malignant IPMT were compared.Results Among the 49 patients,there were 27 males and 22 females;the average age was 58±11 years.There were 18 benign cases,9 borderline cases and 22 malignant ones.The difference in sex ratio,age of disease onset,smoking and drinking habit,history of pancreatitis and diabetes,presence of abdominal pain,radiation pain,abdominal bloating and weight loss symptoms,serum levels of CEA,AST,ALT,tumor location and type were not significantly different between the 3 groups.However,there were significant difference in term of jaundice,serum carbohydrate antigen 19-9(CA19-9)and alkaline phosphatase (AKP) levels,size of tumor,diameter of main pancreatic duct,presence of septum in cystic tumor,mural modules in the tumor.Among the malignant IPMT patients,one patient died 5 years after operation,one patient had malignancy recurrence;among the benign and borderline IPMT patients,1 patient had malignancy recurrence and 1 patient died due to other disease.Conclusions Different types of IPMT had different clinical features and comprehensive judgment were needed to differentiate.
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Pseudomyxoma peritonei is a poorly understood condition characterized by mucinous ascites and multifocal peritoneal mucinous tumors. Pseudomyxoma peritonei is most commonly associated with mucinous tumors of the ovary and appendix. When two lesions are morphologically similar, it is difficult to determine whether one reflects a metastasis or whether the tumors are independent. Many studies concluded that most cases in which both the appendix and ovary were involved were primary appendiceal tumor with secondary involvement of the ovary, but we have experienced one case of pseudomyxoma peritonei originated from independent primary borderline mucinous tumors of the ovary and appendix. So we report this case with the brief review of literatures
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Female , Appendix , Ascites , Mucins , Neoplasm Metastasis , Ovary , Pseudomyxoma PeritoneiABSTRACT
OBJECTIVE: The aims of this study were to analyze the natural history of patients with pseudomyxoma peritonei originated from mucinous ovarian tumor, evaluate clinical and pathologic variables, and review our experience with available therapeutic modalities. METHODS: Six patients were treated for pseudomyxoma peritonei originating from mucinous ovarian tumor at Severance Hospital between 1990 and 1998. The data were collected retrospectively and all charts were reviewed RESULTS: The mean age at diagnosis was 51 years, and most common symptoms were abdominal distension. Pseudomyxoma peritonei was found in association with five mucinous ovarian tumors of borderline malignancy, and one ovarian mucinous adenoma. All patients underwent surgical staging and cytoreduction, three patients received postoperative adjuvant chemotherapy and, of these, two developed recurrence. With respect to survival, all patients were alive, four were alive and free of disease, two were alive with disease at the end point of study. CONCLUSION: Pseudomyxoma peritonei is commonly associated with borderline mucinous ovarian tumors, and is a frequently relapsing and protracted disease. But aggressive and repeated debulking surgery is recommended for long survival.
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Humans , Adenoma , Chemotherapy, Adjuvant , Diagnosis , Mucins , Natural History , Pseudomyxoma Peritonei , Recurrence , Retrospective StudiesABSTRACT
Biological behavior of malignant tumors has been assessed by morphological grading, clinical staging, and estimating other tumor markers. Recently DNA ploidy measured by flow cytometry and image analyser has been suggested as an additional useful indicator of the tumor behavior. In order to extract useful tumor cell-specific information in ovarian mucinous tumors, DNA contents and other morphologic parameters were measured by image analysis and DNA ploidy was also measured by flow cytometry. In all cases of cystadenoma, DNA diploidies were observed. In borderline malignancy, DNA diploidies were chiefly observed except one case of polyploidy. In true malignancy, DNA aneuploidies were observed except one case of polyploidy and two cases of diploidies by image analysis, and except four cases of diploides and one cas of polyploidy by flow cytometry. The statistical significance were observed in DNA ploidy pattern by image analysis. In nuclear areas, perimeters and major axis, statistical significance were not observed. These results suggest that DNA ploidy pattern are more or less independent parameter as an additional useful indicator of the histological grade of malignancy and that image analysis are better than flow cytometry in detecting DNA aneuploidy.