Activation of JAK/STAT in ovarian high-grade serous cancers and its prognostic significance / 北京大学学报(医学版)

OBJECTIVE@#The activation of Janus kinase (JAK) and signal transducers and activators of transcription (STAT) plays an important role in the prognosis and targeted therapy of ovarian high-grade serous carcinoma (HGSC). Utilizing simple and practicable technique, this study aimed to evaluate the activation of JAK/STAT signaling pathway in ovarian HGSC patients, and investigated the correlation between the activation of JAK/STAT signaling pathway and the prognosis of the HGSC patients.@*METHODS@#We performed immunohistochemistry of phosphorylated STAT3 (pSTAT3) and phosphorylated STAT5 (pSTAT5) on paraffin imbedded slides of 73 ovarian HGSC patients, and evaluated the expression level and range of both markers. According to the grading score of the immunostaining of pSTAT3 and pSTAT5, we divided the 73 ovarian HGSC cases into STAT3 low/high expression and STAT5 low/high expression groups, and analyzed the prognosis of the patients in different groups, in order to explore the relationship between the expression of pSTAT3 and pSTAT5 proteins and the prognosis of the HGSC patients.@*RESULTS@#Some of the ovarian HGSC cases showed high expression of pSTAT3 and pSTAT5 protein level, which was related to the poorer prognosis of the HGSC patients. There was a significant difference in the expression level of pSTAT3 and pSTAT5 between the patients with better prognosis (survival time ≥3 years) and poorer prognosis (survival time < 3 years). The patients with higher protein expression of pSTAT3, pSTAT5 or both markers might have poorer prognosis, with significant shorter progression-free survival time and overall survival time (P < 0.001).@*CONCLUSION@#Immunostaining of pSTAT3 and pSTAT5 proteins might be helpful to evaluate and predict the prognosis of the ovarian HGSC patients, and to identify the patients who might have higher chances to respond to the STAT inhibitors and anti-angiogenesis therapy.

Endometrial serous carcinoma: A retrospective review of histological features & their clinicopathological association with disease-free survival & overall survival

Background & objectives: Endometrial serous carcinoma (ESC) is a high-grade epithelial neoplasm with increased risk for metastasis and recurrence. This study was aimed to assess various histomorphological features of ESC and their clinicopathological association with disease-free survival (DFS) and overall survival (OS). Methods: A total of 205 slides (belonging to 120 patients) diagnosed as ESC from January 2009 to December 2015 were reviewed. Receiver operating characteristics (ROC) curves were established for the diagnostic performance of depth of invasion (DOI), tumour-free distance (TFD) to serosa and percentage myometrial invasion (MI%). OS and DFS were generated by Kaplan-Meier curves and prognostic significance by Cox regression analysis. Results: The mean age at diagnosis was 61.8 yr and the mean tumour size was 4.01 cm. Majority of the females were multiparous (84%; n=94) and postmenopausal (89.2%; n=107). On histopathology, <50 per cent of MI was identified in 37 of the 104 (35%), while 62/104 (59.61%) patients had ?50 per cent MI. Seven (6.7%) patients had full-thickness invasion with serosal involvement, while five (4.8%) patients had no microscopic MI (minimal uterine serous carcinoma). Information about MI was not available in 16 patients. TFD ?7.0 mm, DOI ?6.0 mm and MI% ?40 were significant variables in univariate analyses for OS; however, on multivariate analysis; none of these turned out to be an independent predictor in terms of OS. For DFS, DOI (?6.0 mm) and MI% (?40%) showed a significant association, in univariate as well as multivariate analysis; however, TFD (?7.0 mm) did not show any significant association with DFS. Follow up data were available in 111 of the 120 (92.5%) patients with a five-year OS and DFS of 22.2 and 17.2 per cent, respectively. Interpretation & conclusions: Conventionally calculated DOI (less than or more than half thickness) did not show significance in the present study. Thus, calculating the actual myometrial DOI, MI% and TFD to serosa have the potential for contributing meaningfully to prognostication of ESC

Synchronous uterine serous carcinoma and ovarian sex cord stromal tumor (thecoma)–A rare first case report

Synchronous endometrial and ovarian carcinoma is a rare instance and it accounts for 50 to 70% of all synchronous female genital tract tumors. However, it is very rare to find synchronous endometrial carcinoma and ovarian sex cord–stromal tumor (thecoma). The present case is a 75-year-old woman with a complaint of post-menopausal vaginal bleeding. Radiologically, the magnetic resonance imaging (MRI) pelvis revealed altered signal intensity mass in the uterus. Frozen section and routine histopathological examination were done on radical hysterectomy. Microscopically, serous carcinoma involving uterine corpus and left Fallopian tube was identified along with the unusual finding of contralateral ovarian sex cord–stromal tumor (thecoma), which was confirmed on immunohistochemical examination. It is a very rare association and is first reported in the present study after a thorough search of the published literature. Their relationship based on a high level of estrogen produced by the hyperactive ovary is controversial as serous carcinomas are less hormone-dependent.

Double Trouble: A case of synchronous high-grade serous carcinoma of the fallopian tube and borderline mucinous tumor of the ovary / Philippine Journal of Obstetrics and Gynecology

@#A 55‑year‑old, Gravida 2 Para 2 (2002), presented with postmenopausal vaginal bleeding. Workups pointed toward ovarian malignancy with distant metastasis (pleural effusion). Exploratory laparotomy, bilateral salpingo‑oophorectomy, surgical staging, and appendectomy were performed. On histopathological examination, synchronous high‑grade serous carcinoma of the right fallopian tube and borderline mucinous tumor of the left ovary were diagnosed. Primary fallopian tube carcinomas are very uncommon, while synchronous tumors of the female genital tract are extremely rare. Furthermore, there is a paucity of literature discussing the occurrence of synchronous primary malignancies arising from the fallopian tube and the ovary. It is crucial to differentiate primary malignancies from metastatic cancers to determine accurate staging and prognosis, as well as to assign appropriate treatment strategies. Immunohistochemistry and molecular testing play vital roles as adjunctive diagnostic tools to histologic examination in determining the origins of these tumors and distinguishing primary tumors from metastasis.

Histomorphological Spectrum of Ovarian Lesions in a Tertiary Care Institute in Gujarat with Special Emphasis on Ovarian Tumors

Introduction: Ovarian cancer is the third most common cancer among women of India. Microscopic examination is the goldstandard for diagnosing ovarian tumors and plays an important role in determining prognosis.Purpose: The aim of the study is to assess the frequency of non-neoplastic and neoplastic lesions in ovarian specimens andbiopsies and to study the histomorphological spectrum, gross features, and age distribution of the ovarian tumors.Materials and Methods: The present study was an observational retrospective study conducted over a period of 1 year(February 2019–January 2020) in the Department of Pathology in a Tertiary Care Hospital in South Gujarat. A total of cases (8ovarian biopsies and 82 ovarian specimens) were analyzed. Tumors were classified according to the WHO classification 2014.Results: Of 90 cases, eight were of non-neoplastic lesions, 13 were tumor-like lesions, and nine neoplastic lesions. Amongneoplastic lesions, 43 cases (62.3%) were benign, 3 (4.4%) were borderline, while 23 (33.3%) cases were malignant.Histopathologically, surface epithelial tumors (76.7%) were the most common subtype followed by germ cell tumors (13.3%)and then sex cord tumors (10%). Malignant surface epithelial tumors constitute 78.2% of the total malignant ovarian tumors. Themost common neoplastic lesion was serous cystadenoma. 30–39 years age group was the most common age group overall inovarian tumors. Benign tumors were most common in the 30–39 years age group, while malignant tumors were most commonin the 60–69 years age group. Bilaterality was seen in 10 (16.4%) of 61 gross specimens of ovarian tumors.Conclusion: The frequency of malignant ovarian tumors was higher in our institute. Accurate histopathological diagnosis isessential for management and determining prognosis

The correlation between the expression of LncRNA-OVAAL and the recurrence and prognosis of uterine papillary serous carcinoma after operation / 中国医师杂志

Objective To investigate the relationship between long non-coding ovarian adenocarcinoma amplified RNA (LncRNA-OVAAL) and tumor recurrence and prognosis in uterine papillary serous carcinoma (UPSC).Methods From May 2012 to November 2016,32 patients with UPSC in our hospital were selected as observation group,and 30 patients with other benign diseases were selected as control group.Real-time polymerase chain reaction (PCR) was used to detect the expression of LncRNA-OVAAL in the enrolled patients.The receiver operating characteristic (ROC) curve was used to analyze the cutoff value of LncRNA-OVAAL.The relationship between LncRNA-OVAAL expression and clinicopathological features was analyzed.The cumulative survival rate was calculated and survival analysis was performed.The Cox risk regression model was used to analyze the single-factor and multi-factor analysis of prognosis and overall survival rate.Results The expression of LncRNA-OVAAL in patients with UPSC was elevated,which was related to age,vascular invasion,menopause,recurrence and preoperative serum human epididymis protein 4 (HE4) and carbohydrate antigen 125 (CA125) (P ＜ 0.05).High expression of LncRNAOVAAL was a risk factor for postoperative recurrence and overall survival in patients with UPSC (P ＜0.05).Conclusions The high expression of LncRNA-OVAAL has a certain evaluation value for predicting postoperative recurrence and prognosis in patients with UPSC.

Bilateral Ovarian Collision Tumours: Serous Carcinomas and Fibrothecomas / Tumores de colisión ováricos bilaterales: carcinomas serosos y fibrotecomas

ABSTRACT A patient had both ovaries affected by clearly demarcated colliding tumour masses of different gross appearance, histological features and immunohistochemical profiles, corresponding to bilateral collision papillary serous high-grade adenocarcinoma and fibrothecoma. Despite the applied chemotherapy, it led to a lethal outcome for the patient nearly a year after the surgery. Bilateral ovarian tumours raise the question of whether they are primary tumours or metastases. Simultaneous bilateral occurrence of surface epithelial tumours with other types of ovarian tumours is rare. Therefore, it poses a great challenge in proper differential diagnostics.

RESUMEN Una paciente tenía ambos ovarios afectados por masas tumorales en colisión, claramente demarcadas. Las mismas mostraban diferente aspecto macroscópico, y diferentes rasgos histológicos y perfiles inmunohistoquímicos, correspondientes a fibrotecomas y adenocarcinomas serosos papilares bilaterales de alto grado en colisión. A pesar de la quimioterapia aplicada, la condición condujo a un resultado fatal para la paciente, casi un año después de realizada la cirugía. Los tumores ováricos bilaterales plantean la cuestión de si se trata de tumores primarios o metástasis. La ocurrencia bilateral simultánea de tumores epiteliales superficiales con otros tipos de tumores ováricos es rara, y por tanto, plantea un gran desafío a la hora de realizar un diagnóstico diferencial adecuado.

Extensive trophoblastic differentiation in case of an endometrial carcinoma

Trophoblastic differentiation of endometrial carcinoma is extremely rare, till date 18 cases reports are there in the literature. A 68-year-old postmenopausal female presented with abnormal vaginal bleeding. Histopathologically, there were areas of serous carcinoma with trophoblastic differentiation (~90%). On immunohistochemistry, the trophoblastic component was positive for ?-human chorionic gonadotropin (hCG), HPL and EMA. IHC confirmed the diagnosis of serous carcinoma with trophoblastic differentiation. The clinicopathological features of 18 previously reported cases of trophoblastic differentiation in the uterine tumor were analyzed in addition to the present case.

Metastatic papillary serous carcinoma of testis: A rare case

Papillary serous carcinomas of testis are very rare, and only case reports have been reported in the literature. These neoplasms are characterised histologically by papillary fronds and numerous psammoma bodies and exhibit immunoreactivity for markers of ovarian serous carcinomas. These are very aggressive and are both chemo and radioresistant with surgery remained the main stay of management.

Primary serous papillary carcinoma arising from the omentum with metastasis to the parametrium and bilateral ovarian and fallopian tube serosal surface: A case report / The Health Sciences Journal

INTRODUCTION@#Primary peritoneal serous carcinoma is a rare, malignant, epithelial tumor arising from the peritoneum and associated tissues, that presents commonly with diffuse peritoneal involvement and ascites. Carsinomas that morphologically resemble papillary serous carcinoma of the ovary, with uninvolved and minimally involved ovaries, with lesion of the peritoneum larger than other primary ovarian lesions, and with no other identifiable primary tumor, are categorized under such. The aim of this report is to contribute to the fund of knowledge pertinent to this rare lesion with a relatively poor prognosis.

Study on the expression and meaning of FBXW7 and ENO1 in high and low grade serous ovarian adenocarcinoma tissue / 中国综合临床

Objective To investigate the expression and significance of FBXW7 and ENO1 in ovarian serous adenocarcinoma of different grades. Methods Immunohistochemistry was used to study the expression of FBXW7 and ENO1 in 60 cases of ovarian serous adenocarcinoma. The relationship between FBXW7 and ENO1 proteins and the prognosis of ovarian serous adenocarcinoma was analyzed. Results The positive rate of FBXW7 expression was 22. 5％ ( 9/40) in 40 cases of ovarian high grade adenocarcinoma and 10 cases in 15 cases of normal oviduct. The positive rate of FBXW7 expression was 66. 7％ ( 10/15) ,and the difference was statistically significant ( P=0. 003) . The expression of FBXW7 in 20 cases of low grade adenocarcinoma was 5 cases,and the positive rate was 25. 0％( 5/20) . In 15 cases of normal ovarian tissue,9 cases were positive,and the positive rate was 60. 0％( 9/15) . The difference was statistically significant ( P=0. 04) . The expression of ENO1 protein was 27 in 40 cases of high grade adenocarcinoma,and the positive rate of expression was 67. 5％( 27/40) . 5 cases were positive in 15 normal fallopian tubes, and the positive rate was 33. 3％( 5/15 ) . The difference was statistically significant ( P = 0. 024 ) . The expression of ENO1 protein was 15 in 20 cases of low grade adenocarcinoma,and the positive rate of expression was 75. 0％( 15/20) . In 15 cases of normal ovarian tissue,4 cases were positive, and the positive rate was 26. 7％( 4/15 ) . The difference was statistically significant ( P=0. 006) . There was no correlation between the low expression of FBXW7 and the high expression of ENO1 in high grade ovarian adenocarcinoma ( P= 0. 199 ) , but there was a significant correlation between the low expression of FBXW7 and the high expression of ENO1 in low grade ovarian adenocarcinoma ( P<0. 05) . In low grade serous adenocarcinoma,the 5-year survival rates were 44. 4％ and 32. 1％ respectively,with no significant difference ( P = 0. 052 ) . In ovarian high-grade serous adenocarcinoma, the 5-year survival rates of high-expression group and low-expression group were 20. 0％ and 7. 7％, respectively, with no significant difference ( P=0. 097) . In low grade ovarian serous adenocarcinoma,the 5-year survival rate was 7. 4％ in high expression group and 50. 0％ in low expression group ( P=0. 023) . The 5-year survival rates of ENO1 in high-grade serous adenocarcinoma were 0％ and 40. 0％ in high-expression group and low-expression group respectively ( P=0. 001) . Conclusion The low expression of FBXW7 in ovarian adenocarcinoma suggests that FBXW7 may be a tumor suppressor gene in ovarian serous adenocarcinoma, and ENO1 may be an oncogene in ovarian adenocarcinoma. The high expression of FBXW7 in serous adenocarcinoma indicates that ENO1 may be an oncogene,and the survival rate of FBXW7 in serous adenocarcinoma is higher than that in low expression group. The survival rate of the high-expression group was lower than that of the low-expression group. Therefore, they may become a new diagnostic index and therapeutic target for ovarian serous adenocarcinoma.

Expressions of Apaf-1 and Caspase-9 in ovarian serous carcinoma and their clinical significance / 中国综合临床

Objective To investigate the expressions of Apaf-1 and Caspase-9 protein in ovarian serous carcinoma(OSC) and their clinicopathological significance.Methods The expressions of Apaf-1 and Caspase-9 protein in 45 cases of OSC,60 cases of ovarian serous cystadenomas and 32 cases of ovarian borderline serous cystadenomas were detected by immunohistochemical SP method.The relationship between the expressions of these two proteins and the clinicopathological features of OSC and the correlation between Apaf-1 and Caspase-9 expressions in OSC were analyzed.Results The positive rates of Apaf-1 in OSC,ovarian serous cystadenoma and ovarian borderline serous cystadenoma were 24.4%(11/45),75.0%(45/60) and 46.9%(15/32),the difference was statistically significant (χ2=26.734,P<0.01).Apaf-1 expression was correlated with pathological grade,clinical stage and lymph nodes metastasis (χ2=6.318,7.565,5.554,P<0.05).The expression rates of Caspase-9 in OSC,ovarian serous cystadenoma and ovarian borderline serous cystadenoma were 28.9%(13/45),83.3%(50/60) and 56.3%(18/32),the difference was statistically significant (χ2=31.682,P<0.01).The expression of Caspase-9 was correlated with pathological grade,clinical stage and lymph nodes metastasis (χ2=5.750,4.391,5.466,P<0.05).In OSC,the expressions of Apaf-1 and Capase-9 were positively correlated (k=0.433,P=0.003).Conclusion The low expressions of Apaf-1 and Caspase-9 in OSC may be related to the occurrence and development of OSC.

Relationship between SPAG5 Low Expression and Poor Prognosis of Ovarian Early Stage High Grade Serous Carcinoma Patients / 中山大学学报(医学科学版)

[Objective] To investigate the role SPAG5 play in ovarian adenocarcinoma cell mitosis,Taxol sensitivity and ovarian high grade serous carcinoma patients' prognosis.[Methods] Transient knockdown of SPAG5 in SKOV3 cell were performed,and MTT assay and cell cycle flow cytometry assay were carried out.IHC staining of SPAG5 protein in 110 high grade serous carcinoma patients' tumor tissues were performed,and the expression were analyzed with clinical data and prognosis.Finally,SPAG5 were knocked down in OVCAR3 A2780 and SKOV3 cells followed by 0.5μM Taxol treatment,MTT assay were performed to detect cell viability.[Results] SPAG5 knockdown inhibited cell mitosis of ovarian adenocarcinoma cell SKOV3 by G2/M arrest.High grade serous carcinoma patients after neoadjuvant chemotherapy gained the expression of SPAG5.Patients without neoadjuvant chemotherapy with low SPAG5 expression have poor progress free survival,especially in early stage patients.Patients with low SPAG5 expression also have poorer overall survival,but the difference was not statistically significant.Furthermore,SPAG5 knockdown in OVCAR3 A2780 and SKOV3 cells reduced Taxol sensitivity.[Conclusion] SPAG5 regulated cell mitosis and promoted cell proliferation in ovarian adenocarcinoma cell lines.Expression of SPAG5 in patients' tumor tissues predicted patients' prognosis and Taxol sensitivity.As the results,individualized treatment of high grade serous carcinoma patients is necessary.

Expression of autophagy-related genes Beclin1 and LC3 in ovarian serous carcinoma and their clinical significance / 临床与实验病理学杂志

Purpose To detect the expression of autophagy-related genes Beclin1 and microtubule-associated protein1 light chain3 (LC3) in ovarian serous carcinoma (OSC) and to analyze the correlations with clinical pathological characteristics and prognosis of patients with OSC.Methods Immunohistochemical staining of MaxVision two-step was performed to detect the expression of Beclin1 and LC3 in the samples from 63 OSC patients and 20 with benign ovarian serous cystadenomas.The relation between Beclin1 and LC3 with the factors influencing the prognosis of OSC was investgated.The expression levels of mRNA and proteins in 10 fresh OSC samples and their corresponding adjacent noncancerous tissues were examined by RT-PCR and Western blot.Results The positive percentage of Beclin1 and LC3 protein in the tissues of OSC was 36.51％ and 33.33％,which was significantly lower than that of 65.00％ and 60.00％ in serous cystadenomas (P =0.025,P =0.034).The expression of Beclin1 in OSC was significantly correlated with clinical FIGO stage and pathological grade (P =0.001,P =0.001),but not associated with age,site,tumor size and lymph node metastasis (P ＞ 0.05).The expression of LC3 protein in OSC was significantly with clinical FIGO stage and lymph node metastasis (P =0.013,P =0.041),but not associated with age,site,tumor size and pathological grade (P ＞ 0.05).There was a positive correlation between Beclin1 and LC3 in OSC (rs =0.373,P =0.03).The levels of Beclin1 and LC3 mRNA (0.581-±0.091,0.650 ±0.090) in 10 fresh OSC were significantly lower than in their adjacent noncancerous tissues (t=8.083,t =6.614,P =0.016,P =0.022).The levels of Beclin1 and LC3 protein in 10 fresh OSCs were significantly lower than in their adjacent noncancerous tissues (P ＜ 0.05).Kaplan-Meier survival analyses revealed that the expression of Beclin1 and LC3 were associated with the patients prognosis (P =0.028 3,P =0.018 5).Conclusion Expression of Beclin1 and LC3 protein is down-regulated in the tissues of OSC which lead to decrease of function of autophagy.The decrease of Beclin1 and LC3 may be associated with the development and prognosis of OSC.

Expression of Dual-specificity Phosphatase 6 in Ovarian Serous Epithelial Carcinomas and Its Clinical Significance / 中国医科大学学报

Objective To investigate the expression of dual-specificity phosphatase 6 (DUSP6) in ovarian epithelial serous tumors and the relationship between DUSP6 expression and the clinicopathological parameters of ovarian serous cystoadenocarcinoma.Methods The expression of DUSP6 was analyzed by immunohistochemistry.Relationships between the expression of DUSP6 and the clinicopathological parameters of ovarian serous cystadenocarcinoma were also analyzed.Results DUSP6 expression was lower in patients with ovarian serous cystadenocarcinoma group with serum CA125 levels of less than or equal to 900 U/mL than in patients with serum CA125 levels of greater than 900 U/mL (P ＜ 0.05) and in patients whose ascites volume was less than or equal to 500 mL than in patients whose ascites volume was greater than 500 mL (P ＜ 0.05).Conclusion DUSP6 is related to the occurrence of ovarian serous carcinoma and is potentially related to the peritoneal metastasis of ovarian serous carcinoma.DUSP6 may be a new molecule for the early diagnosis and therapy of ovarian serous carcinoma and peritoneal metastasis.

Retrospective analysis of special type endometrial cancer cases in Peking Union Medical College Hospital during 2005-2010 / 基础医学与临床

Objective To estimate outcome and prognostic risk factors of special type endometrial cancer .Methods Clinic data was collected in Peking Union Medical College Hospital during 2005-2010 .SPSS software was used to analyze data .Logistic regression analysis was used to analyze prognostic risk factors respectively .Results Medium follow up time of total 48 endometrial serous carcinoma , clear cell carcinoma and carcinosarcoma patients was 70.5 months.Most of patients could be diagnosed at early time ( FIGO stage Ⅰand stage Ⅱwere 66.7%among all pa-tients) .The main treatment was operation and followed by chemo-therapy and radio-therapy.66.7%of patients ac-cepted chemo-therapy after operation , and 41.7%of patients accepted radio-therapy .The outcome of advanced pa-tients was poor.30.8%stage Ⅲrelapsed and died in 3 years.The recurrence rate and mortality of stage Ⅳwere all 100%.The recurrence rate of advance endometrial serous carcinoma was 80%, which was much higher than the other two.FIGO stage and lymphatic metastasis were the main prognostic risk factors .Conclusions Special type of endometric cancer has a poor prognosis and lymphatic metastasis is main reason to explain the prognosis .

External validation of chemotherapy response score system for histopathological assessment of tumor regression after neoadjuvant chemotherapy in tubo-ovarian high-grade serous carcinoma / 부인종양

OBJECTIVE: The chemotherapy response score (CRS) system based on histopathological examination has been recently proposed for tubo-ovarian high-grade serous carcinoma (HGSC) to assess response to neoadjuvant chemotherapy (NAC). This study was aimed at validating the CRS system in an external cohort of tubo-ovarian HGSC patients. METHODS: This study included 110 tubo-ovarian HGSC patients who underwent NAC followed by interval debulking surgery. The 3-tiered CRS of the omental and adnexal tissue sections was determined by 3 independent pathologists. Differences in patient outcomes according to CRS were analyzed. RESULTS: The CRS system was highly reproducible among the 3 pathologists. Fleiss' kappa value and Kendall's coefficient of concordance for the omental CRS were 0.656 and 0.669, respectively. The omental CRS significantly predicted progression-free survival (PFS). The median PFS of patients whose tumors exhibited the omental CRS 1–2 (15 months) was significantly shorter than that of patients with an omental CRS of 3 (19 months; p=0.016). In addition, after adjusting for age, stage, and debulking status, the omental CRS was an independent prognostic factor for PFS of tubo-ovarian HGSC patients who were treated with NAC (adjusted hazard ratio [HR]=1.74; 95% confidence interval [CI]=1.05–2.87). CONCLUSION: The CRS system for assessing NAC response was a reproducible prognostic tool in our cohort. The application of the CRS system after NAC can improve survival estimation in HGSC patients.

Secretory cell outgrowths, p53 signatures, and serous tubal intraepithelial carcinoma in the fallopian tubes of patients with sporadic pelvic serous carcinoma.

Context: High‑grade serous carcinomas of ovarian, tubal, and peritoneal origin are together referred as pelvic serous carcinoma. The fallopian tubes, ovarian surface epithelium, and the tuboperitoneal junctional epithelium are all implicated in pelvic serous carcinogenesis. Aims: The aim of this study is to identify putative precursor lesions of serous carcinoma including secretory cell outgrowths (SCOUTs), serous tubal intraepithelial carcinoma (STIC), and p53 signatures and assign its probable site of origin. Settings and Design: Prospective case–control study of consecutive specimen comprising 32 serous carcinomas and 31 controls (10 normal adnexa, 10 benign and 6 atypically proliferative surface epithelial tumors, and 5 other carcinomas). Subjects and Methods: Sectioning and extensive examination of the fimbrial end (SEE‑FIM) protocol along with immunohistochemistry for Bcl‑2, p53, and Ki‑67 was employed for evaluating invasive carcinoma and precursor lesions in cases versus controls. Results: SCOUT, p53 signatures, and STIC were most frequent in the serous carcinomas. p53 signatures and STIC were always seen in the fimbrial end. STICs were exclusively present in serous carcinomas, more common in ipsilateral tubes of cases with dominant ovarian mass. Multifocal p53 signatures with STIC were seen in 7 (21.9%) cases. STIC was present with or without an invasive carcinoma in 25% and in 6.25% of cases of pelvic serous carcinomas, respectively. The junctional epithelia did not show any lesion in any group. Conclusions: SEE‑FIM protocol is recommended for evaluation of sporadicpelvic (ovarian/tubal/peritoneal) serous carcinoma. Based on the presence of STIC or invasive carcinoma, nearly 60% of all pelvic serous carcinomas are of fallopian tubal origin.

Serous Surface Papillary Adenocarcinoma: a rare variant of serous carcinoma - report of two cases.

Serous tumors constitute about 25% of all ovarian tumors. Serous adenocarcinomas are the commonest form of the malignant epithelial ovarian tumors accounting for 26% of the cases. The commonest morphologic form is the cystadenocarcinoma. Serous surface papillary adenocarcinoma is a very rare morphologic entity which is often bilateral and highly aggressive. Reports showing an exact incidence are not available in literature. We present a case of serous surface papillary adenocarcinoma confined to ovary.

Histological Patterns in Fallopian Tube Pathology - A Retrospective Study of 200 Consecutive Cases.

The present study was undertaken to evaluate the histological patterns in the various pathological lesions of the fallopian tube. Histology slides of 200 gynaecological specimens containing one or both the fallopian tubes were studied retrospectively and the morphological patterns observed in different tubal pathologies were documented. Tubal pathology was observed in 31% (62/200) of the cases studied. Salpingitis, accounting for 12% (24/200) of the cases was the most common lesion followed by ectopic tubal gestation (10.5%), paratubal cysts (4%), haematosalpinx (1.5%), endometriosis (1%) and torsion of the tube (1%) in decreasing order of frequency. No primary neoplasm of the fallopian tube was observed, however, there were two cases of secondary involvement of the tube by a dysgerminoma ovary and a squamous cell carcinoma of the cervix respectively. Fallopian tubes are primarily involved by inflammatory pathology which manifests either as infertility or as ectopic tubal pregnancy. Recently, the fimbrial end of the tube has been recognized as the site of origin of high grade serous ovarian and peritoneal cancers. Hence, a thorough examination of the fallopian tubes in each gynaecologic specimen is essential for early detection and treatment of these conditions.