ABSTRACT
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
ABSTRACT
Resumen ANTECEDENTES El cáncer de ovario es una importante causa de muerte de mujeres, responsable de 150,000 fallecimientos anuales en el mundo, con una supervivencia a 5 años inferior a 45%. OBJETIVO Exponer los avances en diagnóstico y tratamiento de la carcinogénesis de los tumores serosos ováricos y las repercusiones de los nuevos conceptos en el tratamiento clínico y quirúrgico. METODOLOGÍA Estudio retrospectivo basado en la búsqueda sistemática de artículos con las palabras clave (MeSH): neoplasmas serosos de ovario, carcinogénesis, carcinoma seroso de bajo grado y carcinoma seroso de alto grado. La selección de los artículos estuvo a cargo, de forma independiente, de dos investigadores. De la misma forma dos patólogos evaluaron los artículos preseleccionados. RESULTADOS Se seleccionaron y analizaron 66 artículos. CONCLUSIONES Para la creación y adopción de estrategias en prevención primaria, diagnóstico y tratamiento de esta patología se requiere mayor comprensión de la fisiopatología y de los hallazgos encontrados en la última década, sobre todo los relacionados con las mutaciones en el gen BRCA, antecedentes familiares de tumores serosos del ovario, cáncer de mama o peritoneal de tipo epitelial, entre otras. La atención multidisciplinaria y actualizada repercutirá, significativamente, en la supervivencia de las pacientes.
Abstract BACKGROUND Globally, ovarian cancer is the seventh neoplasm and the eight oncologic cause of death in women, responsible of 150,000 deaths per year, with a 5 year survival under the 45%, mainly represented by high-grade serous carcinomas. Findings such as serous intraepithelial carcinomas and genetic predisposition have become a constant for the vast majority of cases. OBJECTIVE To summarize and review the most recent advances about the carcinogenesis of the ovarian serous tumors, its implications on the pathological diagnosis and the consequences of these new concepts for the clinical and surgical therapies. MATERIALS AND METHODS We performed a systematic search to select all kinds of languages articles, using the keywords "serous ovarian neoplasms" AND "carcinogenesis" AND "low-grade serous carcinoma" OR "high-grade serous carcinoma". Two investigators independently extracted characteristics and results to select the articles. Two pathologists independently did the assessment of the preselected articles selecting the most appropriate ones, based on their utility for this review. RESULTS 66 articles were selected and included in the bibliography for this review. CONCLUSIONS A better understanding of the physiopathology and many other new findings that have been done during the last decade are essential for the treatment of this patients, for the creation and application of strategies for primary prevention and screening for the risk, and the medical and surgical interventions, mainly directed to patients with mutations on BRCA, family history of breast, ovarian or peritoneal cancer, among other conditions. A multidisciplinary and updated approach will affect significantly the long-term survival.
ABSTRACT
Ovarian serous tumors of low malignant potential (borderline serous tumors) are intermediate in their clinical behavior between benign serous cystadenoma and malignant neoplasm, and are associated with 10 year survival rates in excess of 90%. Borderline ovarian serous tumors are characterized by absence of stromal invasion but presence of some characteristics of malignancy. Borderline ovarian tumors occur predominantly in premenopausal women, and associated with a very good prognosis. The principal treatment of borderline malignancy is surgical resection of the primary tumor. But approximatley 20% of patients with ovarian tumors of low malignant potential present with Stage III or IV disease at the time of diagnosis. The benefit of postsurgical therapy in this group of patients has not been well established. We report two cases of advanced ovarian serous borderline tumor, one of which was treated with 3 cycles of cisplatin-taxol chemotherpy.