Exploring the unusual: a testosterone-secreting ovarian tumor

ABSTRACT Ovarian steroid cell tumors are rare, representing less than 0.1% of all ovarian neoplasms. Among the myriad causes of hirsutism, ovarian tumors account for 1% of the reported cases. We present the case of a 49-year-old parous postmenopausal woman who sought medical attention for hirsutism for 2 years. This case illustrates the unusual and interesting connection between rare ovarian pathology and the clinical manifestation of hirsutism in a postmenopausal patient. Her ultrasonography and MRI showed a right adnexal mass of solid-cystic consistency with thin septations. Her laboratory workup revealed high levels of total testosterone of 256 ng/ml (8.4-48.1ng/ml) and free testosterone of 7.36 pg/ml (0.2-4.1 pg/ml), while DHEAS - 234 µg/dl (35.4-256 µg/dl) and CA125 - 15.8U/L (0.0-35 U/L) were in the normal range. She underwent exploratory laparotomy with a total abdominal hysterectomy and oophorectomy. Histopathological examination and immunohistochemistry conclusively established the presence of a steroid cell tumor, specifically classified as "Not Otherwise Specified"(NOS), in the right ovary.

A rare case of giant mucinous cystadenocarcinoma of the right ovary with metastatic deposits and Brenner tumor in the left ovary

Ovarian cancer is the second most common gynecological malignancy. Mucinous tumor accounts for 3% of ovarian tumors and is a challenging task for a surgical pathologist. Association of Brenner tumor, a subtype of epithelial malignancy is a rare entity reported in the literature. Herein, we report a unique case of a 57-years old post-menopausal woman who presented with progressive abdominal distention for 3 years and constipation for 1 year. Clinically, it was suspected as a case of complex ovarian cyst and the patient underwent staging laparotomy. Intraoperatively, a giant mucinous cystadenocarcinoma of the right ovary with deposits in the pouch of Douglas, omentum, umbilical, and the sub-umbilical region was found along with a benign Brenner tumor of the left ovary.

Malignant Transformation in Mature Cystic Dermoid: A Case Series of 8 Cases

Introduction: One of the most common types of ovarian germ neoplasm is Mature cystic teratoma(MCT) which accounts for almost 20% of all ovarian neoplasm. Objective: Analyze patients with Malignant Transformation (Mt) arising from Mature Cystic Teratoma of the ovary to evaluate Clinico-pathological features and treatment modalities. Methods: This is an observational study of 8 patients of Mt in MCT, who had taken complete treatment at GCRI between the period from September 2016 to September 2021. During this observation period, a total of two thousand one hundred and seventy seven ovarian tumors were diagnosed. Out of these patients, 9.32% (203) were MCTs. Of the consecutive cases of 203 ovarian MCTs diagnosed, 3.9% (8) had Mt of MCT, which was our study group. Results: The mean age of patients with Mt in MCT was 47.1 years (27- 65 yrs), while mean age of the patients with MCT was 42 years (35-55 years). Among the 21 postmenopausal, MCT's 28.5% (6) cases developed Mt and only 1% i.e., two cases from premenopausal showed Mt. Abdominal pain as main symptom was seen in 87.5% (7/8) patients. The duration of symptoms ranged from 3 to 6 months. CA125 was elevated in 75% patients. Germ cell markers including beta HCG, AFP, LDH were found to be normal. Conclusion: Diagnosis of malignant transformation of MCT is very difficult. There should be high index of suspicion of malignant transformation if the MCT has been present for a long time; the patient is postmenopausal, age>45 yrs; the tumor diameter is greater than 9.5 cm; or there is thickening of the cyst wall or papillary growth occurs, increased tumor markers

Preparation and targeting capability of corona forming in human ovarian plasma / 药学学报

After entering the physiological environment, proteins and other biomolecules bind to the nanoparticles' surface, called protein corona. The corona establishes a new bio-interface that affects its physicochemical properties and biological behaviors. Variations in types and contents of human plasma proteins during the different physiological states can substantially change the composition and effects of the corona. With folic acid (FA)-modified polylactic acid-polyglycolic acid copolymer (PLGA) nanoparticles, the formation of protein coronas and their influence on the targeting capability are studied in healthy and ovarian human plasma. All human plasma samples were collected at the Peking University Third Hospital and this study protocol has been approved by Peking University Third Hospital Medical Science Research Ethics Committee (2019-409-1). Dynamic light scattering measurements demonstrated a 10-40 nm increase in their size distributions and a 30 mV decreased in their absolute zeta-potential since protein corona-coated PLGA-PEG and PLGA-FA were formed. The SDS-PAGE analysis showed the composition of the protein coronas from ovarian and healthy plasma in PLGA-FA were markedly distinct, particularly for proteins with molecular weight of 45, 110 and >180 kDa. Flow cytometry indicated that the absorption of ovarian plasma in PLGA-FA led to a lower cellular uptake by SKOV3 cells. Our results suggest that in vitro formed ovarian plasma protein corona could shield targeting molecules and reduced receptor-mediated internalization. The results of this pilot study will provide evidence of the effectiveness of active targeting nanoparticles under pathologic conditions. Additionally, the protein corona in different diseases is emerging as a key point; thus, a comprehensive understanding could accelerate clinical translation of functionalized nanoparticles.

Clinical Profile of Patients Presenting with Ovarian Tumors at a Tertiary Care Teaching Hospital in Jharkhand, India

Introduction: Ovary is a common site for tumors, both benignand malignant which causes great morbidity and mortality.The study was undertaken to analyse the clinical profile andhistologic pattern of ovarian tumors.Material and methods: A prospective observational study ofcases presenting with ovarian tumors was done over a periodof 14 months from December 2016 to January 2018.Results: Ovarian tumors accounted for 3.32% of allgynecologic admissions (68/2045) during the study period.There were 50 benign (73.52%) and 18 malignant tumors(26.47%). Age of patients ranged from 12-72 years. Mostof the cases were in the reproductive age group. Surfaceepithelial tumors dominated other types (81.25%). Mucinouscystadenoma was the commonest (35.93%) benign tumorfollowed by serous cystadenoma (23.43%), dermoid cyst(15.6%) and granulosa cell tumor (1.56%). Commonestmalignant tumor was serous cystadenocarcinoma (15.6%),followed by mucinous cystadenocarcinoma (6.25%) andKrukenberg tumor (1.56%). Clinical symptoms and signs werevague but were present for more than one year in majority.Significant number of malignant tumors presented at earlierage (30-50 years) and in later stages (stage 3).Conclusion: Among malignant tumors, younger age ofpresentation, relatively long duration of symptoms for morethan 1 year, and advance stage of disease was more common.This emphasizes the need for early attention to symptoms andsigns and proper evaluation with detailed investigations forexclusion of ovarian malignancy in all age groups.

Sex cord stromal tumor of ovary masquerading as polycystic ovarian syndrome

Virilization is a portentous sign that suggests the possibility of an ovarian or adrenal neoplasm. Diagnosis may be delayed in some patients due to nonspecific symptoms and overlapping symptoms with that of polycystic ovarian syndrome (PCOS). However, it must be remembered that PCOS usually causes mild to moderate elevation of serum testosterone with hirsutism whereas serum testosterone levels are many times elevated in cases of androgen secreting tumors and virilization is a norm. So high testosterone level with new onset virilization rule out PCOS. Authors are reporting two cases of Sertoli Leydig cell tumor despite their similar histopathology and equivalent levels of serum testosterone had a varied clinical spectrum of virilization.

Histopathological classification of ovarian neoplasm: a retrospective study of 612 cases from a regional cancer centre, Odisha, India

Background: Ovarian cancer is the leading cause of cancer related death amongst women in India. Identification of histological types helps to predict tumor behaviour and further appropriate management. Aims and objectives is to study the histopathological parameters of ovarian tumor.Methods: This retrospective study was done on patients who presented ovarian mass and subsequently underwent surgery in a Regional Cancer Centre, Odisha, over a period of three years from January 2016 to December 2018.  All datas such as age, site, gross findings and histological tumor types were retrieved from pathology and analyzed using MS Excel worksheet.Results: A total 612 cases of ovarian tumor were included for study. Non-neoplastic to neoplastic tumor ratio was 1:7.74. Surface epithelial tumors comprised the majority of tumors, accounting for 452 cases (83.39%). Malignant lesions were predominant in this series 416 cases (76%). Majority of borderline tumors were of mucinous subtype 20 (76.92%). The Mean±SD ages of all benign comprising, borderline and malignant tumors were 47.4±11.9, 44.9±14.3 and 46.9±13, respectively. On the basis of two tired grading system, high grade malignant serous tumors were maximum, 226 (74.34%). Ovarian surface involvement, omental invasion, uterine invasion, LVSI, capsular invasion and pelvic lymph node involvement was observed in 146 (35.26%), 106 (25.6%), 12 (2.89%), 70 (16.9%), 6 (1.44%) and 12 (2.89%) respectively. According to the FIGO staging system, among primary malignant tumor, 58% patients were presented in late stage (III and IV).Conclusions: The high incidence of malignant ovarian tumor with late presentation was observed in our study. So, further study is warranted to elucidate the major factors in our population.

Expression of valosin-containing protein in epithelial ovarian cancer tissue and its clinical significance / 吉林大学学报(医学版)

Objective: To observe the expression of valosin-containing protein CVCP) in the epithelial ovarian cancer (EOC) tissue and its relationships with the clinicopathological features of the EOC patients∗ and to provide the basis for the molecular treatment of EOC. Methods: The expressions of VCP in 94 EOC tissue samples, 13 ovarian borderline tumor tissue samples, 36 ovarian benign tumor tissue samples and 8 normal ovarian tissue samples were measured by immunohistochemical method. The relationships between the VCP expression and the clinicopathological parameters (age, FIGO stage, pathological type, histological grade, lymph node metastasis or not, ascites or not, preoperative CA125 level) of the EOC patients were analyzed. The expressions of VCP in human ovarian epithelial HOSEPIC cells and human EOC SKOV-3 cells were detected by immunofluorescence technique and Western blotting method. The SKOV-3 cells were divided into control group (without CB-5083) and treatment group (with CB-5083)∗ the migration rates of the SKOV-3 cells in two groups were analyzed by scratch experiment, and the clone formation rates of the SKOV-3 cells in two groups were analyzed by plate clone formation experiment. The expressions of VCP in the cells in two groups were analyzed by immunofluorescence technique. The expression levels of VCP, NF-kB/P65» IieBa∗ and p-Iiefta proteins in the SKOV-3 cells in two groups were detected by Western blotting method. Results: The positive expression rates of VCP in EOC, borderline ovarian tumor, benign ovarian tumor and normal ovarian tissues had significant difference ( P0. 05). The VCP expression level in the SKOV-3 cells was higher than that in HOSEpiC cells ( P<0. 05). The migration rate of the SKOV-3 cells in treatment group was lower than that in control group ( P<0.05), the cloning formation rate of the SKOV-3 cells in treatment group was lower than that in control group ( P<0. 05). The expression levels of VCP and NF-kB/P65 proteins of the SKOV-3 cells in treatment group were lower than those in control group (P'<0. 05) ∗ and the expression level of p-IieBa protein was higher than that in control group ( P< 0. 05). Conclusion: VCP is highly expressed in the EOC tissue and cells∗ and high-expression VCP can promot the tumor migration and proliferation.

Germline PALB2, ATM variants in a patient with breast and ovarian cancer at risk for familial cancer syndrome: Is there a role for risk-reducing salpingo-oophorectomy?

A 50-year-old non-Hispanic white Caucasian female was diagnosed with breast cancer and was subsequently found to possess the tumorigenic ataxia telangiectasia mutated (ATM) and PALB2 variants but not the BRCA1 and BRCA2 variants. She visited the gynecologic oncology office for routine counseling about risk-reducing salpingo-oophorectomy (RRSO). Although the patient was asymptomatic, an adnexal mass was discovered in the physical examination performed by palpation. Upon using pre-operative imaging techniques, an 8 cm complex adnexal mass was identified. Her CA-125 level was elevated. She underwent complete cytoreductive surgery. Pathological analysis showed a stage IC clear cell carcinoma of the left ovary; subsequently, she received 6 cycles of adjuvant chemotherapy with a combination of carboplatin and paclitaxel. The patient exhibited no signs ovarian cancer in a follow-up appointment after 32 months of treatment. However, bilateral RRSO is not recommended for patients positive for ATM and PALB2. Breast cancer patients with PALB2 and ATM mutations should extensively discuss the risks and benefits of RRSO in light of current data.

Clinico-pathological study of ovarian tumors in Goa medical college: a tertiary care centre in Goa, India

Background: Ovarian neoplasms are a distinct entity in women health care and are increasingly contributing to morbidity and mortality among women. The burden is not only related to the increasing incidence but also to the varied pathological features depending on the tissue of origin and pathogenesis. The study was carried out to find the prevalence and determine the clinical presentation and histo-pathological distribution of ovarian neoplasms. Management options were also noted.Methods: It is a retrospective study carried out at Goa Medical College between January 2013 to December 2015. All patients diagnosed and treated for ovarian neoplasm were included in the study. Data was tabulated using Microsoft Excel and descriptive statistical analysis was carried out using SPSS version 23.Results: A total of 3111 patients were admitted in gynecology at Goa Medical College during the specified time period. Of these 358 cases were diagnosed with ovarian neoplasm. On histopathology 196 were benign tumors and 162 were reported to be malignant. Commonest presenting symptom was abdominal distention seen in 51.1% of the patients, pain in 44.4%, followed by dyspepsia in 26.85%. Epithelial tumors were most common (Benign - 39.3%, Malignant - 41%) followed by sex cord stromal tumors and germ cell tumors in 7.26% of cases.Conclusions: Surface epithelial tumors were most common neoplasm. An alarming high no. of malignant tumors (45.25%) was found in present study. 44.4% tumors presented in 41-50 years age group. Presenting complaints were vague and nonspecific leading to delay in diagnosis. Histological type correlates with prognosis; therefore, preponderance of histological type will guide treatment options and patient education with respect to epidemiology.

Ovarian teratomas: clinicopathological study at tertiary care center

Background: Teratomas are belonging to a group of germ cell tumors. It is also referred to as dermoid cyst. Teratomas are most common germ cell tumor of the ovary. Teratomas are composed of various histological types. In this article we are presenting various morphological patterns, its clinical manifestation and its clinical significance.Methods: This is prospective study for a period of 3 years from March 2016 to February 2019 at tertiary care hospital. It consists of total evaluation of 82 cases of ovarian lesions which were surgically excised for clinically or radiologically suspected of ovarian neoplasm.Results: A total of 82 cases of ovarian specimen were included out of which 18 cases were of ovarian teratoma. In these 17 cases were benign teratomas, 1 case of immature teratoma. All the cases of mature teratoma were predominantly of cystic type with focal solid areas. Right sided ovary was involved in44.5% cases while left sided in 55.5% cases. The tumor size ranges from 2.5 cm to 20.8 cms. The age range in this study was from 20 to 60 year. The common age observed for ovarian teratoma was in group of 31-40 years, having 6 cases. The clinically most of cases were asymptomatic or presented with unexplained abdominal pain or palpable mass. USG finding in most of cases were diffuse or partial echogenic mass lesion with cystic nature and echogenic bands.Conclusions: In our study showed mature cystic teratoma is the most common type of ovarian teratomas. The immature and monodermal types are rare. The histopathological examination plays important role in final diagnosis   and patient management.

Accuracy of frozen section diagnosis and factors associated with final pathological diagnosis upgrade of mucinous ovarian tumors / 부인종양

OBJECTIVE: To determine the accuracy of frozen section diagnosis and factors associated with final pathological diagnosis upgrade in patients with mucinous ovarian tumors. METHODS: This study included 1,032 patients with mucinous ovarian tumors who underwent frozen section diagnosis during surgery. Sensitivity, specificity, and diagnostic accuracy of frozen section diagnosis was calculated. Univariate and multivariate regression analyses were performed to determine factors associated with diagnosis upgrade in the final pathology report. RESULTS: The sensitivity and specificity of frozen section diagnosis were 99.1% (95% confidence interval [CI]=98%–99.6%) and 82.2% (95% CI=77.9%–85.7%), respectively, for benign mucinous tumors; 74.6% (95% CI=69.1%–79.4%) and 96.7% (95% CI=95.2%–97.8%), respectively, for mucinous borderline ovarian tumors; and 72.5% (95% CI=62.9%–80.3%) and 98.8% (95% CI=97.9%–99.3%), respectively, for invasive mucinous carcinomas. The multivariate analysis revealed that mixed tumor histology (odds ratio [OR]=2.8; 95% CI=1.3–6.3; p=0.012), tumor size >12 cm (OR=2.5; 95% CI=1.5–4.3; p=0.001), multilocular tumor (OR=2.9; 95% CI=1.4–6.0; p=0.006), and presence of a solid component in the tumor (OR=3.1; 95% CI=1.8–5.1; p12 cm, multilocular tumor, and presence of a solid component in the tumor were independent risk factors for final pathological diagnosis upgrade based on frozen section diagnosis.

Prior uterine myoma and risk of ovarian cancer: a population-based case-control study / 부인종양

OBJECTIVE: Uterine myoma which results in the magnitude of ovarian cancer remains uncertain. This study aimed to assess the association between women with previous uterine myoma and the risk of ovarian cancer. METHODS: This population-based case-control study was conducted using the Taiwan National Health Insurance Research Database between 2006 and 2010. We identified 4,088 adult women with newly diagnosed ovarian cancer with 16,348 women without ovarian cancer matched for age, urbanization level, income and initial diagnosis date. Logistic regression analyses were used to evaluate the variables associated with ovarian cancer. In addition, the effect of surgical interventions on the risk of ovarian cancer was also evaluated. RESULTS: Women with previous uterine myoma were more likely than those who did not to have ovarian cancer (adjusted odds ratio [aOR]=2.26; 95% confidence interval [CI]=2.06−2.49). Patients with uterine myoma who either received (aOR=1.79; 95% CI=1.51−2.13) or did not receive hormone replacement therapy (aOR=2.51; 95% CI=2.24−2.82) experienced a significantly higher risk of ovarian cancer than those without uterine myoma, respectively. However, patients with uterine myoma who underwent either myomectomy (aOR=0.55; 95% CI=0.39−0.77) or hysterectomy (aOR=0.33; 95% CI=0.26−0.42) had a significantly lower risk of ovarian cancer. CONCLUSION: The results revealed that a significantly higher risk of ovarian cancer in women with previous uterine myoma, through an indirect mechanism. Furthermore, a lower risk of ovarian cancer was observed in women who underwent surgical removal of the uterine myoma.

Treatment strategies for patients with advanced ovarian cancer undergoing neoadjuvant chemotherapy: interval debulking surgery or additional chemotherapy? / 부인종양

OBJECTIVE: To treat advanced ovarian cancer, interval debulking surgery (IDS) is performed after 3 cycles each of neoadjuvant chemotherapy (NAC) and postoperative chemotherapy (IDS group). If we expect that complete resection cannot be achieved by IDS, debulking surgery is performed after administering additional 3 cycles of chemotherapy without postoperative chemotherapy (Add-C group). We evaluated the survival outcomes of the Add-C group and determined their serum cancer antigen 125 (CA125) levels to predict complete surgery. METHODS: A retrospective chart review of all stage III and IV ovarian, fallopian tube, and peritoneal cancer patients treated with NAC in 2007–2016 was conducted. RESULTS: About 117 patients comprised the IDS group and 26 comprised the Add-C group. Univariate and multivariate analyses revealed that Add-C group had an equivalent effect on progression-free survival (PFS; p=0.09) and overall survival (OS; p=0.94) compared with the IDS group. Multivariate analysis revealed that patients who developed residual disease after surgery had worse PFS (hazard ratio [HR]=2.18; 95% confidence interval [CI]=1.45–3.28) and OS (HR=2.33; 95% CI=1.43–3.79), and those who received <6 cycles of chemotherapy had worse PFS (HR=5.30; 95% CI=2.56–10.99) and OS (HR=3.05; 95% CI=1.46–6.38). The preoperative serum CA125 cutoff level was 30 U/mL based on Youden index method. CONCLUSIONS: Administering 3 additional cycles of chemotherapy followed by debulking surgery exhibited equivalent effects on survival as IDS followed by 3 cycles of postoperative chemotherapy. Preoperative serum CA125 levels of ≤30 U/mL may be a useful predictor of achieving complete surgery.

PARAGON (ANZGOG-0903): a phase 2 study of anastrozole in asymptomatic patients with estrogen and progesterone receptor-positive recurrent ovarian cancer and CA125 progression / 부인종양

OBJECTIVE: A subset of patients with recurrent ovarian cancer (ROC) may benefit from antiestrogen therapy with higher response rates reported in tumors that are strongly estrogen receptor (ER)-positive (ER+). PARAGON is a basket trial that incorporates 7 phase 2 trials investigating the activity of anastrozole in patients with ER+ and/or progesterone receptor (PR)-positive (PR+) recurrent/metastatic gynecological cancers. METHODS: Postmenopausal women with ER+ and/or PR+ ROC, who were asymptomatic and had cancer antigen 125 (CA125) progression after response to first line chemotherapy, where chemotherapy was not clinically indicated. Patients received anastrozole 1 mg daily until progression or unacceptable toxicity. RESULTS: Fifty-four patients were enrolled (52 evaluable). Clinical benefit at three months (primary endpoint) was observed in 18 patients (34.6%; 95% confidence interval [CI]=23%–48%). Median progression-free survival (PFS) was 2.7 months (95% CI=2.1–3.1). The median duration of clinical benefit was 6.5 months (95% CI=2.8–11.7). Most patients progressed within 6 months of starting anastrozole but 12 (22%) continued treatment for longer than 6 months. Anastrozole was well tolerated. In the exploratory analysis, ER histoscores and the intensity of ER staining did not correlate with clinical benefit rate or PFS. CONCLUSION: A subset of asymptomatic patients with ER+ and/or PR+ ROC and CA125 progression had durable clinical benefit on anastrozole, with acceptable toxicity. Anastrozole may delay symptomatic progression and the time to subsequent chemotherapy. The future challenge is to identify the subset of patients most likely to benefit from an aromatase inhibitor and whether the clinical benefit could be increased by the addition of other agents.

Expression and prognostic value of metastasis-associated protein 2 in epithelial ovarian cancer / 临床与实验病理学杂志

Purpose To analyze the expression and prognostic value of metastasis-associated protein 2 (MTA2) in epithelial ovarian carcinoma. Methods The expression of MTA2 protein was examined in 91 paraffin-embedded specimens by immunohistochemical SP method, and in fresh specimens by Western blot, and then combined with follow-up data for prognosis analysis. Results There was an increasing tendency in positive rate of MTA 2 expression from benign ovarian cysts (17.5％) to epithelial ovarian cancers (78.43％), and there were significant difference (χ2=33.328, P<0.001). The expression of the MTA2 was significantly correlated to FIGO stage and lymph node metastasis (both P<0.05). The relative expression of MTA2 in benign ovarian cysts and epithelial ovarian cancers was 0.58±0.05, and 1.22±0.10, respectively, and the difference was statistically significant (t=-22.274, P<0.001). The survival curve of patients with MTA2 (+) differed from the survival curve of patients with MTA2 (-) and the difference was statistically significant (χ2=10.203, P<0.05). The multiple factor analysis revealed that the expression of MTA2, FIGO stage and lymph node metastasis were independent prognostic factors for clinical outcome of epithelial ovarian cancer. Conclusion MTA2 may be involved in the progression and metastasis of epithelial ovarian cancer as an oncogene. Overexpression of the marker indicates poor prognosis of patients.

Significance of high expression of PTP1B in the valuation of progenosis of ovarian cancer / 临床与实验病理学杂志

Purpose To investigate the expressions of PTP1B in epithelial ovarian cancer tissues and to analysis its correlation with clinical pathological and survival significance.Methods The expression of PTP1B in ovarian cancer tissues was detected by Oncomine database and immunohistochemistry.The relationships between PTP1B expression and clinicopathological features, including prognosis significance, were analyzed. Results Oncomine database showed that the mRNA expression of PTP1B in ovarian cancer was significantly higher than that in normal tissues (P<0.001). Immunohistochemical staining showed that PTP1B expression was significantly correlation with FIGO stage (P<0.001), omentum majus metastasis (P=0.002). Kaplan-Meier analyses revealed that ovarian cancer patients with high PTP1B expression tumors had a significantly worse overall survival rate than those with low PTP1B expression tumors (P<0.001). Multivariate analysis showed that FIGO stage, PTP1B expression were independent survival predictors.Conclusion PTP1B expression may be involved in the tumor progression and poor prognosis of patients with ovarian cancer, and it might be used as one of the valuable markers for poor prognosis in patients with ovarian cancer.

Bioinformatics analysis of Wnt/β-catenin pathway related regulatory elements in human mesothelin gene and identification of promoter in ovarian cancer cells / 临床与实验病理学杂志

Purpose To analyze the Wnt/β-catenin signaling pathway related TCF/LEF binding sites in human mesothelin gene and to identify the core promoter region of the gene in the ovarian cancer cells. Methods The possible TCF/LEF transcription factor binding sites in the promoter region of human meosothelin gene were analyzed by bioinformatics method. The 1764 bp promoter sequence near the 5'end of the human mesothelin gene were cloned. The fragments was truncated differently at the 5' end and cloned into p GL3-basic report gene vector and transfected into human ovarian cancer cell lines SKOV-3 and 3-AO. The activity of diffetent promoter fragmentis was detected by double luciferase reporter gene system. Results There were multiple potential TCF/LEF binding sites in the promoter region of the human mesothelin gene. Three fragments of mesothelin gene promoter region-1456-+ 308、-164-+ 308、+ 47-+ 308 were cloned and amplified successfully, the p GL3 vector was constructed by sequencing. After transfection of SKOV-3 and 3-AO cells, the double luciferase reporter gene system showed that the-1456-+ 308 fragments and-164-+ 308 framents had high promoting activity in both cell lines, and the activity of + 47-+308 fragments was significantly lower than that of the former two cell lines (P<0.01). Conclusion The-164-+ 47 sequence containing TCF/LEF transcription factor binding site is the core promoter region of mesothelin gene in ovarian cancer, which lays a foundation for further study on the regulation mechanism of mesothelin gene expression in ovarian cancer.

Perfil epidemiológico dos casos de neoplasias de ovário diagnosticados em um laboratório de patologia do sul do estado de Santa Catarina no período de julho de 2008 a julho de 2011 / Epidemiological profile of ovarian cancer cases diagnosed laboratory in southern Santa Catarina between july 2008 and july 2011

O câncer de ovário é considerado a neoplasia ginecológica mais letal e ocupa a sétima posição entre as causas de óbito em mulheres. Tem como dificuldade para seu tratamento o fato de o diagnóstico ser tardio, por apresentar sintomas inespecíficos e ainda não possuirmos um método de rastreamento abrangente e eficaz. O presente artigo traz como objetivo estimar o perfil epidemiológico das neoplasias de ovário diagnosticadas em um laboratório de anatomia patológica no sul do estado de Santa Catarina no período de julho de 2008 a julho de 2011. Se trata de estudo transversal, documental, descritivo e de abordagem predominantemente quantitativa. Foram encontrados 268 casos de neoplasias de ovário com idade média no momento do diagnóstico de 43,20 anos. O tamanho médio do ovário foi de 8,27cm havendo significância entre o tamanho do ovário e a malignidade do tumor. Os tipos histológicos mais encontrados foram o mucinoso benigno 22,0%, o teratoma maduro (cisto dermóide) 28,6% e o seroso benigno 36,3%. O câncer de ovário participa, a cada cinco anos, com cerca de meio milhão de mulheres afetadas. A literatura mostra os tumores epiteliais como os mais prevalentes, seguidos pelos tumores das células germinativas e do cordão sexual-estroma, coincidindo nossos dados, 68%, 29% e 3% respectivamente. A região de Criciúma mantém os padrões encontrados na literatura no que se refere às neoplasias ovarianas e os parâmetros avaliados neste estudo. Destacamos características locais que poderão contribuir para futuros estudos, a fim de desenvolver ações preventivas e diagnósticas.

Ovarian cancer is considered the most lethal gynecologic cancer and ranks seventh among the most common causes of death in women. One thing that complicate its treatment is the fact that the diagnosis is usually late, since the symptoms are nonspecific and still not having a screening method comprehensive and effective of tracking it. To estimate the epidemiological profile of ovarian cancer diagnosed in a pathology laboratory in southern Santa Catarina between July 2008 and July 2011. A transversal, documental, descriptive and addressing predominantly quantitative study. We found 268 cases of ovarian cancer with an average age at diagnosis of 43.20 years old. The average size of the ovary was 8.27 cm with a significant association between the ovarian size and the malignancy of the tumor. The prevalent histological types found were benign mucinous 22.0%, mature teratoma (dermoid cyst) 28.6% and benign serous 36.3%. The ovarian cancer affects about half a million women every five years. The literature shows epithelial tumors as the most prevalent, followed by germ cell tumors and sex cord-stromal, coinciding with our survey, which were 68%, 29% and 3% respectively. The region of Criciúma maintains the standards found in the literature referring to ovarian tumors and the parameters evaluated in this study. We emphasize local characteristics that may contribute to future studies, in order to develop preventive and diagnostic strategies.

Ovarian cancer in a former asbestos textile factory worker: a case report

BACKGROUND: The International Agency for Research on Cancer (IARC) defined that asbestos is a group 1 substance that causes lung cancer, mesothelioma (pleura and peritoneum), laryngeal cancer, and ovarian cancer in humans. Many studies on lung cancer, and mesothelioma caused by asbestos exposure have been conducted, but there was no case report of ovarian cancer due to asbestos exposure in Korea. We describe a case of ovarian cancer caused by asbestos exposure in a worker who worked at an asbestos textile factory for 3 years and 7 months in the late 1970s. CASE PRESENTATION: A 57-year-old woman visited the hospital because she had difficulty urinating. Ovarian cancer was suspected in radiologic examination, and exploratory laparotomy was performed. She was diagnosed with epithelial ovarian cancer. The patient did not undergo postoperative chemotherapy and recovered. She joined the asbestos factory in March 1976 and engaged in asbestos textile twisting and spinning for 1 year, 2 years and 7 months respectively. In addition, she lived near the asbestos factory for more than 20 years. There was no other specificity or family history. CONCLUSION: Considering the patient’s occupational and environmental history, it is estimated that she had been exposed to asbestos significantly, so we determined that ovarian cancer in the patient is highly correlated with the occupational exposure of asbestos and environmental exposure is a possible cause as well. Social devices are needed to prevent further exposure to asbestos. It is also necessary to recognize that ovarian cancer can occur in workers who have previously been exposed to asbestos, and the education and social compensation for those workers are needed.