Cytopathological characterization of ascites for the diagnosis of serous ovarian carcinoma / 中华肿瘤杂志

Objective: To investigate the cytomorphological and immunocytochemical features of tumor cells in the ascites of ovarian plasmacytoma (SOC). Methods: Specimens of serous cavity effusions were collected from 61 tumor patients admitted to the Affiliated Wuxi People's Hospital of Nanjing Medical University from January 2015 to July 2021, including ascites from 32 SOC, 10 gastrointestinal adenocarcinomas, 5 pancreatic ductal adenocarcinomas, 6 lung adenocarcinomas, 4 benign mesothelial hyperplasia and 1 malignant mesothelioma patients, pleural effusions from 2 malignant mesothelioma patients and pericardial effusion from 1 malignant mesothelioma. Serous cavity effusion samples of all patients were collected, conventional smears were made through centrifugation, and cell paraffin blocks were made through centrifugation of remaining effusion samples. Conventional HE staining and immunocytochemical staining were applied to observe and summarize cytomorphological characteristics and immunocytochemical characteristics. The levels of serum tumor markers carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) were detected. Results: Of the 32 SOC patients, 5 had low-grade serous ovarian carcinoma (LGSOC) and 27 had high-grade serous ovarian carcinoma (HGSOC). 29 (90.6%) SOC patients had elevated serum CA125, but the difference was not statistically significant between them and patients with non-ovarian primary lesions included in the study (P>0.05); The serum CEA was positive in 9 patients with gastrointestinal adenocarcinoma and 5 patients with lung adenocarcinoma, and the positive rate was higher than that in SOC patients (P<0.001); The serum CA19-9 was positive in 5 patients with gastrointestinal adenocarcinoma and 5 patients with pancreatic ductal adenocarcinoma, and the positive rate was higher than that in SOC patients (P<0.05). The serum CA125, CEA and CA19-9 were within the normal range in 4 patients with benign mesothelial hyperplasia. LGSOC tumor cells were less heterogeneous and aggregated into small clusters or papillary pattern, and psammoma bodies could be observed in some LGSOC cases. The background cells were fewer and lymphocytes were predominant; the papillary structure was more obvious after making cell wax blocks. HGSOC tumor cells were highly heterogeneous, with significantly enlarged nuclei and varying sizes, which could be more than 3-fold different, and nucleoli and nuclear schizophrenia could be observed in some cases; tumor cells were mostly clustered into nested clusters, papillae and prune shapes; there were more background cells, mainly histiocytes. Immunocytochemical staining showed that AE1/AE3, CK7, PAX-8, CA125, and WT1 were diffusely positively expressed in 32 SOC cases. P53 was focally positive in all 5 LGSOCs, diffusely positive in 23 HGSOCs, and negative in the other 4 HGSOCs. Most of adenocarcinomas of the gastrointestinal tract and lung had a history of surgery, and tumor cells of pancreatic ductal adenocarcinoma tend to form small cell nests. Immunocytochemistry can assist in the differential diagnosis of mesothelial-derived lesions with characteristic "open window" phenomenon. Conclusion: Combining the clinical manifestations of the patient, the morphological characteristics of the cells in the smear and cell block of the ascites can provide important clues for the diagnosis of SOC, and the immunocytochemical tests can further improve the accuracy of the diagnosis.

Tuberculosis abdominal que mimetiza cáncer de ovario. Reporte de una serie de casos / Abdominal tuberculosis mimicking ovarian cancer. A case series report

Resumen Introducción: La tuberculosis peritoneal (tuberculosis abdominal) puede ser confundida con una neoplasia maligna. Objetivo: Describir características clínicas y demográficas de pacientes con tuberculosis abdominal que semeja cáncer de ovario avanzado, diagnosticados en un centro oncológico de referencia nacional. Métodos: Se describen las características clínicas y patológicas de nueve pacientes con tuberculosis abdominal que clínicamente semejaba cáncer de ovario avanzado Resultados: La mediana de edad fue de 47 años, el estrato socioeconómico más común fue bajo (44 %). El dolor abdominal y la pérdida ponderal se presentaron en 77.7 %, ascitis en 55.5 %, prueba COMBE positiva en 22.2 % y ausencia de antecedente de tuberculosis pulmonar en 100 %. La elevación de CA-125 se reportó en 77.7 %, con > 500 U/mL en 57.1 %. La tomografía indicó carcinomatosis en 50 % y tumor pélvico y ascitis en 37.5 %. Todas las pacientes fueron sometidas a cirugía; 62.5 % fueron diagnosticadas mediante estudio patológico transoperatorio como enfermedad neoplásica Conclusión: La tuberculosis es considerada como la gran imitadora, por ello se debe tener en mente el diagnóstico de tuberculosis abdominal ante un caso sospechoso, aun cuando la presentación clínica, estudios de imagen e, incluso, el examen transoperatorio sugieran cáncer de ovario.

Abstract Introduction: Peritoneal tuberculosis (abdominal tuberculosis) can be confused with a malignant neoplasm. Objective: To describe clinical and demographic characteristics of patients with abdominal tuberculosis mimicking advanced ovarian cancer, diagnosed in a national reference cancer center. Methods: Clinical and pathological characteristics of nine patients with abdominal tuberculosis that clinically resembled advanced ovarian cancer are described. Results: Median age was 47 years; the most common socioeconomic status was low (44%). Abdominal pain and weight loss occurred in 77.7%; ascites, in 55.5%; 22.2% had a positive COMBE test, and 100% had no history of pulmonary tuberculosis. CA-125 elevation was reported in 77.7%, with levels > 500 U/mL in 57.1%. Tomography reported carcinomatosis in 50% and pelvic tumor and ascites in 37.5%. All patients underwent surgery, where 62.5% were diagnosed by intraoperative pathology study as neoplastic disease. Conclusion: Tuberculosis is considered the great imitator, which is why abdominal tuberculosis diagnosis should be borne in mind when faced with a suspicious case, even when clinical presentation, imaging studies, and even intraoperative examination suggest ovarian cancer.

Effect of Fuzheng Kangai Decoction on Immune Regulation and Inhibition of Tumor Growth in Rats with Ovarian Carcinoma / 中国实验方剂学杂志

Objective:To explore the effect of Fuzheng Kangai decotion （FZKAD） on the immune regulation and the inhibition of tumor growth in rats with ovarian carcinoma. Method:Kunming mice were randomly divided into normal group， lentinan （0.05 g·kg^-1） group， and high （27.3 g·kg^-1）， medium （13.65 g·kg^-1） and low （6.825 g·kg^-1） dose groups of FZKAD， with 10 mice in each group， serum hemolytic value （HC₅₀）， antibody-forming cells and the phagocytosis of mononuclear macrophages were measured. Fischer 344 rat xenograft model was established through inoculation of NUTU-19 cell in the right axilla， and the model rats were randomly divided into model group， cisplatin group （0.002 g·kg^-1）， and high （18.9 g·kg^-1）， medium （9.45 g·kg^-1）， and low （4.725 g·kg^-1） dose groups of FZKAD， with 10 rats in each group， in addition， 10 healthy rats were randomly selected as the normal group. Tumor quality， tumor inhibition rate， T lymphocyte subsets， and expressions of serum cytokines， enhancer binding protein homologous protein 1（XBP1） and enhancer binding protein homologous protein （CHOP） protein in tumor tissues were detected after 14 days of administration. Result:Compared with normal group， HC₅₀， level of antibody-forming cells， phagocytic index and phagocytic activity of mice in high， medium and low-dose groups of FZKAD were significantly increased （<italic>P</italic><0.05， <italic>P</italic><0.01）. Tumor quality and XBP1 protein expression in high， medium and low-dose groups of FZKAD were significantly decreased （<italic>P</italic><0.01） compared with the model group， while the tumor inhibition rate， CD4⁺， CD8⁺ T cell ratio， CD4⁺/CD8⁺ ratio， tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>）， interleukin-2 （IL-2）， <italic>γ-</italic>interferon （IFN-<italic>γ</italic>） expression and CHOP protein expression were significantly increased （<italic>P</italic><0.05， <italic>P</italic><0.01）. Conclusion:FZKAD can improve the immune function of normal mice and inhibit the tumor growth in rats with ovarian carcinoma， and the immunity regulation effect is the main mechanism.

Synchronous Endometrioid Endometrial and Serous Ovarian Carcinoma: A double gynecologic jeopardy / Philippine Journal of Obstetrics and Gynecology

@#Synchronous malignant tumors are two primary tumors diagnosed at the same time during surgery. A postmenopausal, nulligravid, presented with vaginal bleeding. Ultrasound revealed an endometrial and right ovarian mass, both with nonbenign features. Cancer Antigen 125 and Human Epididymis Protein 4 were elevated. She underwent extrafascial hysterectomy with bilateral salpingo-oophorectomy with the frozen section of the endometrium and right ovary, followed by complete surgical staging. Histopathology report was endometrioid endometrial carcinoma and high-grade serous ovarian carcinoma. The endometrial and ovarian tissues tested positive for vimentin and Wilm's Tumor 1 (WT1), respectively, suggesting both are primary independent tumors. The pelvic lymph nodes and recto-sigmoid lymph nodes tested positive for vimentin and negative for WT1, suggesting endometrial tumor metastasis. The final diagnosis is synchronous endometrioid endometrial carcinoma Stage IIIC1 and high-grade serous ovarian carcinoma Stage IA, right ovary.

Carcinosarcoma de ovario en paciente perimenopáusica / Ovarian carcinosarcoma in a perimenopausal woman

Resumen ANTECEDENTES: El carcinosarcoma de ovario, o tumor mixto de Müller, es una neoplasia infrecuente que representa alrededor del 1 al 4% de los carcinomas ováricos epiteliales. Su histología combina componentes sarcomatosos y carcinomatosos. CASO CLÍNICO: Paciente de 55 años, con diagnóstico de carcinosarcoma de ovario. Acudió a consulta debido a un sangrado uterino irregular y dolor abdominal. En la ecografía transvaginal se encontró una formación anexial sólida y heterogénea de 11.95 x 10.6 cm, con captación Doppler. El estudio se amplió con una tomografía axial computada (TAC) abdominopélvica y de tórax en la que se observó una tumoración en el lado izquierdo de 18 x 13 cm. Los marcadores tumorales se reportaron elevados: CEA 10.60, CA 125 91.3 y CA19.9 153 U/mL, con proteína HE-4 86.8 pmol/L, ligeramente disminuida. La laparotomía exploradora se completó con una cirugía para eliminar toda la carga tumoral. Se indicó quimioterapia con paclitaxel-carboplatino. El estudio histológico definitivo informó la existencia de una tumoración sólida-quística, compatible con un carcinosarcoma en el ovario izquierdo, con amplia diseminación peritoneal. A los 3 meses de la intervención, la paciente continuaba sin signos de recidiva. CONCLUSIONES: El carcinosarcoma es un tumor ginecológico poco frecuente pero muy agresivo; por su excepcional hallazgo aún no se dispone de criterios de tratamiento. Es decisivo fomentar investigaciones futuras acerca de los factores pronósticos y biomarcadores y desarrollar tratamientos dirigidos a las características moleculares de cada paciente.

Abstract BACKGROUND: Ovarian carcinosarcoma, or mixed Müllerian tumor, is a rare neoplasm that represents about 1 to 4% of epithelial ovarian carcinomas. Its histology combines sarcomatous and carcinomatous components. CLINICAL CASE: 55-year-old female patient with a diagnosis of ovarian carcinosarcoma. She consulted due to irregular uterine bleeding and abdominal pain. Transvaginal ultrasound showed a solid and heterogeneous adnexal formation measuring 11.95 x 10.6 cm, with Doppler uptake. The study was expanded with an abdominopelvic and chest computed axial tomography (CT) scan in which a tumor was observed on the left side measuring 18 x 13 cm. Tumor markers were reported elevated: CEA 10.60, CA 125 91.3 and CA19.9 153 U/mL, with HE-4 protein 86.8 pmol/L, slightly decreased. Exploratory laparotomy was completed with R0 surgery. Chemotherapy with paclitaxel-carboplatin was indicated. The definitive histological study reported the existence of a solid-cystic tumor, compatible with a carcinosarcoma in the left ovary, with extensive peritoneal dissemination. Three months after surgery, the patient continued without signs of recurrence. CONCLUSIONS: Carcinosarcoma is a rare but very aggressive gynecologic tumor; because of its exceptional finding no treatment criteria are yet available. It is crucial to encourage future research on prognostic factors and biomarkers and to develop treatments targeted to the molecular characteristics of each patient.

Tumor de células de la granulosa de tipo juvenil en ovario izquierdo / Juvenile granulosa - cells tumor in the left ovary

RESUMEN Se presentó el caso de una adolescente de 14 años, en el servicio de Cirugía Pediátrica del Hospital Pediátrico Docente "Pedro Agustín Pérez" de Guantánamo, que refirió aumento de volumen de todo el abdomen y dolor abdominal difuso. Al examinarla se constató una tumoración visible y palpable en hemiabdomen inferior. Los estudios complementarios imagenológicos mostraron una masa ecogénica, heterogénea que ocupaba hipogastrio, más lateralizada hacia la izquierda. Tras discusión colectiva multidisciplinaria se le realizó oforectomía izquierda y los estudios anatomopatológicos confirmaron la presencia de tumor de células de la granulosa de tipo juvenil en ovario izquierdo. Técnicas quirúrgicas que permitan preservar la capacidad reproductiva a niñas con neoplasias malignas, resultan usadas ahora con frecuencia y garantizan una mayor calidad de vida.

ABSTRACT A 14-year-old girl presented to the pediatric surgery department at the Pediatric Teaching Hospital "Pedro Agustín Pérez" in Guantanamo. She reported a difuse abdominal pain and distention. The examination revealed a visible and palpable tumor in the lower hemiabdomen. Complementary imaging studies showed an ecogenic and heterogeneous mass situated in the left hypogastrium. After a multidisciplinary team meeting, an ophthalmectomy was performed, and anatomopathological studies confirmed the presence of juvenile granulosa cells tumor on the left ovary. Surgical techniques that allow girls with malignant neoplasms to preserve their reproductive capacity are now frequently used and they guarantee higher life quality.

Research progress of anti-gynoecological tumors effect of shikonin and its derivatives / 中草药

Shikonin is a natural naphthoquinone compound extracted from the traditional Chinese medicine-Lithospermum, and it has anti-inflammatory, antioxidant, anti-tumor, wound healing, and other effects. In recent years, the antitumor effects of shikonin and its derivatives have been studied extensively. Numerous studies in vitro and in vivo showed that shikonin and its derivatives can effectively inhibit the initiation and development of breast cancer, cervical cancer and other gynecological malignancies, the research progress of shikonin in the field of anti-gynecological tumors in recent years was reviewed from the aspects of blocking cell cycle, promoting tumor cell apoptosis, inhibiting cancer cell metastasis and invasion, inducing autophagy and necrosis, etc. It provides a reference for the clinical research of shikonin compounds in gynecological tumors.

A diagnostic dilemma: A rare case of an ovarian carcinoma with signet ring cells hidden behind a substantial dermatomyositis

Dermatomyositis (DM) is a malignancy-associated inflammatory connective tissue disease which involves muscles and skin. It accompanies many cancer types. Herein, we aimed to present a 42-year-old patient with primary signet ring cell ovarian carcinoma which has not been seen hitherto. Presentation with DM induces rapid and aggressive progression and emphasizes the importance of more comprehensive malignancy screening in these patients

Clinical and surgical outcomes of 3 cycles versus 6 cycles of neoadjuvant chemotherapy in advanced ovarian carcinoma

Background: Epithelial cancers are the most common ovarian malignancy accounting for 90% of all type of ovarian cancer. Objective of this study was to evaluate the surgical morbidity and to study clinical outcomes of 3 cycles versus 6 cycles of neoadjuvant chemotherapy.Methods: A total 30 women with diagnosis of advanced epithelial ovarian cancer were randomly divided equally to receive either 3 cycles (Group 1) or 6 cycles (Group 2) of neoadjuvant chemotherapy. End points noted were duration of surgery, extent of surgery, perioperative complications and length of stay.Results: Both groups had comparable demographic profile. Surgery was more difficult in early IDS group with lesser percentage of patients achieving minimum intended surgery in early IDS (61.53% versus 80. 47%) peri-operative complications were seen more commonly in early IDS group compared to late IDS group (26.66% versus 69.2%). However mean duration of surgery was similar in both groups. Mean duration of stay in hospital was 5.4 days in late IDS group and 7.6 days in early IDS group. The mean follow-up period in late IDS was 7 months and in early IDS was 5 months. Survival in both groups when patients were followed up till the end of study period (12 months) was similar (p=0.186).Conclusions: Authors conclude that late IDS may be used as a treatment option in the high-risk group of patients. Though there was no significant difference at 6 months follow up, higher percent of women were disease free in late IDS.

Primary Serous Papillary Adenocarcinoma Fallopian Tube: A Rare Case Report

Introduction: Primary fallopian tube carcinoma is a rare tumour accounting to almost 0.1-1.8% of all genital malignancies and difficult to diagnose preoperatively, because of its non-specific presentation as well as simulation with ovarian carcinoma. It is usually an intraoperative finding or a histopathological diagnosis. Case Report:The study present a case of 48 yr old post menopausal women who underwent abdominal hysterectomy with unilateral salpingo-oopherectomy for hydrosalpinx and ovarian cyst. Histopathological examination revealed, primary serous papillary adenocarcinom of fallopian tube. Conclusion: Primary tubal cancer is rare, mostly mistaken for ovarian carcinoma. Histopathological examination is the gold standard for final diagnosis

A Study of β-Catenin and PTEN Expression in Ovarian Surface Epithelial Neoplasms and their Correlation with Grade and Stage in Malignant Cases

Introduction: Ovarian carcinoma is most common ovarianmalignancy which accounts for vast majority (90%) of ovariantumors. It is invariably accompanied by changes in signaltransduction pathways. The aim of the study was to evaluatethe expression of β– catenin and PTEN in diagnosed casesof ovarian surface epithelial neoplasm and correlate themto histological grade and stage of ovarian carcinoma. Studydesign: This was a cross-sectional observational study.Material and methods: The study was conducted over a periodof one year (February 2017 to July 2018). β– catenin and PTENexpression was evaluated in 50 histologically diagnosed casesof ovarian epithelial neoplasm by immunohistochemistry(IHC) using a scoring system. Statistical analysis StatisticalAnalysis was performed with help of Epi Info (TM) 7.2.2.2. Ap-value <0.05 was considered statistically significant.Results: Membranous, Cytoplasmic and Nuclear β-cateninexpression was significantly higher for high grade tumors thanthat of low grade tumors. No significant association betweenβ-catenin expression and stage was found. A significantassociation of PTEN expression with tumor grade (p=0.0367)and histological subtype (p=0.03) has been found. Significantassociation of loss of PTEN expression with stage of the tumorwas also found (p=0.023). No significant correlation betweennuclear score of β-catenin and PTEN score was found.Conclusion: Considering the observations of the presentstudy, it can be concluded that β-catenin and PTEN mayplay an active role in the pathogenesis of ovarian carcinomasubtypes and they have a positive correlation with grade andstage of tumours. So, these biomarkers may be consideredas prognostic parameters and critical evaluator of targetedtherapy

Role of ovarian tumor stem-like cells sorted from human epithelial ovarian cancer SKOV3 cells in vasculogenic mimicry formation / 南方医科大学学报

OBJECTIVE@#To isolate tumor stem-like cells from human epithelial ovarian cancer SKOV3 cells and explore their role in the formation of vascularization mimicry (VM).@*METHODS@#SKOV3 cells were passaged to the 7th generation by suspension culture in serum-free medium, and the percentages of CD133- and CD117-positive cells in the 1st, 3rd, 5th and 7th generations were analyzed using flow cytometry. The proliferative activity of the cells sorted from the 7th generation SKOV3 cells was assessed with colony formation assay. A three-dimensional cell culture model was established to compare the ability of VM formation between the sorted cells and the parental SKOV3 cells. The expression levels of matrix metalloproteinases-2 (MMP-2) and MMP-9 in the two groups were detected using real-time PCR and Western blotting.@*RESULTS@#Some SKOV3 cells formed typical cell spheres with suspension growth in serum-free medium and were passaged to the 7th generation. Flow cytometry revealed that the percentage of CD133-positive cells increased with cell passaging. The cloning efficiency of the sorted cells was significantly higher than that of the parental SKOV3 cells (50.33% 5.33%, < 0.001). The VM formation ability of the sorted cells was stronger than that of the parental SKOV3 cells in the three-dimensional cell culture system. RT-PCR and Western blotting showed that the expression levels of MMP-2 and MMP-9 were significantly higher in the 7th passage cells than in the parental cells ( < 0.05).@*CONCLUSIONS@#The sorted cells from SKOV3 cells cultured in serum-free medium exhibit biological properties of tumor stem cells with strong VM formation ability, suggesting their role in VM formation.

Assessment of solid components of borderline ovarian tumor and stage I carcinoma: added value of combined diffusion- and perfusion-weighted magnetic resonance imaging / 영남의대학술지

BACKGROUND: We sought to determine the value of combining diffusion-weighted (DW) and perfusion-weighted (PW) sequences with a conventional magnetic resonance (MR) sequence to assess solid components of borderline ovarian tumors (BOTs) and stage I carcinomas.METHODS: Conventional, DW, and PW sequences in the tumor imaging studies of 70 patients (BOTs, n=38; stage I carcinomas, n=32) who underwent surgery with pathologic correlation were assessed. Two independent radiologists calculated the parameters apparent diffusion coefficient (ADC), K(trans) (vessel permeability), and V(e) (cell density) for the solid components. The distribution on conventional MR sequence and mean, standard deviation, and 95% confidence interval of each DW and PW parameter were calculated. The inter-observer agreement among the two radiologists was assessed. Area under the receiver operating characteristic curve (AUC) and multivariate logistic regression were performed to compare the effectiveness of DW and PW sequences for average values and to characterize the diagnostic performance of combined DW and PW sequences.RESULTS: There were excellent agreements for DW and PW parameters between radiologists. The distributions of ADC, K(trans), and V(e) values were significantly different between BOTs and stage I carcinomas, yielding AUCs of 0.58 and 0.68, 0.78 and 0.82, and 0.70 and 0.72, respectively, with ADC yielding the lowest diagnostic performance. The AUCs of the DW, PW, and combined PW and DW sequences were 0.71±0.05, 0.80±0.05, and 0.85±0.05, respectively.CONCLUSION: Combining PW and DW sequences to a conventional sequence potentially improves the diagnostic accuracy in the differentiation of BOTs and stage I carcinomas.

Effect of neoadjuvant chemotherapy in advanced ovarian carcinoma

Background: Ovarian cancer is the second most common gynecological malignancy. Patients with ovarian tumors are often asymptomatic for a long time. Most cases are diagnosed late because effective screening methods are not available. Aim of the study: The tumor clearance effect of neoadjuvant chemotherapy in the advanced ovarian tumor in terms of optimal debulking, ascitic fluid volume reduction, blood transfusion requirements and to compare it with those who have not received neoadjuvant chemotherapy. Materials and methods: 25 Patients with advanced ovarian tumor admitted in the Institute of Obstetrics and Gynecology, ISOKGH, Chennai from February 2018 to December 2018 were included in the study. All patients enrolled in the study underwent a detailed physical examination, routine hematological, biochemical investigations, Ultrasound, and CT Scan. For those patients with ascites, ascitic fluid was sent for cytology. When cytology report confirmed that it was Epithelial ovarian tumor, the patient received Neoadjuvant chemotherapy of Cisplatin 75mg/sq. m, Cyclophosphamide 750 mg/sq. m for 3 cycles – 6 weeks. Results: In our study, injury to adjacent structures was present in 7 cases of PDS group (28%) whereas 3 cases in NACT had an injury. Out of the total 10 cases, 2 had bladder injury, 2 had an injury to the small bowel, 3 had a ureteric injury, 2 had a sigmoid colon and the other had a rectal injury. Post-op complications were present in 8 cases of PDS group (32%), 4 cases (16%) of NACT/IDS group in our study. Conclusion: Neoadjuvant chemotherapy is significantly more effective in achieving optimal cytoreduction and reducing the ascitic fluid volume in advanced ovarian cancer. Blood transfusion requirement is significantly less in the neoadjuvant chemotherapy group.

Volumen metabólico tumoral en paciente con cáncer de ovario reestadificado con PET/CT- FDG-F18 / Tumour metabolic volume in a patient with ovarian cancer restaged with PET/CT-FDG-F-18

Resumen El F18-FDG PET/CT es una herramienta de gran utilidad en el proceso de reestadificación de los casos que tienen sospecha de recaída en el contexto de carcinoma de ovario con excelente rendimiento diagnóstico y pronóstico, suministrando datos cuantitativos como el volumen metabólico tumoral (MTV) y lesión glicolitica total (TLG). De manera rutinaria se reporta el valor de captación estandarizado máximo (SUVmax) en las lesiones tumorales, sin embargo, hay que tener en cuenta que es improbable que un solo píxel refleje la actividad de tumores metabólicamente heterogéneos con precisión. Con el fin de resolver el dilema del uso del SUVmax, se han introducido varios parámetros cuantitativos en PET para estimar la medición de manera más exacta y objetiva de la biología de la neoplasia. En años recientes se ha hecho énfasis en la carga metabólica tumoral mediante el uso del MTV y la TLG como marcadores pronósticos y predictores de recaída.

Abstract The F18-FDG PET/CT is a very useful tool in the re-staging process of cases that are suspected of relapse in the context of ovarian carcinoma. It has an excellent diagnostic and prognostic performance, providing quantitative data such as tumour metabolic volume (MTV) and total lesion glycolysis (TLG). The maximum standardised uptake value (SUVmax) is routinely reported in tumour lesions; however it must be taken into account that it is unlikely that a single pixel accurately reflects the activity of metabolically heterogeneous tumours. In order to resolve the dilemma of the use of the SUVmax, several quantitative parameters have been introduced into PET in order to estimate the measurement of the biology of the neoplasm in a more exact and objective way. In recent years, emphasis has been placed on tumour metabolic load through the use of MTV and TLG as prognostic markers and predictors of relapse.

Prognostic significance of normal-sized ovary in advanced serous epithelial ovarian cancer / 부인종양

OBJECTIVE: We compared survival outcomes of advanced serous type epithelial ovarian cancer (EOC) patients with normal-sized ovaries and enlarged-ovarian tumors by propensity score matching analysis. METHODS: The medical records of EOC patients treated at Samsung Medical Center between 2002 and 2015 were reviewed retrospectively. We investigated EOC patients with high grade serous type histology and International Federation of Gynecology and Obstetrics (FIGO) stage IIIB, IIIC, or IV who underwent primary debulking surgery (PDS) and adjuvant chemotherapy to identify patients with normal-sized ovaries. Propensity score matching was performed to compare patients with normal-sized ovaries to patients with enlarged-ovarian tumors (ratio, 1:3) according to age, FIGO stage, initial cancer antigen (CA)-125 level, and residual disease status after PDS. RESULTS: Of the 419 EOC patients, 48 patients had normal-sized ovary. Patients with enlarged-ovarian tumor were younger (54.0±10.3 vs. 58.4±9.2 years, p=0.005) than those with normal-sized ovary, and there was a statistically significant difference in residual disease status between the 2 groups. In total cohort with a median follow-up period of 43 months (range, 3–164 months), inferior overall survival (OS) was shown in the normal-sized ovary group (median OS, 71.2 vs. 41.4 months; p=0.003). After propensity score matching, the group with normal-sized ovary showed inferior OS compared to the group with enlarged-ovarian tumor (median OS, 72.1 vs. 41.4 months; p=0.031). In multivariate analysis for OS, normal-sized ovary remained a significant factor. CONCLUSION: Normal-sized ovary was associated with poor OS compared with the common presentation of enlarged ovaries in EOC, independent of CA-125 level or residual disease.

Preoperative serum levels of cancer antigen 125 and carcinoembryonic antigen ratio can improve differentiation between mucinous ovarian carcinoma and other epithelial ovarian carcinomas

OBJECTIVE: The main aim of this study was to evaluate cancer antigen 125 (CA125)/carcinoembryonic antigen (CEA) ratio (CCR), as a reliable marker to differentiate ovarian mucinous carcinoma from other epithelial ovarian carcinomas (EOCs), namely serous, clear cell, and endometrioid carcinomas. METHODS: Female patients suffering from different kinds of EOCs whom were subjected to elective surgery at the Gangnam Severance Hospital between January 2008 and December 2016, were included in this study. The serum levels of CA125 and CEA were assayed using commercially available kits per the manufacturer's instructions. RESULTS: The CCR in mucinous carcinoma (mean 32.1) was significantly lower than that of clear cell (mean 235.0) and endometrioid carcinoma (mean 427.0) in stage I (all P < 0.05). In stage II–IV, CCR in mucinous carcinoma (mean 37.6) was significantly lower than that of serous carcinoma (mean 148.0) (P < 0.01). The sensitivity and specificity of CCR in detecting mucinous carcinoma from other types of EOC was 75.0% and 77.5%, respectively in stage I and 100.0% and 84.4%, respectively in stage II–IV (both cut-off value < 90.7). CONCLUSION: The present results suggest that pretreatment CCR might provide higher specificity and clinically relevant information as a criterion for the differentiation between ovarian mucinous carcinoma and other types of EOC.

Transforming growth factor beta-1 promotes migration and invasion of ovarian epithelial carcinoma cells through TRAF6-mediated activation of Notch3 signaling pathway / 中国癌症杂志

Background and purpose: Abnormal expression and amplification of transforming growth factor beta 1 (TGF-β1) and Notch3 in ovarian carcinoma tissues are associated with metastasis and low survival rate, respectively. The crosstalk between TGF-β1 and Notch3 signaling pathway promotes invasion and metastasis in various cancers. However, the mechanism is still under debate. Therefore, this study was designed, using in vitro cytological assays, to investigate the effects of TGF-β1 and Notch3 signaling pathway on ovarian cancer cell biological behavior and the potential mechanisms in terms of the crosstalk between TGF-β1 and Notch3 signaling pathway. Methods: Hey A8 and Hey cell lines were used as models in the study. The levels of TGF-β1 in supernatants from culture media were measured by ELISA. Both cell lines were treated with 500 ng/mL TGF-β1 neutralizing antibody (control group), 10 ng/mL TGF-β1, 50 μmol/L DAPT, 10 ng/mL TGF-β1 and 50 μmol/L DAPT, 50 μmol/L tumor necrosis factor receptor-associated factor 6 (TRAF6) peptide inhibitor, 10 ng/mL TGF-β1 and 50 μmol/L TRAF6 peptide inhibitor, respectively. The protein expression levels of TGF-β1 and Notch3 signaling pathway molecules as well as TRAF6 from cell lines with different treatments were detected by Western blot. Cell proliferation, migration and invasion were tested by cell counting kit-8 (CCK-8), scratch and Transwell assays, respectively. Results: The levels of TGF-β1 were timedependently increased in supernatants of culture media from Hey A8 and Hey cell lines. Compared with control group, TGF-β1 treatment increased the expression levels of Notch3-ICD and Hes1, while no obvious change was observed in the group treated with DAPT and TGF-β1. Moreover, TGF-β1 promoted cell proliferation, migration and invasion while DAPT decreased the proliferation, migration and invasion in cell lines treated with TGF-β1. These results indicated that TGF-β1 might promote proliferation, invasion and migration of ovarian epithelial cancer cells through activating the Notch3 signaling pathway. Further study showed that TGF-β1 up-regulated TRAF6 and activated the Notch3 signaling pathway. The activation of the Notch3 signaling pathway by TGF-β1 was inhibited in cells treated with the TRAF6 specific inhibitor. Conclusions: TGF-β1 may promote the proliferation, invasion and migration of ovarian epithelial carcinoma cells through TRAF6-mediated activation of the Notch3 signaling pathway.

Role of RNA-binding protein Larp1 in ovarian cancer invasion and metastasis and mechanism / 实用医学杂志

Objective Recent evidence has implicated Larp1,an RNA-binding protein,in cell motility and EMT therefore prompting the study of Larp1 in EOC.This project aims to examine the potential role of Larp1 in cell invasion.Methods Ovarian cancer cells SKOV-3 and OVCAR-3 were transfected with DNA constructs to overexpress Larp1 and transfect cells were used to assess the overexpression of Larp1 in cell invasion and metastasis using several functional assay.Results Larp1 overexpression in both OVCAR-3 and SKOV-3 cells appear to enhance the invasive ability of cells and the accumulation of Larp 1 in these chemoinvasive protrusions strongly suggests the potential role of Larp1 in invadopodia formation.Cell spot chemoinvasion assay demonstrated increased chemoinvasion of Larp1 overexpressing SKOV-3 and OVCAR-3 cells towards a gradient of TGF-β,EGF and bFGF.Conclusions With its potential role in EMT and cell invasion,a deeper understanding of the physiological role of Larp1 in cancer cell motility will be potentially beneficial in the diagnosis and treatments of ovarian cancer.

A rare case report of double synchronous primary neoplasm of the cervix and ovary

Synchronous primary neoplasms are defined when two or more neoplasms take place concurrently in the same patient. Double synchronous primary gynaecological neoplasms are relatively uncommon and the incidence rate ranges from 0.6% to 5.4%. Synchronous malignancies of the ovary and the uterine cervix are rare situations in which the prognosis is established not only by clinical stage but also by the histological grade of the adenomatous component. Here we have presented the case of a 60 year old patient who presented for diffuse abdominal pain and weight loss that was diagnosed with synchronous cervical and ovarian carcinoma on histopathology. This case report of double synchronous primary neoplasm of the cervix and ovary is presented here because of its rarity