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.

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.

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.

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.

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.

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.