Ectopic, autologous eutopic and normal endometrial stromal cells have altered expression and chemotactic activity of RANTES.

OBJECTIVE: To evaluate if the expression and chemotactic activity of RANTES are different in IL-1beta treated autologous eutopic endometrial stromal cells compared to ectopic and normal endometrium. STUDY DESIGN: Conditioned media from IL-1beta-treated ectopic, autologous eutopic and normal endometrial stromal cells were analyzed with a specific sandwich ELISA to quantify RANTES. The monocyte chemotactic activity of RANTES was assayed in a Boyden Chamber. RESULTS: RANTES expression in IL-1beta-treated autologous eutopic and normal endometrial stromal cells was significantly lower than ectopic endometrium. Autologous eutopic endometrial stromal cells showed a significant increase in RANTES expression compared to normal endometrium after IL-1beta stimulation for 60 h. The monocyte chemotactic activities of these conditioned media were highly correlated with the immunoreactive RANTES concentration. We observed significantly increased monocyte chemotactic activity in conditioned media of ectopic stromal cells compared to autologous eutopic and normal endometrium. The different chemotactic activity of RANTES between the autologous eutopic and normal endometrial stromal cells was also statistically significant. RANTES accounts for the majority (62%) of the monocyte chemotactic activity in ectopic endometrial stromal cells conditioned media and 55% of that activity in autologous eutopic endometrium. CONCLUSIONS: Although the eutopic endometric of women with and without endometriosis are histologically similar, our findings confirm that different expression and chemotactic activity of RANTES exist between autologous eutopic and normal endometrium. The altered expression of RANTES and monocyte chemotactic activity observed in ectopic, autologous eutopic and normal endometrium suggest the autologous eutopic endometrium may contribute to the pathogenesis of endometriosis.

[Benefit of palliative surgery for bowel obstruction in recurrent ovarian carcinoma].

OBJECTIVE: Intestinal obstruction is a frequent sequela of recurrent ovarian cancer and difficult to deal with. We analyzed a series of such patients to determine if their outcomes have changed after undergoing palliative surgery. METHOD: We retrospectively reviewed 67 patients undergoing surgery for intestinal obstruction due to recurrent ovarian carcinoma and 75 patients receiving non-surgical treatment from 1997 to 2002. RESULTS: During the study period, 67 operations were performed on 67 patients. Among them, surgical procedure was completed in 58 cases. Successful palliation was achieved in 64.2% of cases in which surgical correction was possible. The median survival of the entire cohort was 7.8 months, and 12.6 months for the surgically successfully relieved patients and 3.7 months for those non-surgical patients. The rate of major surgical morbidities was 22.4%. The perioperative mortality rate was 6.0%. Successful palliation was associated with the absence of two prognostic factors: multiple obstructive sites and palpable abdominal and pelvic masses. CONCLUSION: Palliative surgery for bowel obstruction in recurrent ovarian cancer can be worthwhile, and properly selected patients are the key to its success.

[Quantitative analysis of circulating DNA in serum of cancer patients].

OBJECTIVE: To develop a method for ng quantitation of circulating DNA in serum and explore the value in the diagnosis of cancer. METHODS: Serum DNA was extracted by commercial "genomic DNA extraction kit" and detected by fluorescent dye (SYBR green I) staining. Loss of heterozygosity (LOH) at BRCA1 (D17S579, D17S855) and p53 (TP53, D17S786) in serum DNA was analyzed by PCR-based method. RESULTS: SYBR green I dot staining could detect DNA as low as 2 ng. Using this method, we detected serum samples from 483 patients with various types of cancer and 150 healthy individuals. The mean DNA concentration in the normal controls was 22.2 +/- 13.4 ng/ml, while that in cancer patients was 81.3 +/- 98.3 ng/ml (P < 0.001). In 33 ovarian cancer patients with increased DNA level, 27(81.8%) displayed LOH in at least one of the four loci analyzed. CONCLUSION: Circulating DNA in serum may become additional tumor marker for the diagnosis of cancer.

[Epithelial ovarian carcinoma metastatic to the brain: report on ten cases with review of literature].

OBJECTIVE: To investigate the incidence, the diagnosis, the multimodal treatment and the relevant factors of the brain metastases in patients with epithelial ovarian carcinoma (EOC). METHOD: The clinical data were analysed in 10 cases of brain metastases from 478 cases of EOC after treatment between 1996 - 2001. RESULTS: The incidence of brain metastases in EOC was 2.1%. The most common manifestation of the brain metastases was headache, nausea and limb paralysis. The most common metastatic sites were the cupular and occipital part of the cerebra. Seven of ten patients were treated with brain radiation and systemic chemotherapy, three abandoned. The brain irradiation dosage was 30 - 38 Gy for only one focus in the brain lasting for 4 weeks and 40 - 45 Gy for two or three foci in the brain lasting for 5 weeks. The overall survival after identification of brain metastases was < 1 - 33 months, the overall median survival was 6.3 months, but for those who abandoned treatment, the median survival was 1.4 months vs 8.3 months for those who completed the courses of therapy. CONCLUSIONS: The diagnosis of brain metastasis was based on the clinical features and the imagings and the therapy was comprehensive and palliative. However, the number and size of the brain metastases and its reaction to radiation was significantly associated with the prognosis. Although the survival after the identification of brain metastases in EOC is poor, most patients can be palliated successfully by using a combination of radiation therapy and systemic chemotherapy.