Association between FOXP3+ regulatory T-cells and occurrence of peritoneal lesions in women with ovarian endometrioma and dermoid cysts.

RESEARCH QUESTION: Is there any relationship between numbers of FOXP3+ regulatory T-cells (Treg) and occurrence of peritoneal lesions in women with ovarian endometrioma and dermoid cysts? DESIGN: Retrospective and prospective case-controlled cohort study. Peritoneal lesions were collected from 27 women with ovarian endometrioma and 25 women with dermoid cysts. Peritoneal fluid was collected from 36 women with ovarian endometrioma and 42 women with dermoid cysts. Tissue expression of Forkhead box P3 (FOXP3), one of the transcription factors of Treg cells, and transforming growth factor-beta (TGF-ß) were examined by immunohistochemistry. Interleukin-6 (IL-6) and TGF-ß levels in the peritoneal fluid were measured by enzyme-linked immunosorbent assay. RESULTS: Ovarian endometrioma cases with coexisting peritoneal lesions were significantly more frequent than dermoid cyst cases with coexistent peritoneal lesions (269/350 [76.9%] versus 74/414 [17.9%]; P < 0.001). Numbers of FOXP3+ Treg cells were significantly higher in peritoneal lesions of women coexistent with ovarian endometrioma (F = 21.52, P < 0.001) and dermoid cysts (F = 22.01, P < 0.001) compared with women without peritoneal lesions. Higher FOXP3+ Treg cell numbers in pathological lesions corresponded with significantly higher TGF-ß (P < 0.001) and lower IL-6 (P = 0.020) levels in peritoneal fluid of women with peritoneal lesions compared with women without lesions. CONCLUSIONS: This study confirms current speculation that endometriosis is related to alteration in Treg cells, causing survival and implantation of ectopic endometrial lesions in women with endometrioma and dermoid cysts. The findings may clarify why only 10% of women in the general population develop endometriosis despite cyclic menstruation with retrograde flow occurring in >90% of women.

Increased levels of oxidative stress markers in the peritoneal fluid of women with endometriosis.

OBJECTIVE: To evaluate 8-hydroxy-2-deoxyguanosine (8-OHdG) and 8-isoprostane levels in the peritoneal fluid (PF) of women with endometriosis. STUDY DESIGN: One hundred and ten women with laparoscopically and histopathologically confirmed endometriosis and, as reference groups, 119 patients with simple serous (n=78) and dermoid (n=41) ovarian cysts were studied. Peritoneal fluid 8-OHdG and 8-isoprostane concentrations were evaluated by enzyme-linked immunosorbent assays. RESULTS: 8-OHdG and 8-isoprostane levels in peritoneal fluid were significantly higher in patients with endometriosis compared with the reference groups. Higher PF 8-OHdG and 8-isoprostane concentrations were observed in patients with advanced stages of endometriosis. A statistically significant positive correlation was found between 8-OHdG and 8-isoprostane levels in peritoneal fluid. CONCLUSION: Endometriosis induces greater oxidative stress and frequent DNA mutations in peritoneal fluid than nonendometriotic ovarian cysts. The most severe oxidative stress occurs in the peritoneal cavity of women with more advanced stages of the disease.

[Prostatic tissue in a dermoid cyst of the ovary]. / Prostataszövet az ovarium dermoid cystájában.

The finding of mature prostatic tissue in a mature cystic teratoma (dermoid cyst) of the right ovary of a young girl is reported. Prostatic tissue rarely occurs in association with a normal phenotype in females. Reports of prostatic tissue in the female genital tract and their possible aetiology are also summarized in the paper.

[Macrophage-colony stimulating factor and ovarian cancer]. / Macrophage-colony stimulating factor e carcinoma ovarico.

BACKGROUND: In this study the use of macrophage-colony stimulating factor (M-CSF) as tumor marker for ovarian cancer is evaluated. METHODS: Serum samples were obtained from 74 patients, 43 of these were affected by ovarian carcinoma and 31 by benign ovarian tumors. The M-CSF levels were assayed with an ELISA method and compared with those of 148 healthy women. CA 125 levels were also evaluated. RESULTS: In healthy women the M-CSF levels were 770.4 +/- 145.9 U/ml, the upper limit of normal level was considered 1056 U/ml. Serum M-CSF levels were significantly high in patients with ovarian cancer (1425.3 +/- 1007.1 U/ml; p < 0.001) and in 29 of the 43 patients exceeded the limit of 1056 U/ml. No differences were observed among the histologic types. There were no significant differences between patients with benign ovarian pathology and healthy women. No definite relationship was found with CA 125, but evaluating at the same time M-CSF and CA 125 positive results were found in 95.3% of cases. CONCLUSIONS: Therefore M-CSF can be considered a marker for ovarian cancer, and the assay of its serum levels can be particularly useful in association with those of CA 125.

Primary malignant melanoma arising in an ovarian dermoid cyst: proposed use of radioimmunoscintigraphy with 99mTc-F(ab')2 antimelanoma antibody for staging and follow-up. Case report.

A case of primary amelanotic ovarian malignant melanoma arising in a dermoid cyst is presented. Grossly, inside the cyst, pigmented solid lesions were not detected. Histologically, an area with undeniable malignant microscopic features was revealed and its melanomatous identity was confirmed by positive S-100 protein and melanoma antigen immunoreactivity. Recently, after 21 months from surgery this patient has also undergone radioimmunoscintigraphy (RIS) with 99mTc labelled antimelanomatous antibodies which revealed a possible secondary paracolic localization. Regardless of this evidence, although the patient has always refused chemotherapy and second look surgery for removal of the suspicious area, she is alive 1 year after surgery and now doing well. The authors also report the usefulness of employing the RIS technique in evaluating the metastatic spread in this type of malignancy.

Natural killer cell activity in patients with ovarian tumors and uterine myomas.

Natural killer (NK) cells are considered to play a role in surveillance against neoplasia. Therefore, the aim of our study was to evaluate peripheral blood NK cell activity in patients with benign and malignant ovarian tumors as well as uterine myomas. NK cell activity was evaluated by means of 51/Cr-release cytotoxicity assay using K562 erythroleukemic cells as a target. We found that natural cytotoxicity of peripheral blood mononuclear cells was significantly (P > 0.01) decreased in patients suffering from both benign and malignant ovarian tumors as compared to healthy women. A degree of NK cell activity abrogation was higher in patients with malignant tumors. Similar decrease was also observed in patients with uterine myomas. Since ovarian tumors and uterine myomas are known to be associated with an increased serum levels of estrogens it is possible that abrogation of NK cell activity in these patients is related to immunosuppression mediated by these hormones.

[Evaluation of tumor marker in ovarian dermoid cyst].

Since ovarian dermoid cyst originates in parthenogenesis of the oocyte, it contains various kinds of tissues. Therefore, some tumor markers are expected to be positive. Clinical features of 174 pathologically confirmed dermoid cysts between Jan., 1985 and Aug., 1989 were reviewed, especially concerning tumor markers. The age of the patients was 11 years to 71 years (Mean 35.0 +/- 0.9 years). The weight of the dermoid cyst was 5g to 2.540g (mean 225.9 +/- 26.3g), while most of them were below 200g. The site of the tumors was similar on both the right and left. CA19-9 showed the highest positive rate of 45.5% (40/80). CA125 was second 12.7% (16/126) in markers with more than 20 examined cases, while the rate for AFP, Ferritin, CEA, LDH and TPA was 2.7% (3/110), 2.6% (1/38), 1.6% (2/128), 0.6% (1/161), 0% (0/24), respectively. SCC, IAP and beta 2-MG were examined in less than 20 cases and the positive rate was 18.8% (3/16), 9.1% (1/11) and 8.3% (1/12), respectively. There was no significant relationship between tumor weight and the CA19-9 concentration. In some cases, the serum CA19-9 concentration was followed up after the operation. The half life of CA19-9 was clinically estimated at 4.9 +/- 1.1 days.

Apparent 'auto'-anti-DE of the IgA and IgG classes in a 16-year-old girl with a mature cystic ovarian teratoma.

Prior to the removal of a mature cystic teratoma in a girl, aged 16, we had difficulties in Rh typing due to immunoglobulin coating of the red blood cells (RBCs). Further examination revealed the presence of anti-D and anti-E antibodies; the clinical course and the serological characteristics indicated that the Rh antibodies originated from the tumor itself, that is, there was alloantibody formation against the host's RBCs. The specific alloantibody production, as well as the fact that these antibodies belong to the IgA and IgG1 classes provide further evidence for the pluripotency of mature cystic ovarian teratomas.

[The clinical significance of tissue polypeptide antigen (TPA) in the patients with gynecologic tumor].

In order to estimate the clinical significance of tissue polypeptide antigen (TPA), TPA was measured by radioimmunoassay in sera from patients with various gynecological tumors. They were 40 uterine myomas, 94 cervical cancers, 21 endometrial cancers, 3 vulval cancers, 51 benign ovarian tumors and 78 malignant ovarian tumors including 18 low potential malignant tumors (LPM). The mean TPA values in patients with benign as well as malignant tumors were significantly higher than that of 97 healthy volunteers (68 +/- 17 U/l; Upper limit; 107 U/l). Among the cervical cancer patients, serum TPA level and positive ratio became higher as the disease progressed. In the advanced cases, the mean serum TPA value and positive ratio were 149 +/- 64 U/l and 75%, respectively. The mean TPA value in the endometrial cancer patients was significantly higher than that of myoma patients. Among the patients with ovarian tumor, serum TPA was elevated in 14% of benign cases, 28% of LPM cases, 47% of stage I cases and 82% of the advanced cases. Serum TPA values varied directly with the stage and malignancy of disease. The present study revealed that TPA is a useful markers in the diagnosis of gynecological tumors, especially for ovarian cancers.

[Demonstration of plasmacytes in gingival immune defense units in dermoid cysts of the ovary]. / Mise un évidence des plasmocytes dans les unités gingivales de défense immunitaire (U.G.D.I.) dans les kystes dermoïdes de l'ovaire.

Gingival units of immunological defense have been observed surrounding erupted teeth in the connective tissue of the wall of ovarian dermoid cysts. Using a modified immunoperoxidase technique, the production of IgA, IgG and J chains has been clearly detected. This technique works perfectly on decalcified specimens. Since dermoid cysts are not contaminated, the origin of the plasma-cells in these units is presumed to be triggered by other antigenic factors. These are present in epithelium and provided a possible explanation for the "homing" of lymph-cells migrating from the immune system.

Autoimmune hemolytic anemia and ovarian dermoid cysts: case report and review of the literature.

A case of autoimmune hemolytic anemia (AIHA) associated with an ovarian dermoid cyst is presented. Early recognition and specific therapy for this entity is stressed for optimal results since conventional forms of therapy of AIHA are ineffectual. Unusual features of the case are discussed. The literature is reviewed and possible mechanisms of the hemolytic process are discussed.

[Presence of lymph-vascular anatomical units in dermoid cysts and the probable existence of a local immune defense system in various tissues]. / De la présence d'unités anatomiques lympho-vasculaires dans les kystes dermoïdes et de l'existence probable d'un système de défense immunitaire locale dans certains tissus.

Studies on tooth eruption in several ovarian dermoïd cysts showing the existence of immune defense gingival structures has allowed the presence of similar structures associated with respiratory and digestive differentiation zones to be observed. These structures are formed of histiocyto-plasmocyto-lymphocytes associated with capillary loops. The origin and histogenesis of those structures remains to be clarified but they suggest the probable existence of localised immune defense systems within certain tissues.

Epithelial and muscle antigens in benign cystic teratomas of ovary.

Thirty beign cystic teratomas of the ovary were studied by immunofluroesecence, using specific human antisera for (a) squamous epithelial intercellular areas (pemphigus sera), (b) squamous epithelial basement membranes (bullous pemphigoid sera), (c) smooth muscle (chronic active hepatitis sera, and (d) striated muscle (thymona sera). Squamous epithelial intercellular staining was seen in all specimens and was present in the basal cell layers as well as in the prickle cell layers, suggesting a slow regeneration rate for the squamous epithelial lining of these tumors. Well-formed basement membranes were identified at the periphery of all squamous epithelial structures. Smooth muscle was found in 73% of the neoplasms, and the immunoflurorescent findings correlated with light microscopy. No skeletal muscle components were identified. Within the limits of the antibodies used and the antigens detected, these resutlts support the concept that benign ovarian cystic teratomas are composed of mature, heterotopic tissue elements.

[Immunochemical identification of carcinoembryonic antigen in ovarian adenocarcinoma and pseudomucinous cystoma extracts]. / Immunokhimicheskaia identifikatsiia rakovoémbrional'nogo antigena v ékstraktakh adenokartsinomy i psevdomutsinoznoi kistomy iaichnika

Carcinoembryonic antigen (CEA) was found in 3 of 17 individual extracts of adenocarcinoma and in 7 or 8 individual samples of pseudomucinous cystoma of the human ovaries. Rabbits were immunized for the purpose of preparation of specific antisera against CEA by individual fractions (ammonium sulfate, sulfosalicylic acid and phosphotungstic acid) of CEA-positive adenocarcinomas of the ovary.

Autoimmune haemolytic anaemia associated with ovarian dermoid cyst.

A case of autoimmune haemolytic anaemia is described in which recovery, with disappearance of antibody, followed splenectomy and removal of an ovarian ;dermoid' cyst. A causal relationship between removal of the ovarian tumour and recovery is strongly suggested and the possible pathogenesis discussed. Fourteen previously recorded cases of this association are reviewed.