Primary Ovarian Small Cell Carcinoma of Pulmonary Type: Analysis of 6 Cases and Review of 31 Cases in the Literatures

Objective Primary ovarian small cell carcinoma of pulmonary type(SCCOPT)is a rare ovarian tumor with a poor prognosis.The platinum-based chemotherapy is the standard treatment.However,there is little research on the clinical characteristics of SCCOPT and the potential benefits of other treatments due to its low incidence.The study aims to investigate clinicopathological characteristics and treatment of SCCOPT.Methods We summarized the clinical,imaging,laboratorical and pathological characteristics of 37 SCCOPT cases,in which 6 cases were admitted to the Gansu Provincial Hospital from the year of 2008 to 2022 and 31 cases reported in 17 English and 3 Chinese literatures.Results The median age of the studied SCCOPT cases(n=37)was 56.00(range,22-80)years.Almost 80%of them had a stageⅢorⅣtumor.All patients underwent an operation and postoperative chemotherapy.Nevertheless,all cases had a poor prognosis,with a median overall survival time of 12 months.Immunohistochemical y,the SCCOPT of all patients showed positive expressions of epithelial markers,such as CD56 and sex-determining region of Y chromosome-related high-mobility-group box 2(SOX-2),and negative expressions of estrogen receptor,progesterone receptor,vimentin,Leu-7,and somatostatin receptor 2.The tumor of above 80%cases expressed synaptophysin.Only a few cases expressed neuron-specific enolase,chromogranin A,and thyroid transcription factor-1.Conclusions SCCOPT had a poor prognosis.SOX-2 could be a biomarker to be used to diagnose SCCOPT.

Clinical characteristics and survival of patients with normal-sized ovarian carcinoma syndrome: Retrospective analysis of a single institution 10-year experiment

BACKGROUND Normal size ovarian cancer syndrome(NOCS)is a challenge for clinicians regarding timely diagnosis and management due to atypical clinical and imaging features.It is extremely rare with only a few cases reported in the literature.More data are needed to clarify its biological behavior and compare the differences with abnormal size ovarian cancer.AIM To assess the clinical and pathological features of NOCS patients treated in our institution in the last 10 years and to explore risk factors for relapse and survival.METHODS Patients who were pathologically diagnosed with NOCS between 2008 and 2018 were included.Papillary serous ovarian carcinoma(PSOC)patients were initially randomly recruited as the control group.Demographics,tumor characteristics,treatment procedures,and clinical follow-up were retrospectively collected.Risk factors for progression-free survival and overall survival were assessed.RESULTS A total of 110 NOCS patients were included;80(72.7%)had primary adnexal carcinoma,two(1.8%)had mesotheliomas,18(16.4%)had extraovarian peritoneal serous papillary carcinoma,and eight(7.3%)had metastatic tumors.Carbohydrate antigen(CA)125 and ascites quantity were lower in the NOCS cohort than in the PSOC group.The only statistically significant risk factors for worse overall survival(P<0.05)were the levels of CA199 and having fewer than six chemotherapy cycles.The 1-year,3-year,and 5-year survival rates were 75.5%,27.7%,and 13.8%,respectively.CONCLUSION The clinical symptoms of the NOCS group are atypical,and the misdiagnosis rate is high.Ascites cytology and laparoscopic exploration are valuable in the early diagnosis to avoid a misdiagnosis.The level of CA199 is the most important predictor of overall survival,and more than six cycles of chemotherapy contributes to the increased survival rates of NOCS patients.

Inhibitory Effects of Anti-sense PTTG on Malignant Phenotype of Human Ovarian Carcinoma Cell Line SK-OV-3

To construct eukaryotic expression vector expressing full length anti-sense pituitary tumor transforming gene (PTTG) mRNA and observe its blocking effect on the potential invasion of human ovarian carcinoma cell line SK-OV-3. PCR primers containing designed enzyme cut sites were used for cloning full-length PTTG gene fragment, and the resulting PCR product was inserted into the eukaryotic vector pcDNA3.1 in the antisense direction. The recombinant vector was then transfected into SK-OV-3 by Lipofectamine. The positive cell clone was screened by G418, PTTG and bFGF at protein level expression were detected by Western blot. The biological behavior change of transfection positive cells was observed by colony formation in soft agar assay. Our results showed that SK-OV-3 clones stably expressing full-length recombinant pcDNA3.1-PTTGas were obtained. The expressions of PTTG and bFGF protein in transfected cells were decreased by 61.5 % and 52.3%, respectively as compared with non-transfected ones. The number of colony formation was reduced significantly in transfected cells as compared with empty vector transfected and non-transfected cells. It is concluded that the recombinant vector pcDNA3.1-PTTGas is a novel tool and provides an alternative anti-sense gene therapy targeted at PTTG in human carcinoma.

The Relationship between p38MAPK and Apoptosis during Paclitaxel Resistance of Ovarian Cancer Cells

To investigate the relationship between p38 mitogen-activated protein kinase （p38MAPK） and cell apoptosis during the paclitaxel resistance of ovarian carcinoma cell lines, flow cytometry （FCM） and PI staining were employed to determine the effect of p38MAPK inhibitor SB203580 on the apoptosis of A2780/Taxol cells, a drug-resistant human ovarian carcinoma cell line. p38MAPK protein expression in SB203580-treated cells was immunochemically measured. The 50% inhibition concentration （IC50） of paclitaxel on A2780/Taxol cells was determined by MTT assay. MDR-1 mRNA, and expression of p38MAPK and phospho-p53 protein were detected by RToPCR and Western blotting, respectively. The apoptosis rate of A2780/Taxol cells was （19.7±1.04）% 24 h after SB203580 treatment. A significant difference in apoptosis rate was found among experiment group, control group and untreated group （p〈0.05）. The relative reversal rate of A2780/Taxol cells to paclitaxel was （57.18±2.01）%. As compared with the control group and the untreated group, p38MAPK protein and MDR-1 mRNA in SB203580-treated cells was substantially decreased. The expression of p53 protein was significantly increased. It is concluded that p38MAPK pathway is related to paclitaxel resistance of ovarian carcinoma, and blockade of this pathway can promote the apoptosis of the drug-resistant cells and reverse the drug-resistance. Moreover, p38MAPK-mediated apoptosis in paclitaxel-resistant ovarian carcinoma cells depends on the activation of p53.

Targeting of p38 Mitogen-activated Protein Kinases to Early Growth Response gene 1 (EGR-1) in the Human Paclitaxel-resistance Ovarian Carcinoma Cells

To investigate the relationship between the expression of early growth response gene 1 （EGR-1） and p38MAPK pathway in the paclitaxel resistance of ovarian carcinoma cells, the effect of p38MAPK inhibitor SB203580 on cell apoptosis was examined by using Hoechst 33258 staining. The intracellular Rh123 （Rhodamine 123） accumulation was detected by the flow cytometry （FCM）. The 50% inhibition concentration （IC50） of paclitaxel for A2780/Taxol cells was determined by MTT method. Electrophoretic motility shift assay （EMSA） was employed to examine the EGR-1DNA binding activity. MDR1 and EGR-1 mRNA were assessed by RT-PCR. The expressed of p-gp, phos- phorylated p53 and p38 were detected by Western blotting. SB203580 could remarkably promote the apoptosis of A2780/Taxol cells, and the cell apoptosis was in a time-dependent manner. Cellular Rh123 accumulation was increased, and the IC50 of paclitaxel for A2780/Taxol cells was decreased significantly. A2780/Taxol cell line after SB203580 treatment was shown to have a significantly higher level of EGR-1 DNA binding activity. SB203580 down-regulated the activity of p38MAPK pathway, but up-regulated EGR-1 expression. SB203580 significantly increased the level of cellular phosphorylated p53 protein, but decreased the p-gp protein level and MDR1 mRNA level in A2780/Taxol cells. There existed a close relationship between p38MAPK pathway and the paclitaxel resistance of ovarian carcinoma cells. The expression of EGR-1 mediated by p38MAPK pathway plays a critical role in paclitaxel resistance of ovarian carcinoma cells.

P16 GENE EXPRESSION IN OVARIAN EPITHELIAL CYSTADENOCARCINOMA

P16 gene expression was measured by immnohistochemical method in poor differentiated serous cystadenocarcinoma cell line, xenograft of highly metastasizing human ovarian carcinoma in nude mice and paramn embedded tissues from 69 patients with ovarian carcinoma. The result showed that P16 gene was positive expression in HO-8910 cell of mother line,HO8910PM cell line and xenograft of highly mcatstasizing human ovarian carcinoma in nude mice. However, P16gene in the metastatic cell had a weaker expression. P16gene positive expression were also found in sl cases of 69cases (73.9%) in the ovarian epithelial carcinoma paramn embedded tissues. Comparative studies showed that the positive rate of P16 gene expression markedly reduced with the increase of pathologic grade and clinical stage,metastasis in the lymph node and decrease of 5-year survival (P<0.05, p<0.01).P16 gene is not only a controller of cytokerastic cycle, but also a key member of tumorigenic suppresser:its absence and expression degree are also correlated with the ovarian carcinoma genesis and development,especially with the metastasis of the ovarian cancer.

Construction of Three-dimensional In Vitro Culture Model of Ovarian Carcinoma and the Study of Its Multicellular Drug Resistance

To explore the role and possible mechanism of apoptosis and caspase-3 activity in the development of multicellular drug resistance of ovary cancer. Ovarian cancer cell A2780 multicellular spheroids （MCS） were obtained from three-dimensional culture. Drug sensitivity of monolayer cells （MC） and MCS were respectively tested by MTT staining and cytometry. The apoptosis of MC and MCS were determined by the flow cytometry （FCM）. The expression of bcl-2 and caspase-3 in A2780/MC and A2780/MCS were detected by using Western blot and caspase-3 assay kit, A2780/MC was compacted into mass after 2 days in three-dimensional cell culture model, and MCS had more than two layers of cells growing within 5 days. Compared with A2780/MC, A2780/MCS were more resistant to the anticancer drug, and the apoptosis rate was significantly lower than those of A2780/MC, The activity of caspase-3 in A2780/MCS was significantly lower than the A2780/MC. But the expression of bcl-2 in A2780/MCS was significantly higher than that in A2780/MC. It was suggested that the drug resistance of MCS might be associated with the overexpression of anti-apoptosis protein bcl-2 and the down-regulation of caspase-3 activity.

ESTABLISHMENT OF INTRAPERITONEAL TRANSPLANTATION MODEL OF CISPLATIN-RESISTANT OVARIAN CARCINOMA CELL IN SCID MICE

Objective： to develop an intraperitoneal transplantation model of human ovarian carcinoma SKOV3/CDDP cell in severe combined immunodeficiency （SCID） mouse and to study its biologic characteristics. Methods： Sixteen qualified C.B 17/SCID mouse were divided into two groups randomly. Human ovarian carcinoma SKOV3 or SKOV3/CDDP cells were injected intraperitoneally into the SCID mouse at the amount of 1×10^7 cells （0.5 mL） per mouse. The behaviors of mice, tumor growth and morphology were analyzed. The expression of cancer antigen 125 （CA125）, GST-π and Topo-Ⅱ were examined by immunohistochemical method. Results： In this experimental study, transplanted tumors are formed in 100% SCID mice in the two groups. The morphology, growth pattern and CA125 secretion of SKOV3/CDDP group were as same as those of SKOV3 group. It shows that the tumors of the two groups kept the characteristics of ovaries serosity papillary adenocarcinoma. Compared with SKOV3 group, the expression of GST-π and Topo-Ⅱ gene in SKOV3/CDDP group were significantly higher （P〈0.05）. Conclusion： An intraperitoneal transplantation model of human ovarian carcinoma SKOV3/CDDP in SCID mice has been developed successfully. It may be an ideal animal model for biotherapy research of ovarian carcinoma as it can simulate the biological behavior of peritoneal metastasis of human ovarian carcinoma and the drug tolerance is maintained.

Three Weeks Carboplatin/Paclitaxel versus Weekly Regimen in Egyptian Women Cohort Treated for Ovarian Carcinoma

Introduction: Epithelial Ovarian Carcinoma (EOC) comprises the vast majority (almost 90%) of ovarian carcinomas. Chemotherapy is the main treatment in ovarian cancers. The standard of care in the chemotherapeutic is the combination of a platinum (carboplatin or cisplatin) and a taxane (paclitaxel or docetaxel). Studies were done to determine whether this combination to be given weekly or every 3 weeks. Patient and Method: Inclusion criteria: 1) Female patients between the ages of 17 - 78 years. 2) Baseline hematological, renal and liver laboratory profiles were within accepted ranges. 3) Performance status of the patients was 0-II. 4) Patients were pathologically proven ovarian cancer. 5) A follow-up period for at least 6 months was required. Exclusion criteria: 1) Patients who had double malignancy were excluded. 2) Performance status more than II. 3) Other comorbidity. Results: We reviewed 69 female patients with EOC, with 60% received every three weeks regimen. Mean age was 53.22 years. At a median follow up of 45.9 months, there was no significant different between the two protocols in terms of mean PFS, 62.35 months (95% CI: 50.08 - 74.63 months) for the three-weekly cohort, and 69.25 months (95% CI: 55.24 - 83.26 months) for weekly protocol (p = 0.613). The three weekly regimen patients had a higher incidence of hospital admission (40% vs 18.5% for the weekly protocol patients), but it didn’t reach a statistical significance (p = 0.063). The three weekly protocol had a significantly higher incidence of causing a neutropenic fever (p = 0.003). Conclusion: In our cohort of Egyptian women with EOC, no significant difference in PFS was found when compared the weekly Carboplatin/paclitaxel when compared to the classic three weeks, although the weekly protocol may be causing less febrile neutropenia and fewer hospital admissions.

RELATIONSHIP AMONG COX-2 PROTEIN EXPRESSION,PGs LEVELS AND BIOLOGIC BEHAVIOR IN OVARIAN CARCINOMA TISSUES

Objective: To study the relationship among cyclooxygenase-2 (COX-2) protein expression, prostaglandins levels and biologic behavior in ovarian carcinoma tissues. Methods: The expression of COX-2 protein, levels of prostaglandin (PG)E2, 6-keto-PGF1α and thromboxane (TX)B2 in 54 biopsy specimens from patients with ovarian serous tumors which included three groups: 33 samples of ovarian serous carcinoma; 10 samples of borderline ovarian serous tumors and 11 samples of benign ovarian serous tumors and 10 samples of normal ovarian tissues were detected by Western blot analysis and radioimmunoassay to investigate their clinical significance. Results: The expression of COX-2 protein (82%, 27/33) and its relative content (20.08±3.53) in ovarian serous carcinoma tissues were statistically higher than those in benign ovarian serous tumor tissues and normal ovary tissues i.e., 0 and (15.04±0.12), 0 and (15.33±0.60) (P<0.05). The expression of COX-2 protein in borderline ovarian serous tumor tissues (90%, 9/10) and relative content (20.61±3.03) were statistically greater than those in benign ovarian serous tumor and normal ovary tissues (P<0.05). The expression of COX-2 protein and its relative content showed no significant differences in ovarian carcinoma tissues of different clinical stages (I to II and III to IV), different histological grades, with or without ascites and lymph metastasis. The levels of PGE2, 6-keto-PGF1 and TXB2 α in ovarian serous carcinoma tissues were statistically higher than in borderline ovarian serous tumor, benign ovarian serous tumor or normal ovarian tissues (P<0.05). No significant differences of the levels were found among borderline tissues, benign tissues and normal ovarian tissues (P>0.05). The levels of PGE2, 6-keto-PGF1 α and TXB2 showed no significant differences in ovarian carcinoma tissues with different clinical stages (I to II and III to IV), different histological grades, with or without ascites and lymph metastasis. COX-2 expression was correlated with the levels of PGE2, 6-KETO-PGF1 α and TXB2 (P<0.01). Conclusion: Our data suggest that COX-2 overexpression leads to increased PGE2, 6-KETA-PGF1 α and TXB2 biosynthesis, which may be mechanisms underlying the contribution of COX-2 to the development of ovarian serous carcinoma. BGF2, 6-keto-PGF1 and TXB2 may be helpful parameters of α diagnosis and differentiate diagnosis in ovarian serous carcinoma.

Morphological and molecular basis of ovarian serous carcinoma

Serous carcinoma is the most common type of epithelial ovarian cancer. In this review, we provide a com- prehensive picture of ovarian serous cancers from multiple aspects： the first part of this review summarizes the morphological, histological, and immunological signatures of ovarian serous carcinoma; subsequently, we review the history of the evolvement of different grading systems used in ovarian serous cancer; in the end, we focus on characterizing the genetics that underlie the 2-tiered pathways through which ovarian serous cancers are believed to arise： the low-grade and the high-grade pathways.

IMMUNOLOGIC CHARACTER OF TUMOR INFILTRATING LYMPHOCYTES IN OVARIAN CARCINOMA

Objective: To study immunologic character of tumor-infiltrating lymphocytes (TIL) on postin vitro expansion in ovarian carcinoma, and evaluate the prospects by adopting TIL treatment of ovarian carcinoma at an advanced stage. Methods: Cellular phenotype changes in TIL were analyzed by flow cytometry. By means of molecular biology and immunologic methods, ability to secrete cytokines and anti-tumor activities of in TIL was studied. Results: Difference of cellular phenotypes in TIL was probably related to the type, feature and resource of the tumor. TIL obtained from phoroplast and parenchyma was dominant in CD3+CD4+. TIL obtained from tumor tissues, around microvessels and ascitic fluid was dominant in CD3+CD8 Concentration of rIL-2in vitro played a significant role in immunologic character of TIL. By means of rIL-2 expansionin vitro, TIL has apparently been improved in competence of secreting some cytokines, such as IL-2, TNF-α, IFN-γ, and anti-tumor activities. The activated TIL was more stimulated by further adding anti-CD3 or PHA (suitable concentration), which significantly increased its ability to secrete cytokines. Treatment with TIL+CTX or TIL+ rIL-2, could apparently improve phenotypes in peripheral blood of patients, with definitive effects. Conclusion: Immunologic activities of TILin vitro are apparently improved by rIL2 expansion. Regression of tumor, by means of infusion TIL, is not largely attributed to direct cytotoxicity to tumor cells, but indirectly and partly augmenting cellular activities and abilities of immunomodulation in patients with ovarian carcinoma being dependent on secreting multiple cytokines.

Epithelial ovarian carcinoma in women aged below 30 years

Objective:To study the manifestation,pathohistologic type,stage of disease,treatment andoutcome of epithelial ovarian carcinoma in women under the age of 30 years.Methods:The 21 cases of epithelial ovarian carcinoma in women aged below 30 years betweenJan,1986 and Mar,2002 were analyzed retrospectively.Results:The median age at the time of diagnosis was 24 years(range,16-29 years).All car-cinomas occurred after menarche.The most common symptoms were abdominal pain(50%),fol-lowed by tympanites(25%)and menstrual disorders(19%).The initial diagnosis was usuallymade by physical examination,ultrasonography and serum CA125.The mean maximal tumor di-ameter was 17.6 cm.Ten patients had Stage Ⅰ disease(5 Ⅰa,5 Ⅰc),five had Stage Ⅲ disease,andthe other six were unknown during staging operation.There were nine mucinous tumors,six se-rous tumors.Most tumors were well-differentiated and classified as Grade1 in 11 cases,Grade2 in2 cases,Grade3 in 2 cases,unknown in 6 cases.Optimal and suboptimal cytoreduction wasachieved in 14 patients in primary treatment and 5 in recurrent treatment.8 patients were treatedwith conservative surgery.18 patients were treated with chemotherapy and 7 patients had experi-enced six or more than six courses of chemotherapy.The median follow-up was 50 months(range,2-192 months).There were 6 deaths,2 alive with tumor,11 alive without the disease,2losing follow-up.The 3-year survival rate was 89%,and 5-year survival rate was 76%.Conclusion:Young patients with epithelial ovarian carcinoma appeared to have a less aggres-sive form of the disease and a more favorable prognosis.

Extremely rare case of successful treatment of metastatic ovarian undifferentiated carcinoma with high-dose combination cytotoxic chemotherapy: A case report

BACKGROUND Ovarian undifferentiated carcinomas are significantly rare and have an aggressive clinical course.Surgical resection is the only curative treatment in early-stage ovarian undifferentiated carcinomas that has a favorable prognosis.In case of recurrent and metastatic disease,palliative chemotherapy is the only available treatment.However,the effectiveness of standard chemotherapy regimen is not well-known,specifically in the case of extra-ovarian spread.We report an ovarian undifferentiated carcinoma of recurrent and inoperable advanced stage that was successfully treated with high-dose combination chemotherapy.CASE SUMMARY A 52-year-old woman presented with a 1-mo history of right lower quadrant and epigastric pain.A computed tomography(CT)scan of the abdomen revealed a multicystic mass with extensive internal necrosis of the right ovary without evidence of metastatic disease.A total hysterectomy with bilateral salpingooophorectomy and omentectomy was performed,but the surgery had a positive resection margin.Pathologically,it was diagnosed as ovarian undifferentiated carcinoma with sarcomatoid change.Although adjuvant chemotherapy was planned,it was delayed for 6 wk because of postoperative recovery,and the patient complained of abdominal pain.A CT scan and positron emission tomography-CT revealed a huge mass with multiple nodules in the pelvic cavity and para-aortic lymph node metastasis.Instead of standard therapy such as paclitaxel and platinum,combined chemotherapy with etoposide,ifosfamide,and cisplatin was administered.The patient experienced no recurrence for 5 years.CONCLUSION This is a case of metastatic ovarian undifferentiated carcinoma with sarcomatoid change that was successfully treated with high-dose combination cytotoxic chemotherapy.

Breast and Ovarian Carcinoma Overexpress HLA-G, a Neglected Cancer Immunosuppressive Protein

Purpose: HLA-G binds to the inhibitory receptors of uterine NK cells and plays an important role in protection of fetal cells from maternal NK lysis. HLA-G also mediates tumor escape, but the immunosuppressive role is often neglected. These studies have focused on the examination of HLA-G expression in human breast and ovarian carcinoma and HLA-G immunosuppressive role in NK cytolysis. Methods: We examined HLA-G expression in breast and ovarian carcinoma cell lines by real time PCR, ELISA and immunofluorescent staining, and in frozen breast and ovarian carcinoma tissues by immunohistochemistry (IHC). We treated the breast cancer cell lines with anti-human HLA-G antibody or progesterone. Then, NK cytolysis was measured by using MTT assay. Results: We find breast and ovarian cancer cell lines increase the expression of HLA-G mRNA and protein, compared to normal cells. IHC shows that 100% of frozen breast and ovarian carcinoma tissues overexpress HLA-G protein. HLA-G IHC scores of breast and ovarian carcinoma are significantly higher than normal breast and ovarian tissues, respectively (both p < 0.01). Blocking HLA-G of the breast cancer cells by the antibody increases NK cytolysis. Progesterone upregulates HLA-G mRNA and protein of human breast cancer cell lines. The increased HLA-G expression by progesterone suppresses the NK cytolysis. Conclusion: Human breast and ovarian carcinoma overexpress HLA-G immunosuppressive molecules. Blocking HLA-G protein by antibody improves the cytolysis of NK cells against human breast cancer cell lines. In contrast, upregulation of HLA-G expression by progesterone impairs NK cytolytic function. Thus, HLA-G is a new immune checkpoint protein and potential cancer immunotherapeutic target.

Feasibility of Complete Cytoreduction in Advanced Epithelial Ovarian Cancer

Objective: Complete resectability of all visualized tumor implants at debulking surgery for advanced epithelial ovarian cancer is confirmed to be the single most important prognostic factor. This study aims to develop preoperative predicting score based on clinical, biological, and radiological criteria of epithelial ovarian cancer to assess the feasibility of complete cytoreduction. Study Design: A retrospective record-based study. Patients and Methods: The study was conducted upon 50 consecutive patients managed for epithelial ovarian cancer with FIGO stage III. Patients’ data were collected from records of the Gyne-Oncology Clinic of El Shatby University Maternity Hospital affiliated to Alexandria University. Results: Many parameters were significantly associated with completeness of resectability in univariate analysis;including age, BMI, CA125, albumin, pre-albumin, PCI, mesenteric, and right copula of diaphragm affection by CT scan (p value < 0.05). A 100-point predictability score was developed, 10 for BMI ≥ 35 kg/m2, 25 points for Pre albumin < 14.5 mg/dl, 35 points for mesenteric affection, and 30 points for affection of Rt. copula of diaphragm. The overall accuracy of the score was 92%. Conclusion: In advanced ovarian cancer, pre-operative predicting score (including clinical, biological, and radiological criteria) can be used as a roadmap for prediction of feasibility of complete resectability. However, more research is needed on larger sample sizes.

Prognostic Significance of Fluorodeoxyglucose Positron Emission Tomography Maximum Standardized Uptake Value in Stage I Ovarian Clear Cell Carcinoma: A Retrospective Observational Study

Background: Ovarian clear cell carcinoma (CCC) is often diagnosed at stage I. However, because of the poor prognosis of recurrent cases, even for stage Ia CCC, treatment strategies such as expansion of fertility-sparing treatment and omission of adjuvant chemotherapy have been carefully discussed in recent years. We previously reported the possibility of the maximum standardized uptake value (SUVmax) as a biomarker of CCC prognosis prediction at all stages. In this study, we confirmed differences in SUVmax within stage I CCC and considered treatment strategies. Methods: We selected all 31 patients with ovarian CCC stage I who underwent fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) before treatment between 2006 and 2013 at our institution. This retrospective study was based on their medical records. Results: Clinical tumor stage was Ia in 13 patients, and Ic in 18 (Ic (b) in 11, and Ic (1) + Ic (2) in seven). There were no differences in serum CA125 level, maximum tumor diameter or mural nodules. Median SUVmax was significantly higher in stage Ic (5.87) than stage Ia (3.08) cases (P = 0.02). Progression-free survival was longer in the low SUVmax group than the high SUVmax group (P = 0.08). Conclusions: SUVmax for primary lesions in CCC was significantly higher in stage Ic than stage Ia. As SUVmax represents a prognostic factor in stage I CCC, these findings may suggest SUVmax as an indicator for the application of fertility-sparing surgery and omission of adjuvant chemotherapy for stage Ia CCC.

In Front of Bilateral Pseudo Tumoral Ovarian Mass: Think about Tuberculosis

Ovarian and peritoneal localizations of tuberculosis are rare. They raise the problem of differential diagnosis with malignancy. In this regard, we reported the case of a 25-year-old woman who presented with bilateral pseudo tumoral ovarian mass mimicking an advanced ovarian carcinoma with ascites. Extemporaneous examination of the peritoneum confirmed the diagnosis of tuberculosis and avoided bilateral annexectomy that could compromise the fertility of the patient.

C-kit:PDGFRα的表达与卵巢浆液性癌顺铂耐药的临床研究(英文)

Objective:To investigate the expression of C-Kit and PDGFRα and their correlation with chemotherapy resis-tance in ovarian serous carcinoma.Methods:We undertook SP immunohistochemical technique to examine the expression of C-Kit and PDGFRα in 59 cases with ovarian serous carcinomas,using archival paraffin-embedded specimens.Then we observed the correlation with chemotherapy resistance.Results:C-Kit and PDGFRα immunostainings were observed posi-tively expressed in 57.63% and 66.10% cases.C-Kit expression was statistically correlated with the progression of disease after first-line chemotherapy(P < 0.05),but PDGFRα was not statistically significant(P > 0.05).There were great difference between of C-Kit and PDGFRα expressions in samples of different differentiated and clinical stages of ovarian serous carci-nomas(P < 0.01 or P < 0.05).Conclusion:C-Kit is statistically correlated with chemotherapy resistance,while PDGFRα is not correlated.

POSTMENOPAUSAL PALPABLE OVARY SYMDROME:A RETROSPECTIVE SURVEY

Objective: A retrospective study of the postmenopausal palpable ovary (PMPO) on their incidence, characteristics of masses and treatment selected were carried out. Methods: 97 postmenopausal women over age 50 with ovarian masses diagnosed by the manual pelvic palpation were analyzed. The age, size and characteristics of tumor, symptoms, as well as pathological findings and treatment were discussed. Results: 86.6% of cases had tumor masses, and 13.4% were physiological in nature. 23.7% of the masses were malignant. 72 patients (74.2%) visited doctors because of existing symptoms. Among them 82.5% cases had the masses discovered by manual pelvic examination, and 91.3% found by abdominal ultrasound screening. Transvaginal sonography can diagnose all the palpable masses. Conclusion: All PMPO patients should be operated as soon as diagnosis is established.