Management of retroperitoneal high-grade serous carcinoma of unknown origin:A case report

BACKGROUND Retroperitoneal high-grade serous carcinoma(HGSC)of unknown origin is a sporadic tumor that can originate from ovarian cancer.Herein,we report the case of a woman with retroperitoneal HGSC of unknown origin and describe how she was diagnosed and treated.CASE SUMMARY A 71-year-old female presented with the tumor marker CA125 elevated to 1041.9 U/mL upon a regular health examination.Computed tomography revealed retroperitoneal lymph node enlargement.Subsequently,positron emission tomography scanning revealed lesions with increased F-18 fluorodeoxyglucose uptake at the nodes.As a result,she underwent laparoscopic lymph node resection,and pathology revealed metastatic adenocarcinoma with CK7(+),PAX8(+),WT1(+),PR(-),and p53 mutational loss of expression,indicating that the origin may be from the adnexa.The patient was admitted to our ward and underwent laparoscopic staging;however,the pathological results were negative.Under the suspicion of retroperitoneal HGSC of unknown origin,chemotherapy and targeted therapy were initiated.Tumor marker levels decreased after treatment.CONCLUSION We present a case of HGSC of unknown origin managed using retroperitoneal lymphadenectomy,staging surgery,chemotherapy,and targeted therapy.

High-grade serous carcinoma of the fallopian tube in a young woman with chromosomal 4q abnormality:A case report

BACKGROUND Few studies have reported an association between an increased risk of acquiring cancers and survival in patients with 4q deletion syndrome.This study presents a rare association between chromosome 4q abnormalities and fallopian tube highgrade serous carcinoma(HGSC)in a young woman.CASE SUMMARY A 35-year-old woman presented with acute dull abdominal pain and a known chromosomal abnormality involving 4q13.3 duplication and 4q23q24 deletion.Upon arrival at the emergency room,her abdomen appeared ovoid and distended with palpable shifting dullness.Ascites were identified through abdominal ultrasound,and computed tomography revealed an omentum cake and an enlarged bilateral adnexa.Blood tests showed elevated CA-125 levels.Paracentesis was conducted,and immunohistochemistry indicated that the cancer cells favored an ovarian origin,making us suspect ovarian cancer.The patient underwent debulking surgery,which led to a diagnosis of stage IIIC HGSC of the fallopian tube.Subsequently,the patient received adjuvant chemotherapy with carboplatin and paclitaxel,resulting in stable current condition.CONCLUSION This study demonstrates a rare correlation between a chromosome 4q abnormality and HGSC.UBE2D3 may affect crucial cancer-related pathways,including P53,BRCA,cyclin D,and tyrosine kinase receptors,thereby possibly contributing to cancer development.In addition,ADH1 and DDIT4 may be potential influencers of both carcinogenic and therapeutic responses.

High-grade pancreatic intraepithelial neoplasia diagnosed based on changes in magnetic resonance cholangiopancreatography findings:A case report

BACKGROUND High-grade pancreatic intraepithelial neoplasia(PanIN)exhibits no mass and is not detected by any examination modalities.However,it can be diagnosed by pancreatic juice cytology from indirect findings.Most previous cases were diagnosed based on findings of a focal stricture of the main pancreatic duct(MPD)and caudal MPD dilatation and subsequent pancreatic juice cytology using endoscopic retrograde cholangiopancreatography(ERCP).We experienced a case of high-grade PanIN with an unclear MPD over a 20-mm range,but without caudal MPD dilatation on magnetic resonance cholangiopancreatography(MRCP).CASE SUMMARY A 60-year-old female patient underwent computed tomography for a follow-up of uterine cancer post-excision,which revealed pancreatic cysts.MRCP revealed an unclear MPD of the pancreatic body at a 20-mm length without caudal MPD dilatation.Thus,course observation was performed.After 24 mo,MRCP revealed an increased caudal MPD caliber and a larger pancreatic cyst.We performed ERCP and detected atypical cells suspected of adenocarcinoma by serial pancreatic juice aspiration cytology examination.We performed a distal pancreatectomy and obtained a histopathological diagnosis of high-grade PanIN.Pancreatic parenchyma invasion was not observed,and curative resection was achieved.CONCLUSION High-grade Pan-IN may cause MPD narrowing in a long range without caudal MPD dilatation.

Comparison of biological behavior of lacrimal gland adenoid cystic carcinoma with high-grade transformation cells

AIM:To evaluate the differences between human lacrimal gland adenoid cystic carcinoma with high-grade transformation(LACC-HGT)primar y cells cultured by high-grade transformation tissue and non-high-grade transformation(non-HGT)primary cells cultured by non-highgrade transformation tissue in proliferation,metastasis,drug susceptibility,and genes.METHODS:LACC-HGT primary cells were established by tissue block culture,and the 4^(th)to 10^(th)generation primary cells were selected as research objects.The cells were preliminarily identified by immunofluorescent staining.The differences between non-HGT and LACC-HGT primary cells in terms of proliferation,metastasis,and drug susceptibility were compared by cell counting kit-8(CCK-8)assay,wound healing,and drug sensitivity experiments.Differentially expressed genes were screened using mRNA array.Gene expression was analyzed using real-time quantitative polymerase chain reaction(RT-qPCR).RESULTS:LACC-HGT primary cells were successfully cultured by tissue block culture.Immunofluorescence staining results showed that cytokeratin(CK)and CK7 expression levels were positive in LACC-HGT primary cells.CCK-8 results showed that the proliferation ability of LACCHGT cells was significantly higher than that of non-HGT cells.Wound healing experiment showed that the migration ability of LACC-HGT cells was significantly higher than that of non-HGT cells.LACC-HGT cells were also less sensitive to cisplatin and paclitaxel than non-HGT cells.Compared with non-HGT cells,9566 differentially expressed genes were found in LACC-HGT primary cells,of which 5162 were upregulated and 4404 were down-regulated.The expression of N-acetylneuraminate pyruvate lyase(NPL),MARVEL domain containing 3(MARVELD3),syntabulin(SYBU),and allograft inflammatory factor 1(AIF1)was higher in LACCHGT cells than in non-HGT cells,whereas that of periostin(POSTN)was lower.CONCLUSION:LACC-HGT primary cells have faster proliferation,stronger migration ability,and poorer sensitivity to chemotherapy drugs than non-HGT primary cells.The expression of mRNAs in non-HGT and LACC-HGT primary cells are significantly different.These features are speculated to be the reasons why high-grade transformation tissues exhibit higher malignant degree and poorer prognosis than their counterparts.

A Case Report: High-Grade Urothelial Carcinoma in the Renal Pelvis with Complete Kidney and Ureter Duplication Featuring Heterologous Differentiation

This report describes a considerably rare case of high-grade urothelial carcinoma of the renal pelvis and ureter,presenting with heterologous differentiation,in a patient with bilateral duplicated kidneys.A 73-year-old male experienced intermittent gross hematuria for 5 months,accompanied by lower back and abdominal pain.Ultrasound and computed tomography scans revealed bilateral renal and ureteral duplication with multiple tumors in the left renal pelvis.A total nephroterectomy and bladder cuff resection were performed on the left two nephrons.Multiple space-occupying lesions were identified in the left renal pelvis and ureter.Histopathological examination showed poorly differentiated and diverse tumor cells,manifesting as sarcomatoid carcinoma,papillary adenocarcinoma,and infiltrating high-grade urothelial carcinoma.The tumor infiltrated the subcutaneous fibrous connective tissue of the renal pelvis and the full thickness of the ureter.Given the rarity of recurrent renal urothelial carcinoma with heterogeneous differentiation,comprehensive imaging and pathological assessments are vital to delineate the nature of the lesion and the direction of tissue pathological heterologous differentiation.These evaluations guide early radical surgical interventions,improving survival rates.

Incidental Serous Tubal Intraepithelial Carcinoma Detected by a Surgery for Ectopic Pregnancy

Serous tubal intraepithelial carcinoma is a putative precursor of high-grade serous carcinoma, which is the most common histological type of ovarian or pelvic peritoneal cancer. Serous tubal intraepithelial carcinoma is commonly found in patients with breast cancer susceptibility gene mutations who undergo risk-reducing salpingo-oophorectomy. Incidental serous tubal intraepithelial carcinoma found by a non-prophylactic surgery is rare. A 33-year-old woman referred to our hospital for a diagnosis of ectopic pregnancy. She underwent a laparoscopic right salpingectomy. Pathologically, ectopic pregnancy in the ampulla of the right fallopian tube was confirmed and serous tubal intraepithelial carcinoma was observed in the fallopian tube. Subsequently, she underwent a laparoscopic hysterectomy, bilateral oophorectomy, and left salpingectomy as additional treatment. She has experienced no recurrence thus far for 37 months since the surgery.

Papillary serous carcinoma of the uterine cervix:a clinicopathological analysis of 4 cases and a literature review

Objective To investigate the clinicopathological characteristics and clinical treatment outcomes of patients with papillary serous carcinoma of the uterine cervix(PSCC).Methods In this study, 4 patients with histologically confirmed papillary serous carcinoma of the uterine cervix were retrospectively investigated. Pap smears, human papillomavirus(HPV) screening, tumor marker status, biopsy analysis, and relevant imaging examinations were conducted for the confirmation of primary diagnosis and recurrence. Patients underwent surgery, chemotherapy, or radiotherapy, and survival were the main endpoint.Results The 4 patients were diagnosed with IB1, IB1, IIA, or IIIB disease. Two patients(2/4) presented with recurrence within 18 months after primary therapy. Compared with chemotherapy alone(progressionfree survival(PFS): 11 months), radiotherapy combined with adjuvant chemotherapy showed favorable PFS rates(PFS: 20, 36, 13 months in 3 cases), although valid statistical analysis was not feasible because of the small sample size. The 5-year survival rate was 0%, and the 3-year survival rate was 75%. Our data, in agreement with the literature evidence, showed that the number of moderate-risk and high-risk factors in patients diagnosed with PSCC at an early stage was higher than that in patients diagnosed with common adenocarcinoma/squamous carcinoma of the uterine cervix.Conclusion PSCC has a poor clinical prognosis, and compared with chemotherapy alone, radiotherapy combined with adjuvant chemotherapy may lead to improved PFS.

Esophageal resection for high-grade dysplasia and intramucosal carcinoma: When and how?

High-grade dysplasia (HGD) and intramucosal carcinoma (IMC) in the setting of Barrett’s esophagus have traditionally been treated with esophagectomy. However, with the advent of endoscopic mucosal resection and endoscopic ablative therapies, endoscopic therapy at centers with expertise is now an established treatment of Barrett’s-esophagus-related neoplasia, including HGD and IMC. Esophagectomy is today reserved for more selected cases with submucosal invasion, evidence for lymph node metastasis, or unsuccessful endoscopic therapy.

Uterine papillary serous carcinoma: Its clinical and fundamental studyUterine papillary serous carcinoma: Its clinical and fundamental study

Uterine papillary serous carcinoma(UPSC) was established as a distinct type of endometrial carcinoma by Lauchlan in 1981 and Hendrickson et al in 1982, and ac- counted for 1 % - 10% of endometrial cancers. The occurrencer of papillary patterns of en- dometrial adenocarcinoma had been reportedly recognized since 1900, while until the late 1970s several authors have had described a variant of papillary endometrial cancer. UPSC is a morphologically unique variant of endometrial carcinoma that is pathologically defined by the presence of high nuclear grade, distinct papillary architechtural changes, psammoma bodies, and extensive lymph - vascular space invasion. CA125 is often mentioned a useful tumor marker either for diagnosis before starting treatment or in monitoring recurrence. The optimal treatment of UPSC is controversial and appears to be dependent upon the stage of the disease. Primary surgery comprised of TAH/BSO and complete staging is the mainstay of treatment. The patients with recurrent UPSC in many studies were treated with various combinations of surgery , radiation therapy, and chemotherapy. The molecular basis for the gneeral poor response of UPSC to adjuvant chemotherapy and radiotherapy is not well under- stood. UPSC tumors are more often aneuploid and contain overexpressed mutant p53 protein as compared to endometrioid adenocarcinoma. Unlike patients with adenocarcinoma of the endometrium, women with UPSC were less likely to be obese, hypertensive, or diabetic.

Rescue of p53 functions by in vitro-transcribed mRNA impedes the growth of high-grade serous ovarian cancer

Background:The cellular tumor protein p53(TP53)is a tumor suppressor gene that is frequently mutated in human cancers.Among various cancer types,the very aggressive high-grade serous ovarian carcinoma(HGSOC)exhibits the high-est prevalence of TP53 mutations,present in>96%of cases.Despite intensive efforts to reactivate p53,no clinical drug has been approved to rescue p53 func-tion.In this study,our primary objective was to administer in vitro-transcribed(IVT)wild-type(WT)p53-mRNA to HGSOC cell lines,primary cells,and ortho-topic mouse models,with the aim of exploring its impact on inhibiting tumor growth and dissemination,both in vitro and in vivo.Methods:To restore the activity of p53,WT p53 was exogenously expressed in HGSOC cell lines using a mammalian vector system.Moreover,IVT WT p53 mRNA was delivered into different HGSOC model systems(primary cells and patient-derived organoids)using liposomes and studied for proliferation,cell cycle progression,apoptosis,colony formation,and chromosomal instabil-ity.Transcriptomic alterations induced by p53 mRNA were analyzed using RNA sequencing in OVCAR-8 and primary HGSOC cells,followed by ingenuity path-way analysis.In vivo effects on tumor growth and metastasis were studied using orthotopic xenografts and metastatic intraperitoneal mouse models.Results:Reactivation of the TP53 tumor suppressor gene was explored in differ-ent HGSOC model systems using newly designed IVT mRNA-based methods.The introduction of WT p53 mRNA triggered dose-dependent apoptosis,cell cycle arrest,and potent long-lasting inhibition of HGSOC cell proliferation.Transcriptome analysis of OVCAR-8 cells upon mRNA-based p53 reactivation revealed significant alterations in gene expression related to p53 signaling,such as apoptosis,cell cycle regulation,and DNA damage.Restoring p53 function concurrently reduces chromosomal instability within the HGSOC cells,under-scoring its crucial contribution in safeguarding genomic integrity by moderating the baseline occurrence of double-strand breaks arising from replication stress.Furthermore,in various mouse models,treatment with p53 mRNA reduced tumor growth and inhibited tumor cell dissemination in the peritoneal cavity in a dose-dependent manner.Conclusions:The IVT mRNA-based reactivation of p53 holds promise as a potential therapeutic strategy for HGSOC,providing valuable insights into the molecular mechanisms underlying p53 function and its relevance in ovarian cancer treatment.

Coexistence of tuberculous peritonitis and primary papillary serous carcinoma of the peritoneum:A case report and review of the literature

A major diagnostic challenge to the evaluation of an incomplete intestinal obstruction is to distinguish between infectious and malignant etiologies.We present a case of an elderly woman complaining of abdominal pain accompanied with nausea and vomiting,and failure to pass gas or stools.Anti-tuberculosis drugs were used to relieve her abdominal pain,and a needle biopsy of the peritoneal cavity showed evidence of primary papillary serous carcinoma of the peritoneum(PSCP). This is a rare description of tuberculosis in the setting of PSCP.This report illustrates the potential complex nature of malignancies,and emphasizes the need to consider coexistence of malignancy and infection in patients, especially in those with risk factors for malignancy who fail with antibiotic therapy.

Clinical Significance of Serum Galectin-1 and Its Tissue Immunohistochemical Expression in Serous Ovarian Carcinoma Patients

Objectives: Serous ovarian carcinoma (SOC) is the commonest ovarian carcinoma type with poor prognosis due to early metastasis and first presentation with advanced stage. In this work, we investigated serum level of Galactin-1 (Gal-1) and its tissue immunohistochemical expression in SOC patients at different stages trying to find out its significance as a diagnostic and prognostic marker. Patients and methods: The study included 95 females I-Control group: Twenty five healthy females;II-Patients group: Seventy females diagnosed as SOC at different stages;Stage I: 8 cases, Stage II: 12 cases, Stage III: 32 cases and Stage VI:18 cases. Serum Galectin-1 and CA-125 were measured by ELIZA and tissue Galectin-1 was assessed by immunohistochemistry. All patients were followed for up to 3 years after surgery. Results: Serum Gal-1 and CA-125 levels were significantly higehr in SOC patients compared to controls (p 0.001). We found a direct positive statistically significant correlation between serum Gal-1 and CA125 levels (p 0.001). Serum Gal-1 at cut off value > 135 ng/ml was superior to CA-125 a cut off value > 49 u/ml with sensitivity, specificity of 100%, vs 88.57, 96% for CA-125. Serum Gal-1 was significantly associated with tumor stage (p 0.001). Immunohistochemistry showed that patients with strong Gal-1 expression had higher serum level (p = 0.002). Stromal and tumor Gal-1 expression were significantly correlated with tumor grade (p 0.001) and stage (p = 0.001). Serum Gal-1, CA-125 and IHC Gal-1 expression were associated with poor survival (p 0.001, p = 0.009 and p = 0.002) respectively. Conclusion: Serum Gal-1 and its tissue IHC expression are useful diagnostic and prognostic markers for SOC patients.

A Case of Serous Tubal Intraepithelial Carcinoma Diagnosed by Cytology during the Operation

We experienced a case of serous tubal intraepithelial carcinoma (STIC), which is the earliest morphologically recognizable precursor of pelvic high grade serous carcinoma, diagnosed by cytology during the operation. A 48-year-old Japanese woman visited to our department because of abnormal cytological result and the left adnexal mass on female cancer screening. Pre-operatively, she was diagnosed as cervical intraepithelial neoplasia (CIN) 3, adenomyosis, and the left adnexal cystic lesion with papillary growth. At laparotomy, the left adnexal tumor turned out to be cystic fallopian tube with small papillary growth on the inner surface, but abnormal findings were not present on bilateral ovaries. The cytology of the imprint smears from the papillary projection and ascitic fluid showed positive, suggesting serous adenocarcinoma. Histopathological examination of the lesion revealed the left fallopian tube lesion was STIC with immunohistochemically positive reactivity against p53. No metastases including disseminated lesions were noted. The patient received four courses of systemic chemotherapy, and had no recurrent signs 10 months after the operation.

Characterization of candidate factors associated with the metastasis and progression of high-grade serous ovarian cancer

Background:High-grade serous ovarian cancer(HGSOC)is the biggest cause of gynecological cancer-related mortality because of its extremely metastatic nature.This study aimed to explore and evaluate the characteristics of candidate factors associated with the metastasis and progression of HGSOC.Methods:Transcriptomic data of HGSOC patients’samples collected from primary tumors and matched omental metastatic tumors were obtained from three independent studies in the National Center for Biotechnology Information(NCBI)Gene Expression Omnibus(GEO)database.Differentially expressed genes(DEGs)were selected to evaluate the effects on the prognosis and progression of ovarian cancer using data from The Cancer Genome Atlas(TCGA)database.Hub genes’immune landscapes were estimated by the Tumor Immune Estimation Resource(TIMER)database.Finally,using 25 HGSOC patients'cancer tissues and 10 normal fallopian tube tissues,immunohistochemistry(IHC)was performed to quantify the expression levels of hub genes associated with International Federation of Gynecology and Obstetrics(FIGO)stages.Results:Fourteen DEGs,ADIPOQ,ALPK2,BARX1,CD37,CNR2,COL5A3,FABP4,FAP,GPR68,ITGBL1,MOXD1,PODNL1,SFRP2,and TRAF3IP3,were upregulated in metastatic tumors in every database while CADPS,GATA4,STAR,and TSPAN8 were downregulated.ALPK2,FAP,SFRP2,GATA4,STAR,and TSPAN8 were selected as hub genes significantly associated with survival and recurrence.All hub genes were correlated with tumor microenvironment infiltration,especially cancer-associated fibroblasts and natural killer(NK)cells.Furthermore,the expression of FAP and SFRP2 was positively correlated with the International Federation of Gynecology and Obstetrics(FIGO)stage,and their increased protein expression levels in metastatic samples compared with primary tumor samples and normal tissues were confirmed by IHC(P=0.0002 and P=0.0001,respectively).Conclusions:This study describes screening for DEGs in HGSOC primary tumors and matched metastasis tumors using integrated bioinformatics analyses.We identified six hub genes that were correlated with the progression of HGSOC,particularly FAP and SFRP2,which might provide effective targets to predict prognosis and provide novel insights into individual therapeutic strategies for HGSOC.

朊蛋白与p53突变在卵巢浆液性癌组织中表达的相关性及预后意义

目的:探讨卵巢浆液性癌组织中朊蛋白表达水平及其与p53突变的相关性。方法:选取2012年11月10日至2019年10月30日北京大学第三医院妇产科收治的Ⅰ~Ⅳ期卵巢浆液性癌139例,同时选取20例正常卵巢组织、20例卵巢良性肿瘤组织作为对照。免疫组化、p53突变测序法检测朊蛋白表达水平及p53突变类型。结果:朊蛋白在卵巢浆液性癌组织中阳性表达率明显高于卵巢良性肿瘤组织和正常卵巢组织,差异均有统计学意义(59%vs 30%、20%,P分别为0.034、0.003)。卵巢浆液性癌中p53突变率高达84.89%(118/139),主要位于第5外显子(29.66%,35/118)以及DNA结合域的热点突变位点(50.84%,60/118);朊蛋白高表达组中p53构象突变率为71.93%(41/57),显著高于朊蛋白低表达组(45.90%,28/61),差异有统计学意义(P=0.004)。p53构象突变与卵巢浆液性癌淋巴结转移(P=0.005)及耐药(P=0.009)密切相关。p53构象突变患者的平均疾病无进展生存期[(34.99±2.72)月vs(43.01±2.35)月,P=0.036]及平均总生存期[(47.94±3.40)月vs(56.00±2.89)月,P=0.049]均低于p53接触突变患者。结论:卵巢浆液性癌组织中朊蛋白呈高表达,并与p53构象突变相关。p53构象突变与卵巢浆液性癌不良预后相关。

MCM5在卵巢癌中的作用及机制分析

目的探讨MCM5在卵巢癌中的表达、作用机制和临床意义。方法利用GEO、TCGA等数据库分析MCM5 mRNA在卵巢癌中的表达与预后关系;采用免疫组化SP两步法染色分析卵巢癌中MCM5的表达;应用CCK-8法、EDU、平板克隆、Transwell小室和流式细胞术检测MCM5对细胞增殖、迁移侵袭和凋亡的影响。结果生物信息学分析发现MCM5在卵巢癌中mRNA水平明显升高,且高表达者无进展生存期短(P<0.01)。免疫表型:MCM5在输卵管上皮中不表达(0/6),在卵巢癌中阳性率为48.3%(57/118),MCM5在卵巢癌中的表达显著高于输卵管上皮,在高级别浆液性癌中呈弥漫强表达,MCM5^(+)与ER-、Ki67增殖指数高相关。敲低MCM5的表达,抑制卵巢癌细胞增殖(P<0.05)、克隆形成(P<0.05)、侵袭和迁移(P<0.05),促进凋亡。结论MCM5在卵巢癌细胞和组织中表达升高,与预后不良相关,有望成为治疗卵巢癌的新靶标。

卵巢浆液性癌中miR-182和E-cadherin的表达及意义

目的检测卵巢浆液性癌中微小RNA-182(microRNA-182,miR-182)和上皮型粘附素(E-cadherin)的表达,探讨其相关性及临床意义。方法选择行卵巢浆液性癌根治性手术的患者59例作为研究组,选择行手术治疗的卵巢浆液性囊腺瘤患者59例作为对照组,应用实时荧光定量PCR法检测组织中miR-182的表达,应用免疫组化法检测组织E-cadherin的表达。结果研究组中miR-182的表达量(1.83±0.32)明显高于对照组(1.31±0.31)(t=4.59,P=0.012),研究组中E-cadherin表达阳性率(47.46%)明显低于对照组(84.75%)(X~2=18.31,P=0.000)。miR-182和E-cadherin在卵巢浆液性癌不同级别(2.01±0.29 vs.1.66±0.22)(27.59%vs.66.67%)、不同肿瘤最大径(1.93±0.22 vs.1.64±0.39)(28.21%vs.85.00%)及有无脉管癌栓(1.80±0.15 vs.2.03±0.20)(20.00%vs.53.06%)的比较中差异有统计学意义(P<0.05),而在不同年龄、有无淋巴结转移分组的比较中差别无统计学意义(P>0.05)。线性相关分析显示研究组中miR-182与E-cadherin呈负相关性(r=-0.57,P=0.008)。生存分析显示miR-182的表达与患者生存时间有关(P<0.05)。结论miR-182和E-cadherin在卵巢浆液性癌中异常表达且具有相关性,组织中miR-182高表达提示不良预后。

血清CA125和HE4的动态变化在预测卵巢高级别浆液性腺癌无进展生存期方面的价值研究

目的:研究血清糖类抗原125(carbohydrate antigen 125,CA125)和人附睾蛋白4(human epididymal protein 4,HE4)在术前以及术后化疗过程中的动态变化与卵巢癌患者无进展生存期(progression-free survival,PFS)及铂敏感性之间的关系。方法:回顾性分析上海交通大学医学院附属第一人民医院妇科肿瘤病房收治的经过规范化治疗的卵巢癌患者术前、术后化疗前,以及化疗中至少2次血清CA125及HE4水平,并收集对铂类药物敏感性、PFS等数据。主要统计学方法包括卡方检验、t检验、方差分析和Logistic回归分析及Cox比例风险回归分析等。结果:对117例卵巢高级别浆液性腺癌患者的分析结果提示,CA125和HE4阳性与肿瘤较高期别、多腹水量、不满意减灭、腹水细胞学阳性相关。通过Cox回归分析验证得出CA125和HE4均是预后的危险因素(OR=4.29,P=0.010;OR=1.77,P=0.049)。CA125、HE4均阳性患者组与仅CA125阳性的患者组比较,预后差异无统计学意义(P>0.05)。根据公式t_(1/2)=t_(1)/[2×lg(c_(1)/c_(2))]计算CA125和HE4半衰期,截取术前CA125和HE4、术后CA125和HE4最低值、CA125和HE4半衰期的最优cut-off值,分别为436 U/L和400 pmol/L、12 U/L和35 pmol/L、21 d和25 d,预后分析提示除了HE4最低值与预后无关,其余均和预后相关,其中CA125半衰期>21 d的HR值最高为3.28,中位PFS下降57.5%(P<0.001)。通过绘制受试者工作特征曲线计算曲线下面积(area under the curve,AUC),CA125半衰期>21 d(AUC=0.76)、CA125最低值>12 U/L(AUC=0.70)及第3程化疗后CA125未回归正常(AUC=0.71)这3项指标对于预测存在3年内复发有一定的临床价值,其灵敏度分别为71.8%、68.3%、68.2%,特异度分别为79.6%、71.7%、72.6%。结论:CA125半衰期、CA125化疗过程中最低值、第3程化疗后CA125未回归正常及6项指标中≥2项阳性这4个指标对于预测存在3年内复发有一定的临床价值,而对于预测铂敏感性的价值有待进一步探索。

Primary ovarian cancer combined with primary fallopian tube cancer:A case report

BACKGROUND Low grade serous carcinoma of the ovary(LGSOC)is a rare type of epithelial ovarian cancer with a low incidence rate.The origin of ovarian cancer has always been a hot topic in gynecological oncology research,and some scholars believe that the origin of ovarian malignant tumors is the fallopian tubes.Primary fallopian tube cancer is the lowest incidence of malignant tumors in the female reproductive system.There are only a few reports in the literature,but the mortality rate is very high.But in clinical practice,fallopian tube cancer is very common,but in most cases,it is classified as ovarian cancer.CASE SUMMARY We report a 54 years old postmenopausal woman who was hospitalized with a lower abdominal mass and underwent surgical treatment.The final pathological confirmation was low-grade serous carcinoma of the right ovary and low-grade serous carcinoma of the left fallopian tube.No special treatment was performed after the surgery,and the patient was instructed to undergo regular follow-up without any signs of disease progression.CONCLUSION The prognosis of LGSOC is relatively good,over 80%of patients still experience disease recurrence.

长链非编码RNA LINC00641调控卵巢浆液性癌细胞增殖的探究

目的探讨长链非编码RNA LINC00641(long noncoding RNA LINC00641,LINC00641)在卵巢浆液性癌中的表达,探讨其对细胞增殖的调控作用。方法应用GEPIA数据库预测LINC00641在卵巢癌中表达的趋势。选择57例卵巢浆液性癌组织作为观察组,选择57卵巢浆液性囊腺瘤组织作为对照组,应用实时荧光定量PCR(quantitative real time PCR,qRT-PCR)法检测LINC00641的表达,应用免疫组化法检测Ki67的表达。选择人卵巢浆液性癌SKOV3细胞系和人卵巢表面上皮细胞HOSEpiC细胞系,应用qRT-PCR检测LINC00641的表达,转染过表达LINC00641质粒建立SKOV3细胞的OE-LINC00641组,并设立未行任何转染的空白对照组(NC)。应用CCK-8检测细胞增殖活性。结果GEPIA数据库显示LINC00641在卵巢癌中的表达有下调趋势(P<0.05)。组织学实验显示卵巢浆液性癌组织中LINC00641的表达量(1.325±0.115)明显低于对照组(1.665±0.147)(t=6.24,P<0.05),LINC00641在不同病变分级(1.31±0.11 vs 1.43±0.09)和肿瘤最大径(1.25±0.11 vs 1.36±0.10)的比较中差异有统计学意义(P<0.05),卵巢浆液性癌中LINC00641和Ki67增殖指数具有负相关性(P<0.05)。体外细胞培养实验显示SKOV3中LINC00641的表达量(1.33±0.13)明显低于HOSEpiC(1.89±0.24)(P<0.05)。OE-LINC00641组细胞增殖活性明显低于NC组(P<0.05)。结论LINC00641在卵巢浆液性癌中低表达,对肿瘤细胞增殖有抑制作用。