Accuracy of Intraoperative Frozen Section in the Diagnosis of Ovarian Neoplasms

Objective: The aim of the work is to evaluate the accuracy of intraoperative frozen section in the diagnosis of ovarian neoplasms in Zagazig University. Design: A prospective cross sectional cohort study. Method: This study was performed between March 2011 and March 2012, on 50 patients presented with ovarian mass. Gross examination of the tumor removed was done by inspection and palpation. The specimen was then cut with a sharp knife into two halves. The most appropriate area thought to be representative of lesion was chosen. The number of sections frozen was depended on the type and size of the tumor. Seven to eight μm sections were obtained and stained with hematoxylin-eosin. The specimens were then fixed in formalin. Paraffin blocks of the sections were processed in the routine way and sections were stained with hematoxylin and eosin (H and E). The diagnosis obtained by intraoperative frozen section based on cellularity and cell morphology was compared with final histopathological diagnosis in terms of diagnostic sensitivity, to differentiate between benign and malignant lesions. Assessment of the overall accuracy of the intraoperative diagnosis was classified as concordant or discordant. Results: There was no statisticaly significant differencre in the studied patients as regard the clinical data, macroscopic and intraoperative picture, while there was statisticaly significat association as regard the laterality of the ovarian masses. The validity of frozen section in the diagnosis of benign tumour was 100% with 100% accuracy, specificity, positive predictive value, negative predictive value, while sensitivity & negative prediction for borderline tumour and specificity & positive prediction of malignant tumour were 100%, specifecity for borderline tumours was 95% while the positive predictive value was 33.3% with 96% accuracy for both malignant and borderline tumours. Conclusion: Intraoperative frozen section is accurate for rapid diagnosis of ovarian tumors. It can help surgeons avoid under-treatment or overtreatment of patients. Our study was designed prospectively using a small number of patients. The door is open to larger studies using a larger number of patients to be performed in order to substantiate our results.

The diagnostic value of multiple tumor markers in malignantovarian neoplasms

Objective:To study the diagnostic value of multiple tumor markers in malignant ovarian neoplasm.Methods:Sera obtained from 430 patients with ovarian masses (110 cases were malignant ovarian tumors,320 cases were benign ovarian tumors) before operation,and from 50 healthy women as control.Serologic examination of tumor markers included CA125,TSGF,SA,CEA,AFP,HCG and Fer.Results:The serum levels of CA125,TSGF,SA and Fer in patients with ovarian cancer were higher than those in patients with benign ovarian tumors (P<0.05),also in control group (P<0.05).In the diagnostic value of application for malignant ovarian neoplasm,CA125,TSGF and SA were better than the others.The sensitivity,specificity and accuracy in diagnosis of ovarian cancer were 86.4%,82.8%and 83.7% respectively for CA125 alone,78.2%,81.3%and 80.5% for TSGF alone,74.5%,81.9%and 80.0% for SA alone,whereas 95.5%,45.6%and 58.4% for multiple tumor markers combined in which 1 or more indices showed positive,93.6%,80.6%and 84.0% for that in which 2 or more indices showed positive,and 87.3%,90.3%and 89.5% for that in which 3 or more indices show positive.Conclusion:multiple tumor markers examination could improve the diagnosis of ovarian cancer,and examination of CA125,TSGF and SA combined is most ideal.

Management of mucinous cystic neoplasms of the pancreas

The purpose of this study was to investigate the actual management of mucinous cystic neoplasm (MCN) of the pancreas. A systematic review was performed in December 2009 by consulting PubMed MEDLINE for publications and matching the "pancreatic mucinous cystic neoplasm", "pancreatic mucinous cystic tumour", "pancreatic mucinous cystic mass", "pancreatic cyst", and "pancreatic cystic neoplasm" to identify English language articles describing the diagnosis and treatment of the mucinous cystic neoplasm of the pancreas. In total, 16 322 references ranging from January 1969 to December 2009 were analysed and 77 articles were identified. No articles published before 1996 were selected because MCNs were not previously considered to be a completely autonomous disease. Definition, epidemiology, anatomopathological findings, clinical presentation, preoperative evaluation, treatment and prognosis were reviewed. MCNs are pancreatic mucinproducing cysts with a distinctive ovarian-type stroma localized in the body-tail of the gland and occurring in middle-aged females. The majority of MCNs are slow growing and asymptomatic. The prevalence of invasive carcinoma varies between 6% and 55%. Preoperative diagnosis depends on a combination of clinical features, tumor markers, computed tomography (CT), magnetic resonance imaging, endoscopic ultrasound with cyst fluid analysis, and positron emission tomography-CT. Surgery is indicated for all MCNs.

Expression and significance of tumor suppressor gene p16 in human ovarian neoplasm

To observe the relationship between tumor suppressor gene p16 expression and ovarian cancer occurrence and development. Metbods: Using ABC immunohistochemistry method, we investigated the expression of p16 in 72 cases of ovarian neoplasm. Results: The positive rates of p16 in malignant, benign, borderline tumors and normal ovarian tissue were 7. 89%, 60.00%, 66. 67% and 83. 33%, respectively (P<0.01). In the cases whose tumors were more malignant and poorly differentiated, and who relapsed and died, the positive stainings were not discovered. Conclusiou: p16 is well related with the occurrence and development of malignant ovarian tumor.

EXPRESSION AND SIGNIFICANCE OF BASIC FIBROBLAST GWOWTH FACTOR AND FIBROBLAST GROWTH FACTOR RECEPTOR-1 IN OVARIAN EPITHELIAL NEOPLASM

Objective To study the relevance of expression of basic fibroblast growth factor (bFGF), fibroblast growth factor receptor 1 (FGFR 1) and carcinogenesis and progression of ovarian epithelial neoplasm. Methods Ten cases of normal ovarian tissues and 75 cases of ovarian epithelial neoplasm tissues were detected by immunohistochemical methods: S P for bFGF, FGFR 1,double immunohistochemistry Lab SA for Ki 67 antigen and bFGF. Results The expression level of bFGF, FGFR 1in ovarian epithelium and ovarian epithelial neoplasm showed a step wise increase in the following order:normal <benign <borderline <malignant; The expression level and intensity of bFGF and FGFR 1 were increased with the decrease of differentiation degree and increase of clinical stage in ovarian carcinoma; There was no statistical difference between the expression of bFGF, FGFR 1 in serous cystadenocarcinoma and that of mucinous cystadenocarcinoma; The expression of bFGF was correlated with that of FGFR 1 in neoplastic tissues; There were positive expression rates of bFGF and Ki 67 antigen in ovarian epithelial neoplasm. Conclusion As an important proliferative factor, bFGF plays an important role in carcinogenisis and progression of ovarian epithelial neoplasm.

The relationship between the expression of hK6 in ovarian neoplasm and the clinicopathologic variables and prognosis

Objective: The aim of this study was to approach the relationship between the expression of human kallikrein 6 (hK6) in ovarian neoplasm and the clinicopathologic variables and prognosis for finding a new tumor marker for ovarian cancer. Methods: Through immunohistochemistry to examine the expression of hK6 in 19 cases with benign, 11 cases with borderline and 45 cases with malignant ovarian neoplasms and statistically analyzed whether the expression of hK6 correlated with the clinicopathologic variables and prognosis in patients with ovarian cancer. Results: The positive rate of hK6 in ovarian cancer tissues (60.0%) was significantly higher than that in the benign (15.8%) and borderline (27.3%) ovarian neoplasm tissues (P < 0.01). The expression of hK6 in low-grade ovarian cancer tissues was higher than that in high-grade (68.4% vs 14.3%; P < 0.05); hK6 in late–stage (stage III) was more frequently expressed than that in early-stage (stage I or II) (76.7% vs 26.7%; P < 0.01); and it significantly higher in ovarian carcinomas with lymph node metastases than those without lymph node metastases (77.8% vs 33.3%; P < 0.01 ); moreover, the expression of hK6 in the cancer tissues that the patients died or their pathogenetic condition recurred or their tumor metastasized within 3 years after surgery was higher (75.0%) than that in the cancer tissues that the pathogenetic condition of the patients was stable (42.9%; P < 0.05). Conclusion: The expression of hK6 in ovarian cancer tissues was higher than that in the benign and borderline ovarian neoplasm tissues, and high hK6 expression correlated with late–stage, low-grade, node metastasis and poor prognosis of patients. hK6 could potentially be a novel tumor marker for ovarian cancer that can predict the prognosis of the patients.

A Case of Low-Grade Appendiceal Mucinous Neoplasm of Its Difficultly to Distinguish from a Right Ovarian Tumor Due to Postmenopause

We here present a rare case of appendiceal tumor mimicking ovarian tumor in menopause woman. The patient was a 56-year-old woman, G1P1, who presented to our hospital with a right adnexal cyst diagnosed at another hospital. Transvaginal echocardiography showed a cyst in the right adnexal region, and pelvic contrast-enhanced MRI revealed a small cyst in the same region. The left ovary was atrophic and identifiable. It was unclear whether the cyst was contiguous with the gastrointestinal tract. Blood tests showed no elevation of tumor markers. We considered its possibility of a gastrointestinal origin, but since right normal ovary was not found, we thought the tumor was of ovarian origin and decided on a laparoscopic resection of the right adnexa. Intraoperatively, we observed atrophied bilateral normal ovaries, and the pelvic tumor was contiguous to the appendix. Surgeons performed a laparoscopic appendectomy after consultation with us. After resection we searched the abdominal and pelvic cavities, but found no obvious disseminated lesions. The histological diagnosis was low-grade appendiceal mucinous neoplasm (LAMN), a rare benign tumor of the appendix. Appendiceal tumors can be difficult to differentiate from right ovarian tumors due to their close anatomic location in the pelvis. It is possible to determine whether the tumor is of ovarian or appendiceal origin by identifying normal ovaries and the location of the feeding vessels into the tumors. In our case, there were no lesions other than the appendix, but LAMN can metastasize to the ovary, cause pseudomyoxoma peritonei, or be an overlapping tumor with an ovarian tumor. If an appendiceal tumor is diagnosed after surgery for ovarian tumor, the intra-abdominal cavity should be searched for metastasis or dissemination, and a thorough search for ovarian lesions should be performed with the possibility of an overlapping tumor in mind.

Human ovarian neoplasm cell CD147 stimulates production and activation of matrix metalloproteinases in co-cultures with mouse fibroblasts

Objective: To investigate the expression of CD147 on human ovarian neoplasm cell lines and its influence on production and activation of matrix metallproteinases(MMPs). Methods: The expression of CD147 on different human ovarian neoplasm cell lines was studied by western blotting. Co-culture was carried out to investigate the stimulative effect of the positive expression CD147 cell HO-8910 on the production of MMPs of fibroblast cell in vitro. Zymography and immune blotting were used to study the production and activity of positive MMPs, at the time, to explore the relation between CD147 and MMPs. Results: CD147 was positively presented in 2 ovarian neoplasm cell lines(HO-8910,3-AO), but in SKOV3, TC-1,NIN3T3 cell was negative. MMP-2 and MMP-9 were detected by HO-8910 cell line, mouse fibroblast cell and co-culture cells; but the expression in co-culture cell is obviously higher than individual cultures of each type alone.CD147 stimulated MMPs in dose-dependent manner. Conclusion: CD147 causes increased production and activation of MMP-2, MMP-9.CD147 is probably a indirect marker of some ovarian cancer cells with invasion and metastasis.

TGF-β-regulated different iron metabolism processes in the development and cisplatin resistance of ovarian cancer

The impact of different iron metabolism processes(DIMP)on ovarian cancer remains unclear.In this study,we employed various gene chips and databases to investigate the role of DIMP in the initiation and development of ovarian cancer.cBioPortal was used to determine mutations in DIMP-associated genes in ovarian cancer.Kaplan-Meier plotter was used to examine the influence of DIMP on the prognosis of ovarian cancer.By analyzing 1669 serous ovarian cancer cases,we identified a range of mutations in iron metabolism genes,notably in those coding for the transferrin receptor(19%),melanotransferrin(19%),and ceruloplasmin(10%)in the iron import process,and glucose-6-phosphate isomerase(9%),hepcidin antimicrobial peptide(9%),metal regulatory transcription factor 1(8%),and bone morphogenetic protein 6(8%)in the iron regulation process.Compared to the unaltered group,the group with gene alterations exhibited a higher tumor mutation burden count(43 vs.54)and more advanced histologic grade(78.19%vs.87.90%).Compared to the normal ovarian counterparts,a reduction in expression was observed in 9 out of the 14 genes involved in iron utilization and 4 out of the 5 genes involved in iron export in ovarian cancer;in contrast,an increase in expression was observed in 2 out of the 3 genes involved in iron storage in ovarian cancer.Furthermore,in cisplatin-resistant cells compared to cisplatin-sensitive ones,the expression of all genes in iron storage and 13 out of 14 genes in iron import was decreased,while that of 8 out of the 10 genes in iron utilization was increased.In addition,survival curve analysis indicated that a higher expression in the majority of genes in the iron import process(12/21),or a reduced expression in most genes in the iron export process(4/5)correlated with poor progression-free survival.Additionally,TGF-βcould regulate the expression of most iron metabolism-associated genes;particularly,expression of genes involved in the iron storage process(2/2)was inhibited after TGF-β1 or TGF-β2 treatment.In conclusion,DIMP plays multifaceted roles in the initiation,chemo-resistance,and prognosis of ovarian cancer.Therapeutically targeting DIMP may pave the way for more tailored treatment approaches for ovarian cancer.

Immune pathway through endometriosis to ovarian cancer

Endometriosis is an estrogen-dependent inflammatory disease,defined by the presence of functional endometrial tissue outside of the uterine cavity.This disease is one of the main gynecological diseases,affecting around 10%-15%women and girls of reproductive age,being a common gynecologic disorder.Although endometriosis is a benign disease,it shares several characteristics with invasive cancer.Studies support that it has been linked with an increased chance of developing endometrial ovarian cancer,representing an earlier stage of neoplastic processes.This is particularly true for women with clear cell carcinoma,low-grade serous carcinoma and endometrioid.However,the carcinogenic pathways between both pathologies remain poorly understood.Current studies suggest a connection between endometriosis and endometriosis-associated ovarian cancers(EAOCs)via pathways associated with oxidative stress,inflammation,and hyperestrogenism.This article aims to review current data on the molecular events linked to the development of EAOCs from endometriosis,specifically focusing on the complex relationship between the immune response to endometriosis and cancer,including the molecular mechanisms and their ramifications.Examining recent developments in immunotherapy and their potential to boost the effectiveness of future treatments.

妇科常见恶性肿瘤全专结合管理专家共识

为提升妇科恶性肿瘤患者的全程健康管理质量,充分发挥基层医疗卫生机构在妇科恶性肿瘤患者筛查、早期识别、干预及康复中的作用,首都医科大学肿瘤学系妇科肿瘤学组联合全科医学、营养学、心理学、康复医学、护理学、卫生统计学等专家,基于基层医疗机构现状,结合循证医学证据、妇科恶性肿瘤管理相关指南等,制定了本共识。妇科常见恶性肿瘤患者全专结合管理应该以妇科医生和全科医生为核心,联合肿瘤、康复等多学科团队,从妇科恶性肿瘤的预防、筛查、随访、转诊、心理疏导、运动康复、营养管理、延续护理、健康教育以及社会功能恢复等方面进行综合管理,致力于延长患者生存期和提高患者生存质量。

上皮性卵巢癌患者淋巴结转移预测模型的构建:基于^(18)F-氟代脱氧葡萄糖正电子发射计算机体层摄影-CT影像组学技术

背景术前准确评估上皮性卵巢癌患者淋巴结转移情况对于制订治疗方案、评估预后等具有重要意义,影像组学技术已被作为多种癌症术前预测淋巴结转移情况的无创手段,但关于其在妇科癌症领域应用效果的研究报道较少。目的采用基于^(18)F-氟代脱氧葡萄糖正电子发射计算机体层摄影-CT(^(18)F-FDG PET/CT)的影像组学技术构建上皮性卵巢癌患者淋巴结转移预测模型。方法选取2020年9月—2022年12月在中南大学湘雅二医院妇科住院的上皮性卵巢癌患者98例,根据其淋巴结转移情况分为淋巴结转移组65例与非淋巴结转移组33例,同时按照7∶3比例进行随机抽样后分为训练集68例与验证集30例。分析所有患者临床特征,以淋巴结转移情况作为结果标签进行模型构建。结果本研究上皮性卵巢癌患者淋巴结转移率为66.3%(65/98)。淋巴结转移组与非淋巴结转移组患者人附睾蛋白4(HE4)水平、原发灶位置比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,HE4水平、原发灶位置、影像组学评分(Radscore)是上皮性卵巢癌患者淋巴结转移的预测因素(P<0.05)。以HE4水平、原发灶位置构建临床预测模型,以HE4水平、原发灶位置、Radscore构建联合预测模型。Delong's检验结果显示,联合预测模型预测训练集中上皮性卵巢癌患者淋巴结转移受试者工作特征曲线下面积(AUC)为0.80(95%CI=0.70~0.90),高于临床预测模型的0.73(95%CI=0.61~0.85,P=0.042);校准曲线显示,联合预测模型通过校准度检验(P=0.990),具有良好的区分能力;决策曲线(DCA)分析结果显示,临床预测模型、联合预测模型的预测效能良好,但联合预测模型的净效益较高。结论采用基于^(18)F-FDG PET/CT的影像组学技术成功构建了上皮性卵巢癌患者淋巴结转移的联合预测模型,且模型稳健性较高、区分能力良好、净效益较高,可为临床医生制订患者个体化治疗方案、评估患者预后等提供参考。

TMPyP4-PDT对人卵巢癌A2780细胞的杀伤作用及其对MCM2和CA-Ⅸ mRNA表达的影响

目的:观察四-(N-甲基-4-吡啶基)卟啉(TMPyP4)对人卵巢癌A2780细胞的光动力学杀伤作用及其对微型染色体维持蛋白2(MCM2)和碳酸酐酶Ⅸ(CA-Ⅸ)mRNA表达水平的影响,阐明TMPyP4-PDT(光动力疗法)对人卵巢癌A2780细胞的杀伤作用机制。方法:体外培养人卵巢癌A2780细胞株,按不同处理因素分为空白对照组、单纯TMPyP4组、单纯PDT组和TMPyP4-PDT组。采用CCK-8法检测TMPyP4-PDT对A2780细胞株的增殖抑制作用。流式细胞术测定不同浓度TMPyP4对A2780细胞株凋亡的影响。光镜下观察各组细胞HE染色的形态学变化。实时荧光定量PCR法检测MCM2和CA-IX mRNA表达水平的变化。结果:与空白对照组比较,单纯TMPyP4组随着药物浓度的增加,细胞的增殖抑制率逐渐增加(P<0.05);单纯PDT组细胞增殖抑制率增加不明显(P>0.05);TMPyP4-PDT组细胞增殖抑制率随着药物浓度及激光能量密度的增加而增加(P<0.05)。流式细胞术检测,TMPyP4-PDT可诱导A2780细胞凋亡,在激光能量密度为4J.cm-2的条件下,3、6、15、30和60μmol.L-1 TMPyP4作用4h,A2780细胞凋亡率分别为(9.46±0.04)%、(17.7±0.3)%、(25.4±0.2)%、(30.2±0.2)%和(66.3±0.3)%。光镜下可观察到空白对照组及单纯PDT组贴壁细胞多,无核固缩及核碎裂样改变;单纯TMPyP4组及TMPyP4-PDT组贴壁细胞减少,出现核固缩、空泡及部分胞浆溶解样改变。实时荧光定量PCR法检测,在激光能量密度为4J.cm-2的条件下,3、6、15、30和60μmol.L-1TMPyP4作用4h,MCM2和CA-IX mRNA表达水平明显降低,与空白对照组比较差异有统计学意义(P<0.01)。结论:TMPyP4-PDT对人卵巢癌A2780细胞有明显杀伤作用,其机制可能与负性调节MCM2和CA-Ⅸ的表达有关。

The Relationship between Methylation and Expression Defect of Tumor Suppressor Gene p16INK4A in Epithelial Ovarian Cancer

Objective： To evaluate the expression of p16INK4A gene in ovarian cancer and analyze the relation between this alteration and the promoter methylation of p16INK4A DNA. Methods： Seven ovarian cancer cell lines and eighteen ovarian cancer specimens were selected for the study. Genomic DNA and RNA were extracted from fresh tissues and cell lines, DNA was treated with sodium bisulfite and then analyzed with methylation-specific PCR （MSP） to detect p16INK4A methylation. The expression of p16INK4A mRNA was detected by reverse transcription-polymerase chain reaction （RT-PCR）. In addition, the proliferation of methylated cell lines before and after treatment of demethylating agent 5-Aza-2＇-deoxycytidine （5-ADC） was examined with 3-（4, 5-dimethylthiazol-2-yl）-2, 5-diphenyltetrazolium bromide （MTT） assay in vivo. Results： Compared with the control, the expression of p16INK4A mRNA decreased significantly or absolutely defaulted in 10 of 18 （55.56%） ovarian cancer specimens and 71.4% （5/7） ovarian cancer cell lines （P〈0.05）, and the expression of p16INK4A protein also decreased （P〈0.05）. The decrease of p16INK4A was due, in part, to p16INK4A methylation, which was found in the first exon of three cell lines and six ovarian cancer specimens and the rate was 42.86% and 33.33% in ovarian cancer cell lines and specimens respectively. All the methylated cells and tissues showed expression defect of p16INK4A, but the treatment of 5-ADC reactivated the expression of p16INK4A in methylated cells and decreased the proliferation of tumor cells in vitro and in vivo. Conclusion： The expression defect of p16INK4A gene possibly has an important role in the development of ovarian cancer, and this alteration is due, in part, to the methylation of the first exon in p16INK4A.

抗氧化剂PDTC对酸性环境诱导的人卵巢癌SKOV3细胞IL-8表达的作用及机制

目的:探讨二硫氨基甲酸吡啶(PDTC)对酸性环境中培养的人卵巢癌细胞SKOV3的增殖活性及白细胞介素8(IL-8)表达的影响,以及细胞核转录因子-κB(NF-κB)在此过程中的作用。方法:将SKOV3细胞分为5组:常规培养液组(对照组)和酸性培养组以及酸性培养液加PDTC组(分别加入终浓度为25、50、100μmol·L-1的PDTC);各组培养12h后,MTT法检测PDTC对SKOV3细胞增殖的影响,ELISA法检测培养上清中IL-8蛋白含量,Western blotting检测核内NF-κB蛋白的表达。结果:SKOV3细胞在酸性环境中IL-8表达水平[(1384.211±42.320)ng·L-1]高于对照组[(617.505±47.850)ng·L-1](P<0.01)。加入不同浓度PDTC(25、50、100μmol·L-1),IL-8表达逐步降低[(1239.053±14.490)、(1113.578±29.140)、(1014.457±55.490)ng·L-1],均低于酸性培养组(P<0.05)。在酸性环境中的SKOV3细胞可观察到颜色较深的核内NF-κB蛋白条带,应用PDTC后NF-κB在核内的蛋白条带颜色变浅。结论:PDTC对酸性环境中SKOV3细胞IL-8的表达具有抑制作用,该作用与PDTC抑制NF-κB的活化有关。

卵巢癌组织CLDN10、三结构域蛋白59表达及其临床意义

目的分析卵巢癌组织紧密连接蛋白10(CLDN10)、三结构域蛋白59(TRIM59)表达及其临床意义。方法该研究选取2017年2月至2019年2月在鹤壁市人民医院接受手术的112例卵巢癌病人术中切除的卵巢癌组织及癌旁组织。采用实时荧光定量PCR法检测CLDN10、TRIM59 mRNA表达;采用免疫组织化学法检测CLDN10、TRIM59蛋白表达;采用Pearson法分析CLDN10、TRIM59的相关性;CLDN10、TRIM59与预后的关系采用Kaplan-Meier生存曲线分析;卵巢癌病人预后的危险因素采用Cox回归分析。结果与癌旁组织相比,卵巢癌组织中CLDN10 mRNA表达水平(0.62±0.14比1.00±0.23)及蛋白阳性表达率(39.29%比63.39%)明显降低(P<0.05),TRIM59 mRNA表达水平(1.64±0.32比1.01±0.25)及蛋白阳性表达率(64.29%比38.39%)明显升高(P<0.05)。根据Pearson相关性分析得知,卵巢癌组织中CLDN10、TRIM59 mRNA表达水平呈负相关(P<0.05)。卵巢癌组织中CLDN10、TRIM59表达与国际妇产科联盟(FIGO分期)、分化程度、淋巴结转移有关(P<0.05)。根据Kaplan-Meier法得知,卵巢癌组织中CLDN10阳性表达病人3年生存率高于阴性表达病人(P<0.05);卵巢癌组织中TRIM59阳性表达病人3年阳性生存率低于阴性表达病人(P<0.05)。根据Cox回归分析表明,CLDN10阴性、TRIM59阳性是影响卵巢癌病人预后的危险因素[HR=2.15,95%CI:(1.15,4.00);HR=3.55,95%CI:(1.55,8.10)]。结论卵巢癌组织中CLDN10阴性、TRIM59阳性是卵巢癌预后的危险因素,二者有可能作为有价值的预后标志物。

多模态超声检查技术和卵巢-附件影像报告与数据系统在卵巢肿瘤诊断中的应用进展

卵巢癌是女性生殖系统常见的恶性肿瘤之一,在我国其发病率居女性生殖系统恶性肿瘤第3位。超声检查是识别卵巢肿瘤首选的影像学方法,具有操作简单、价格低廉等优势,但传统超声检查对操作者依赖性强,操作者技术和经验对检查结果的影响较大。多模态超声检查技术通过结合多种超声成像模式,如二维超声、三维超声、超声造影、超声弹性成像等,集合了不同超声检查的优势,能够实现对组织结构的精细观察、功能评估以及病理变化监测,从而为卵巢肿瘤提供更准确的诊断依据。卵巢-附件影像报告与数据系统(O-RADS)作为一项评估卵巢肿瘤恶性风险的工具,包含病变的描述、定义、解释,其基于超声检查获得全面的诊断信息,根据肿块的最大径线、实性或类实性、囊性、囊性内分隔、血供、卵巢外表现等信息将卵巢-附件肿块划分为6个类别,分别对应不同程度的恶性风险,可为卵巢肿瘤的超声诊断提供标准化的评估框架,不仅有助于临床医师对肿物的恶性风险程度进行判别,还能快速对卵巢肿瘤的性质进行初步判断。多模态超声检查技术联合O-RADS可充分发挥二者的优势,能够为卵巢肿瘤的诊断提供更为全面、准确的信息,在卵巢肿瘤的诊疗中发挥了重要作用。随着医学影像技术的进步和临床需求的拓展,多模态超声检查技术联合O-RADS有望得到更广泛的临床应用。

Effect of WFDC 2 silencing on the proliferation,motility and invasion of human serous ovarian cancer cells in vitro

Objective:To investigate effect and possible mechanisms of silencing human WFDC2（HE4） gene on biological behavior changes as cell proliferation,apoplosis,movement and invasion of human serous ovarian cancer cell line SKOV3.Methods:Lentiviral WFDC2 gene sequence of small interfering siRNA was stablely transfected into SKOV3 identified by Q-PCR and western-blot. Obtained SKOV3 stable strains with silenced HE4 were measured by proliferation,apoplosis, migration,and invasion.Results:Gene sequencing showed that the oligonucleotides were successfully inserted into the expected site.After silencing HE4 in the SKOV3,proliferation was significandy inhibited（P【0.05）.G0/G1 phase was arrested by the cell cycle（P【0.01） and capacity of the migration and invasion decreased significandy（P【0.01）.Slight early apoptosis ratio and no change of late apoplosis were found without change of Caspase-3 or Bcl-2 protein.Proteins involed in ERK pathway as phosphorylated protein as p-EGFR,p- ERK decreased and protease protein involved in tissue remoding as matrix metalloproteinases MMP-9,MMP-2 and cathepsin B decreased compared with control group.Conclusions:HE4 gene plays an important role in regulating proliferation,apoptosis,migration,invasion of serous ovarian cancer cells by ERK pathway and protease system.Its role in apoptosis needs to be further explored,and it may be a potential target for serous ovarian cancer.

Identification of differentially expressed long non-coding RNAs in human ovarian cancer cells with different metastatic potentials

Objective： To identify differentially expressed long non-coding RNAs （lncRNAs） involved in the metastasis of epithelial ovarian cancer. Methods： An in vitro invasion assay was performed to validate the invasive capability of SKOV3 and SKOV3.ip1 cell lines. Total R.NA was then extracted, and microarray analysis was performed. Moreover, nine lncRNAs were selected for validation using RT-qPCR. Results： Compared with the SKOV3 cells, the SKOV3.ip1 cells significantly improved in the in vitro invasive activity. Of the 4,956 lncRNAs detected in the microarra~ 583 and 578 lncRNAs were upregulated and downregulated, respectivel~ in SKOV3.ip1 cells, compared with the parental SKOV3 cells. Seven of the analyzed lncRNAs （MALAT1, H19, UCA1, CCAT1, LOC645249, LOC100128881, and LOC100292680） confirmed the deregulation found by microarray analysis. Conclusion： LncRNAs clusters were differentially expressed in ovarian cancer cells with varying metastatic potentials. This result indicates that some lncRNAs might exert a partial or key role in epithelial ovarian cancer metastasis. Further studies should be conducted to determine the roles of these lncRNAs in ovarian cancer metastasis.

Multimodality imaging of ovarian cystic lesions: Review with an imaging based algorithmic approach

Ovarian cystic masses include a spectrum of benign, borderline and high grade malignant neoplasms. Imaging plays a crucial role in characterization and pretreatment planning of incidentally detected or suspected adnexal masses, as diagnosis of ovarian malignancy at an early stage is correlated with a better prognosis. Knowledge of differential diagnosis, imaging features, management trends and an algorithmic approach of such lesions is important for optimal clinical management. This article illustrates a multi-modality approach in the diagnosis of a spectrum of ovarian cystic masses and also proposes an algorithmic approach for the diagnosis of these lesions.