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.

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.

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.

EZH2 Contributes to Anoikis Resistance and Promotes Epithelial Ovarian Cancer Peritoneal Metastasis by Regulating m6A

Objective:Histone modification has a significant effect on gene expression.Enhancer of zeste homolog 2(EZH2)contributes to the epigenetic silencing of target chromatin through its roles as a histone-lysine N-methyltransferase enzyme.The development of anoikis resistance in tumor cells is considered to be a critical step in the metastatic process of primary malignant tumors.The purpose of this study was to investigate the effect and mechanism of anoikis resistance in ovarian adenocarcinoma peritoneal metastasis.Methods:In addition to examining EZH2 protein expression in ovarian cancer omental metastatic tissues,we established a model of ovarian cancer cell anoikis and a xenograft tumor model in nude mice.Anoikis resistance and ovarian cancer progression were tested after EZH2 and N6-methyladenosine(m6A)levels were modified.Results:EZH2 expression was significantly higher in ovarian cancer omental metastatic tissues than in normal ovarian tissues.Reducing the level of EZH2 decreased the level of m6A and ovarian cancer cell anoikis resistance in vitro and inhibited ovarian cancer progression in vivo.M6a regulation altered the effect of EZH2 on anoikis resistance.Conclusion:Our results indicate that EZH2 contributes to anoikis resistance and promotes ovarian adenocarcinoma abdominal metastasis by m6A modification.Our findings imply the potential of the clinical application of m6A and EZH2 for patients with ovarian cancer.

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.

Primary ovarian choriocarcinoma occurring in a postmenopausal woman:A case report

BACKGROUND Nongestational ovarian choriocarcinoma(NGOC)is a rare but aggressive neoplasm with limited sensitivity to chemotherapy and a very poor prognosis.Few cases of NGOC have been reported,and there is limited information regarding its clinical features,treatment protocols,or prognosis.CASE SUMMARY A postmenopausal woman in her 5th decade of life visited our clinic because of abnormal vaginal bleeding and an abdominal mass.Although she had been menopausal for more than eight years and her last abortion occurred nine years ago,she had an increased level of serumβ-human chorionic gonadotropin(β-hCG).Thus,an ovarian neoplasm of trophoblastic origin was suspected,and exploratory laparotomy was performed.Based on the patient’s clinical history and the histopathological examination and immunohistochemistry results obtained postoperatively,we concluded that she most likely had primary NGOC.Cytoreductive surgery was performed in combination with adjuvant chemotherapy comprising bleomycin,etoposide,and cisplatin.Serumβ-hCG levels decreased to normal after two cycles,and there was no evidence of recurrence after four cycles of chemotherapy.CONCLUSION Even in postmenopausal women,ovarian choriocarcinoma should be considered in the initial differential diagnosis for an adnexal mass.

卵巢-附件报告和数据系统超声2022版(O-RADS US v2022)及其联合恶性风险指数4鉴别附件良、恶性肿瘤

目的观察卵巢-附件报告和数据系统超声2022版(O-RADS US v2022)及其联合恶性风险指数4(RMI4)鉴别附件良、恶性肿瘤的价值。方法回顾性分析126例手术病理诊断为附件肿瘤患者,根据O-RADS US v2022将1~3类归为良性病变、4~5类归为恶性病变,以450为RMI4分类的临界值,基于二者进行联合分类。以病理结果为金标准,绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估单一O-RADS US v2022、RMI4及其联合鉴别附件良、恶性肿瘤的效能。结果126例附件肿瘤中,良性94例、恶性32例。O-RADS US v2022鉴别附件良、恶性肿瘤的敏感度、特异度、准确率及AUC分别为78.13%、80.85%和80.16%、0.795,RMI4分别为71.88%、84.04%和80.95%、0.780;二者联合的特异度及准确率(93.62%、92.06%)均高于单一O-RADS US v2022(χ^(2)=7.322、5.967,P=0.007、0.015)或RMI4(χ^(2)=4.625、5.331,P=0.032、0.021),而敏感度及AUC(87.50%、0.906)差异均无统计学意义(P均>0.05)。结论O-RADS US v2022能有效鉴别附件良、恶性肿瘤,联合RMI4可提高鉴别特异度及准确率。

超声细微特征鉴别卵巢多房囊性、囊实性肿瘤来源的价值

目的探讨超声细微特征在鉴别卵巢多房囊性、囊实性肿瘤来源的价值。方法选取河北医科大学第四医院超声诊断为卵巢多房囊性、囊实性肿瘤的患者246例作为研究对象,观察并记录肿瘤的超声细微特征。结合其临床特征和组织学分类,分析超声细微特征与卵巢原发性肿瘤、转移瘤的关系。结果246例卵巢肿瘤的组织学类型:原发性肿瘤217例(88.21%)和转移瘤29例(11.79%);在原发性肿瘤中,良性肿瘤62例(25.20%),以浆液性和黏液性囊腺瘤为主;交界性肿瘤27例(10.98%);恶性肿瘤128例(52.03%),以浆液性和黏液性囊腺癌为主;在转移瘤中,以原发部位结-直肠为主。临床特征:与原发性肿瘤相比,转移瘤的发病年龄较高,差异有统计学意义[(60.80±8.04)岁vs.(51.29±12.32)岁,P=0.035];原发性肿瘤组均无其他部位肿瘤的确诊病史,而转移瘤组中有9例在发现卵巢肿瘤时已有其他部位肿瘤确诊史(P<0.001);转移瘤组的血清CA199≥37000 U/L者多于原发性肿瘤组,差异有统计学意义[24(11.06%)vs.17(58.62%),P<0.001];其余临床特征2组间比较差异均无统计学意义(P>0.05)。超声细微特征:与原发性肿瘤相比,卵巢转移瘤具有瘤体较大[(15.7±4.80)cm vs.(9.54±3.96)cm,P<0.001]、瘤内囊腔个数≥10者较多(55.17%vs.18.89%,P<0.001)、壁结节少见(6.90%vs.21.66%,P=0.007)但直径较大[(1.44±0.36)cm vs.(0.97±0.39)cm,P=0.031]以及彩色多普勒血流阻力指数低(0.46±0.07 vs.0.61±0.13,P<0.001)的特点。结论当超声诊断卵巢多房囊性、囊实性肿物时,特别是同时伴发其他部位恶性肿瘤,利用超声细微特征可提高鉴别卵巢肿物来源的能力。

原发性卵巢类癌合并肝转移一例

原发性卵巢类癌是一种罕见的神经内分泌肿瘤,大多数患者无特异性表现,诊断主要依靠组织病理学检查。现报告1例原发性卵巢非典型类癌,患者因腹围增加2年、发现盆腔巨大肿物3 d就诊,盆腔磁共振成像(magnetic resonance imaging,MRI)提示腹、盆腔内巨大囊实性异常强化肿物,肝脏及右侧腹膜后异常强化结节及软组织肿物,予以卵巢恶性肿瘤全面分期术+肝脏表面活检术,根据术后病理检查结果诊断为卵巢非典型类癌Ⅳ期(G2T3cN1bM1b)合并肝转移、腹膜后转移,术后化疗6个周期,术后1年余复发。结合此病例讨论并复习相关文献,总结原发性卵巢类癌的临床特点、组织病理学表现、诊断、治疗及预后,旨在提高临床医师对原发性卵巢类癌的认识,为此类疾病的临床诊治提供参考。

PARP抑制剂与免疫检查点抑制剂联合治疗在妇科恶性肿瘤中的应用

近年来肿瘤靶向和免疫治疗的研究进展迅速,如多腺苷二磷酸核糖聚合酶抑制剂[poly(ADP-ribose)polymerase inhibitor,PARPi]、免疫检查点抑制剂(immune checkpoint inhibitors,ICI)等已改变了妇科肿瘤的传统治疗模式,但部分患者疗效有限或出现耐药。临床前研究发现,PARPi损伤DNA修复过程,可造成肿瘤突变负荷与肿瘤特异性抗原增加,调节肿瘤微环境,刺激肿瘤浸润淋巴细胞(tumor infiltrating lymphocytes,TIL)产生并促进抗肿瘤免疫反应,为PARPi与ICI联合治疗提供了理论基础。近年多项临床研究发现PARPi与ICI联合使用可显著改善妇科恶性肿瘤患者的预后。

以脑梗死为首发症状的卵巢癌患者围手术期护理

总结1例以脑梗死为首发症状的卵巢癌患者围手术期护理体会。针对患者病情危重复杂,围手术期易诱发血栓和出血,术后并发症风险增加,患者心理康复、肢体康复等问题,组建多学科合作团队全程管理;术前充分评估病情,制订护理计划;做好桥接抗凝期间用药护理;积极预防肺栓塞及新发脑梗死;采用中药灌肠法预防术后肠梗阻;鼓励家属参与患者心理护理,促进康复。通过积极治疗和护理,患者于术后第9天顺利出院。术后随访6个月,恢复良好。

lncRNA FUT8-AS1通过调控miR-142-5p/BCL2轴促进上皮性卵巢癌细胞增殖、侵袭和EMT

目的 观察FUT8-AS1基因在上皮性卵巢癌(epithelial ovarian cancer, EOC)组织和细胞株中的表达,探讨影响EOC细胞增殖、侵袭和EMT的机制。方法 采用GEPIA2和Kaplan-Meier Plotter数据库分析FUT8-AS1在EOC组织中的表达及与患者生存期的关系。收集74例EOS组织标本和60例正常组织标本,应用RT-PCR法检测FUT8-AS1、miR-142-5p、BCL2和EMT相关基因的表达;运用CCK-8和Transwell实验检测敲低FUT8-AS1基因表达对EOC细胞CAOV3增殖和侵袭的影响。利用双荧光素酶报告分析FUT8-AS1与miR-142-5p的相互作用。结果 GEPIA2和Kaplan-Meier Plotter数据库分析发现,FUT8-AS1在EOC组织中的表达显著高于正常组织(P<0.05),FUT8-AS1高表达组的总生存率显著低于FUT8-AS1低表达组(P<0.01);FUT8-AS1基因在74例EOC组织中的表达明显高于正常组织[(2.547±1.370)vs(1.330±0.831),P<0.01],与大网膜转移、淋巴结转移、FIGO分期和总生存期均相关(P<0.01或P<0.05),敲低FUT8-AS1基因可以抑制CAOV3细胞的体外增殖、侵袭能力和EMT(P<0.01或P<0.05)。双荧光素酶报告分析系统检测显示,共转染miR-142-5p mimics和野生型FUT8-AS1-WT质粒,CAOV3细胞的荧光素酶活性明显降低(P<0.05),同时转染miR-142-5p mimics可抵消CAOV3细胞中由敲低FUT8-AS1导致的BCL2基因表达下调(P<0.05)。结论 FUT8-AS1基因在EOC中呈高表达且导致预后差,敲低FUT8-AS1基因可以抑制CAOV3细胞的体外增殖、侵袭能力和EMT,FUT8-AS1基因可能通过靶向miR-142-5p/BCL2分子轴促进EOC的进展。

卵巢微乳头亚型浆液性交界性肿瘤临床病理与分子特征分析

目的探讨卵巢微乳头亚型浆液性交界性肿瘤(micropapillary serous borderline tumor,MSBT)的临床病理学特征、免疫表型、分子改变、鉴别诊断、治疗和预后。方法收集14例卵巢MSBT的临床资料,采用免疫组化EnVision法染色分析IMP3的表达,运用qRT-PCR法和Sanger测序法检测BRAF和KRAS的基因突变,分析其临床病理特征并复习相关文献。结果患者年龄27~56岁,平均41.7岁;9例为双侧卵巢肿物;11例术前血清CA125值升高。肿瘤切面呈囊实性,伴囊内乳头状物。14例卵巢MSBT均呈乳头状结构,特征性的细长微乳头直接从囊壁或大的无分支乳头上发散出来,乳头长宽比>5,乳头被覆细胞呈立方至多角形,轻-中度异型性,微乳头区范围均>5 mm。5例伴微浸润;6例伴腹膜非浸润性种植;5例伴腹水均可见异型肿瘤细胞;3例伴淋巴结受累;9例伴砂粒体。免疫表型:ER、PR、CA125、CK7和WT-1均呈阳性,p53野生型,HER2、IMP3均阴性,Ki67增殖指数为5%~30%。分子病理学特征:14例中KRAS基因突变3例(3/14,21.4%),突变位点分别为G12C、G12D和Q70(无义突变);BRAF V600E均未突变;BRAF T559I突变1例(1/14,7.1%)。7例患者行根治性手术,另7例患者行保守性手术,术后均未经特殊治疗。随访时间1~12年,14例患者中5例有复发。结论MSBT形态学特殊,多双侧发病,易伴腹膜种植,易复发,诊断时应与经典型卵巢浆液性交界性肿瘤鉴别。

铜死亡在妇科恶性肿瘤中的研究进展

铜离子作为重要的辅酶,参与了广泛的代谢过程,包括有氧呼吸、肽酰胺化、铁转运、超氧化物歧化和细胞外基质的生物合成。铜稳态是维持细胞活性的重要机制。铜死亡是由铜离子积累引发的细胞死亡形式,其特点是铜稳态失衡,细胞内铜积累,选择性地扰乱三羧酸循环,使脂酰化线粒体酶聚集和铁硫蛋白丢失,引起线粒体蛋白质毒性应激,细胞膜裂解,最终导致细胞死亡。妇科恶性肿瘤是引起女性癌症死亡的重要原因。研究发现,铜死亡与妇科恶性肿瘤的发生、发展、预后及耐药密切相关。一些铜死亡调节剂可通过抑制血管生成、调节癌细胞的耐药性,抑制肿瘤转移和复发,因此铜死亡是治疗妇科恶性肿瘤有价值的研究方向。