Identification of serous ovarian tumors based on polarization imaging and correlation analysis with clinicopathological features

Ovarian cancer is one of the most aggressive and heterogeneous female tumors in the world,and serous ovarian cancer(SOC)is of particular concern for being the leading cause of ovarian cancer death.Due to its clinical and biological complexities,ovarian cancer is still considered one of the most di±cult tumors to diagnose and manage.In this study,three datasets were assembled,including 30 cases of serous cystadenoma(SCA),30 cases of serous borderline tumor(SBT),and 45 cases of serous adenocarcinoma(SAC).Mueller matrix microscopy is used to obtain the polarimetry basis parameters(PBPs)of each case,combined with a machine learning(ML)model to derive the polarimetry feature parameters(PFPs)for distinguishing serous ovarian tumor(SOT).The correlation between the mean values of PBPs and the clinicopathological features of serous ovarian cancer was analyzed.The accuracies of PFPs obtained from three types of SOT for identifying dichotomous groups(SCA versus SAC,SCA versus SBT,and SBT versus SAC)were 0.91,0.92,and 0.8,respectively.The accuracy of PFP for identifying triadic groups(SCA versus SBT versus SAC)was 0.75.Correlation analysis between PBPs and the clinicopathological features of SOC was performed.There were correlations between some PBPs(δ,β,q_(L),E_(2),rqcross,P_(2),P_(3),P_(4),and P_(5))and clinicopathological features,including the International Federation of Gynecology and Obstetrics(FIGO)stage,pathological grading,preoperative ascites,malignant ascites,and peritoneal implantation.The research showed that PFPs extracted from polarization images have potential applications in quantitatively differentiating the SOTs.These polarimetry basis parameters related to the clinicopathological features of SOC can be used as prognostic factors.

Expression of Matrix Metalloproteinase-7 in Serous Ovarian Tumors

Objective:To explore the expression of matrix metalloproteinase-7 in serous ovarian tumors. Methods: Expression of MMP- 1 in 6 normal ovaries, 12 serous cystadenomas of ovary, 6 borderline cystadenomas of ovary, and 22 serous cystadenocarcinomas of ovary were studied by immunohistoc/temical SP staining. Results: No expression of MMP- 1 was detected in normal ovaries. In most serous ovarian tumors, expression of MMP-7 was detected in both the cytoplasm of tumor cells and stroma, although it was reported in other tumors that MMP- 7 was mainly expressed in the cytoplasm of tumor cells. The expression level of MMP-7 in the cytoplasm of tumor cells was statistically insignificant between serous cystadenomas of ovary, borderline cystadenomas of ovary, and serous cystadenocarcinomas of ovary. But in the stroma, the expression level of MMP-7 in borderline cystadenomas of ovary and serous cystadenocarcinomas of ovary was significantly higher than that in serous cystadenomas of ovary (P<0. 05). In borderline cystadenomas and serous cystadenocarcinomas of ovary, expression of MMP-7 could also be detected in the nuclei of some tumor cells. Conclusion: MMP-7 may play an important role in the progression of serous ovarian tumors.

Case Report <i>ex Vivo</i>Oocyte Collection to Maintain Fertility in a Patient with Micropapillary Serous Borderline Ovarian Tumor

Background: Approximately 11% of cancer cases are diagnosed in people of childbearing age. Borderline ovarian tumors (BOTs) make up 10%-15% of all ovarian epithelial malignancies. More than one-third of all BOTs occur in women under 40 years of age. Maintaining the fertility of cured patients is the common goal of both oncologists and reproductologists. Aim: Giving young women diagnosed with a prognostically worse type of BOT and after bilateral adnexectomy the possibility to have their genetically own children by the method of ex vivo oocyte collection. Case Presentation: A 34-year-old nulligravid woman with BOT underwent right laparoscopic salpingo-oophorectomy. Histologically, a serious borderline tumor with a micropapillary pattern and a tumor locus on the ovarian surface were found. Due to histopathology, the oncologist recommended re-staging surgery: laparotomy, left salpingo-oophorectomy, omentectomy and hysterectomy. The patient refused a hysterectomy as she was planning to get pregnant with her partner. To maintain her fertility, controlled hormonal hyperstimulation and ex vivo aspiration of follicles from the ovary after salpingo-oophorectomy was performed. Ex vivo follicle expiration yielded 10 oocytes. 9 mature oocytes were fertilized by ICSI. The 6 embryos of the highest quality were individually frozen by vitrification. Cryoembryotransfer will be scheduled with the consent of the oncologist. Conclusion: This method is suitable for young women with BOT after bilateral salpingo-oophorectomy in whom ex vivo oocyte collection prevents possible leakage of tumor cells into the abdominal cavity, unlike during the conventional in vivo collection prior to surgery.

Clinical characteristics and treatment of ovarian serous borderline tumors

Ovarian serous borderline tumors (SBTs) are characterized by good prognosis and occasional late recurrence. The 5-year and 10-year survival rates are all more than 90%. But traditionally patients with SBTs used to be treated with bilateral oophorectomy, hysterectomy and postoperative chemotherapy. A high proportion of SBTs occurred in young patients. The traditional treatment with complete excision of reproductive organs seemed to be too aggressive for young patients. It is imperative that conservative surgical procedures with fertility sparing should be employed to them. In this paper the literatures in regard to the final outcome of the conservative surgical therapy for SBTs were reviewed and the appropriate extent of conservative surgical procedures was discussed in detail.

Role of Tissue Factor Pathway Inhibitor-2 in Ovarian Tumor Migration and Invasion

Objective: To elucidate the relation between human tissue factor pathwayinhibitor-2 (TFPI-2) expression and ovarian tumor migration and invasion. Methods: Human TFPI-2expression vector pBos-Cite-neo/TFPI-2 was transfected into ovarian tumor cells line A2780- Afterthe transfected cells were selected by G418, transfected and nontransfected cells were screened forTFPI-2 mRNA and protein by reverse transcription-polymerase chain reaction and Western blotanalysis, respectively. The number of transfected or nontransfected cells passing through membraneof Boyden chamber was counted as the basis assessing tumor cells migratory and invasive behaviors.Results: Expression of mRNA and protein of TFPI-2 was detectable in transfected cells. In invasionassay, the number of TFPI-2-expressing cells to traverse a Matrigel-coated membrane was obviouslydecreased compared with that of nonexpressing cells (59.3±6.5 vs 109.7±5.5, P 【 0.01); While inmigration assay, no significant difference through a noncoated membrane was observed amongtransfected and nontransfected cells (114.7±8.6 vs 127.3±7.1, P 】 0.05). Conclusion: Expression ofTFPI-2 may strongly inhibit the invasive ability of ovarian tumor cells in vitro, but has no effecton the migratory ability which provides an experimental basis for genotherapy of human ovariantumor.

Activation of the PI3K/AKT pathway mediates FSH-stimulated VEGF expression in ovarian serous cystadenocarclnoma

There is evidence to suggest that follicle-stimulating hormone （FSH） can facilitate the neovascularization of ovarian cancers by increasing vascular endothelial growth factor （VEGF） expression in cancer cells, although the underlying molecular mechanism of this process is not well known. Therefore, we investigated the effect of FSH on VEGF expression in the ovarian cancer cell lines SKOV-3 and ES-2. Treatment with FSH significantly increased VEGF expression in a dose- and time-dependent manner. In addition, FSH treatment enhanced the expression of survivin and hypoxlainducible factor-1 （HIF-1α）. Knockdown of survivin or HIF-1α suppressed VEGF expression, but only knockdown of survivin inhibited FSH-stimulated VEGF expression. Pretreatment with LY294002, a phosphoinositide 3-kinase （PI3K）/AKT inhibitor, neutralized the enhanced expression of survivin induced by FSH, but treatment with U0126, a mitogen-activated protein kinase/extracellular signal-regulated kinase inhibitor, had no such effect. We further showed that ovarian serous cystadenocarcinoma samples had much higher incidence of positive AKT and phosphorylated AKT （pAKT） protein staining than did benign ovarian cystadenoma samples （p 〈 0.01）. The 5-year survival rate was only about 15% in patients with ovarian serous cystadenocarcinoma who had AKT and pAKT expression, whereas it was about 80% in those who did not have AKT or pAKT expression. Taken together, these results indicate that FSH increases the expression of VEGF by upregulating the expression of survivin, which is activated by the PI3K/AKT signaling pathway. Understanding the role of the PI3K/AKT pathway in FSH-stimulated expression of survivin and VEGF will be beneficial for evaluating the prognosis for patients with ovarian serous cystadenocarcinoma and for pursulug effective treatment against this disease.

DIFFERENTIATION BETWEEN MALIGNANT AND BENIGN OVARIAN TUMORS BY MAGNETIC RESONANCE IMAGING

Objective To determine the magnetic resonance （MR） imaging findings of an ovarian mass which are most predictive of malignancy and assess the value of intravenous gadolinium administration in the characterization of an ovarian mass. Methods Totally 74 consecutive patients with a clinically or sonographicaUy indeterminate adnexal mass underwent MR imaging, of whom 59 had subsequent surgical resection of 70 adnexal masses. These 59 patients formed the study population. MR imaging studies were prospectively and independently reviewed by a senior and a junior radiologist. The senior radiologist also reevaluated the studies in a blind fashion after a minimum 6 months interval. The sensitivity, specificity, positive predictive value, and negative predictive value of contrast-enhanced and unenhanced MR im- aging were evaluated Results The most predictive MR imaging findings for malignancy were presence of vegetations in a cystic lesinn and presence of necrosis in a solid lesion. The odds ratio was even higher when the ancillary finding of peritoneal metastasis or ascites was present. Contrast media contributed significantly to lesinn characterization. Total 70 ovarian masses were detected by contrast-enhanced MR imaging including 37 malignant ovarian masses and 33 benign ovarian masses with 87% （61/70）accuracy, 86% （32/37）sensitivity, 88% （29/33）specificity, 89% （32/36）positive predictive value, and 85% （29/34） negative predictive value, whereas 70 ovarian masses were detected by unenhanced MR imaging with 74% （52/70） accuracy, 73 % （27/37） sensitivity, 76 % （ 25/33 ） specificity, 77% （27/35） positive predictive value, and 71% （ 25/35 ） negative predictive value. There were significant differences in accuracy （ P 〈 0. 01 ）, sensitivity （ P 〈0. 01 ）, specificity （ P 〈0. 01 ） between contrast-enhanced and unenhanced MR imaging. Conclusion Contrast-enhanced MR imaging is highly accurate in detection and characterization of complex adnexal masses.

Detection of Laminin in Serum and Ascites from Patients with Epithelial Ovarian Tumor

The change in serum laminin (LN) level and its clinical significance in epithelial ovarian tumor were investigated. The LN levels in serum and ascites samples from 69 patients with epithelial ovarian tumor and 42 cases as control group before and after operation were analyzed by radioimmunoassay. The results showed that the serum LN levels in the patients with malignant tumors (157.85 ±14.37 ng/ml) were significantly higher than that in the control group (125.14 ±7.03 ng/ml) and in the patients with benign tumors (128.36±8.75 ng/ml)(both P <0.01) before operation. The serum LN levels in the malignant group were decreased significantly after operation as compared with those before operation ( P <0.05). The serum LN levels in low differentiated tumors was higher than those in moderate differentiated tumors and high differentiated tumors ( P <0.05). The LN levels in ascites (172.94±15.26 ng/ml) was significantly higher than in serum (161.34±6.59 ng/ml)( P <0.05) in malignant tumors. The serum LN levels in the patients with lymph node metastasis (165.41±19.91 ng/ml) was obviously higher than those without lymph node metastasis (152.35±10.34 ng/ml)( P <0.05). It was concluded that LN levels in serum and acistes were remarkably increased in malignant epithelial ovarian tumors, suggesting that LN might be one of important diameters reflecting tumor biological characteristics.

CLINICAL DIAGNOSIS AND TREATMENT OF SMALL OVARIAN TUMOR IN POSTMENOPAUSAL WOMEN

Objective： To investigate the clinical symptom, ultrasonographic scan finding, serum CA125 value, histopathological type and treatment of small ovarian tumor （〈5 cm） in postmenopausal women. Methods： Retrospective analysis was carried out for 52 clinical materials of ovarian tumor cases in women more than one year after menopausal between Jan 1997 and Dec 2004. The largest diameter of the ovarian mass is less than 5 cm. Results： There were 11 ovarian cancers and 1 borderline ovarian tumor among 52 small ovarian tumors （23.1%）. 10 ovarian cancers were epithelial neoplasms and 2 were sex cord-stromal tumors, and 8 cases were in late stage according to FIGO staging system （33.3%）. Compared with benign tumor, there is no significant difference in the onset age, interval after menopausal and duration of history. The main clinical feature is abdominal symptoms, such as abdominal pain and distension in the malignant cases. The patients with benign tumors often showed the ovarian mass during the annual screening or admitted into hospital for other causes. The ultrasonography finding and serum CA125 level showed much difference between benign and malignant cases. Unilocular smooth-walled ovarian cysts mostly were found in benign tumor and the CA125 values were always less than 35 U/ml; but the solid or complex sonographic structures （multilocular, or with a papillary projections on the wall） often indicated a high risk of cancer, especially there was ascites in the pelvic cavity. Serum CA125 level in many cancer cases was elevated （〉35 U/ml）, over 300 U/ml in more than half of the patients. Surgery is still the first choice to treat ovarian cancer, and chemotherapy would be an auxiliary method. Till now, 3 ovarian cancer patients died of complications of cancer and 2 cases had recurrence. Conclusion： Small ovarian tumor in postmenopausal women has a comparatively low malignant occurrence but more in later stage. Many are epithelial carcinoma. If there is complex or parenchymal sonographic structure accompanied with a high serum CA125 level, operation should be considered, while it can be followed up when the ultrasound shows a smooth cyst with normal CA125 value.

Construction of Human ScFv Phage Display Library against Ovarian Tumor

In order to construct a single chain fragment variable （ScFv） phage display library against ovarian tumor, by using RT-PCR, the human heavy chain variable region genes （VH） and light chain variable region genes （VL） were amplified from lymphocytes of ovarian tumor patients and subsequently assembled into ScFv genes by SOE. The resulting ScFv genes were electrotransformed into E. coli TG1 and amplified with the co-infection of helper phage M13KO7 to obtain phage display library. The capacity and titer of the resulting library were detected. The phage antibody library with a capacity of approximately 3 × 10^9 cfu/μg was obtained. After amplification with helper phage, the titer of antibody library reached 5 μ 10^12 cfu/mL. Human ScFv library against ovarian tumor was constructed successfully, which laid a foundation for the screening of ovarian tumor specific ScFv for the radioimmunoimaging diagnosis of ovarian tumor.

Coexistence of ovarian serous papillary cystadenofibroma and type A insulin resistance syndrome in a 14-year-old girl: A case report

BACKGROUND Type A insulin resistance syndrome is a rare disorder caused by mutations in the gene encoding the insulin receptor.Its coexistence with ovarian serous papillary cystadenofibroma is even rarer.CASE SUMMARY A 14-year-old girl developed type A insulin resistance syndrome and showed high fasting insulin,glucose,and hemoglobin A1c(HbA1c)levels.The girl suffered from ovarian serous papillary cystadenofibroma.The laboratory results were as follows:fasting insulin was 2624.90 pmol/L and HbA1c was 8.5%.A heterozygous missense mutation on exon 20 of the insulin receptor gene(c.3601C>T,Arg1201Trp)was observed.The histopathological diagnosis was a cystic lesion that extended to the upper right uterus,indicating a right ovarian serous papillary cystadefibroma accompanied by focal interstitial hyperplasia.The patient was treated with metformin for over 6 mo.Additionally,laparoscopic resection(bilateral)of the ovarian lesion and laparoscopic intestinal adhesiolysis were performed under general anesthesia.Diet therapy combined with exercise was then initiated.The patient had an uneventful recovery.The patient also showed improved blood glucose control,with reduced levels of fasting insulin(857.84 pmol/L)and HbA1c(7.0%).CONCLUSION Insulin resistance may play a significant role in the induction of tumors.It is important to investigate further the association between insulin resistance and tumors and the underlying mechanism.

THE MODIFIED RADIOIMMUNOASSAY OF SERUM INHIBIN AND ITS VALUE IN MONITORING OVARIAN TUMOR

Objectives and Methods: A modified radioimmunoassay (RIA) of serum inhibin (INH) was developed and applied to measure serum INH contents in 39 fertile and 16 postmenopausal women. Thirty-three cases of ovarian tumors, including granulosa cell tumors and other kinds of ovarian tumors, were monitored by serum INH RIA. Results: The mean value of serum INH contents in follicular, peri-ovulatory and mid-luteal phases of fertile women were 9.48±7.10 pg/ml (2.04～18.53pg/ml), 19.04±9.73 pg/ml (3.49～33.26 pg/ml) and 131.13±110.81 pg/ml (3.49～ 341.10 pg/ml), respectively. Serum INH concentration was negatively correlated with serum FSH concentration, (rs=?0.483,P<0.01). Serum IHN contents were less than 3.6 pg/ml in normal postmenopausal women. The mean value of serum INH contents in ovarian granulosa cell tumor, thecoma, mucinous cystadenocarcinoma and malignant teratoma cases were significantly higher than that of other ovarian tumors, (P<0.01). Serum INH contents were elevated in ovarian granulosa cell tumor, thecoma, mucinous cystadenocaricinoma and endometrioid carcinoma cases with serum CA-125 values in normal range before operation, but serum INH contents decreased to normal range within one week after operation. And consecutive serum INH RIA could be a valuable tool in monitoring for therapeutic effect. Conclusion: Modified INH RIA was of convenient, time-saving and quantitative characteristics, especially with its high sensitivity (<1 pg/ml). There was a regular change of serum INH concentrations during menstrual cycle. INH could inhibit the synthesis and secretion of follicle stimulating hormone (FSH). INH would become a valuable marker for ovarian tumor. INH RIA combined with the measurement of serum CA-125 would be helpful to the early diagnosis, treatment and follow-up for ovarian cancer.

MUTATIONAL SCREEN AT THE OEYTS-JEGHERS (LKB1) LOCUS IN SPORDIC COLON AND OVARIAN TUMORS

Objective: To screen LKB1 mutation in sporadic colon and ovarian tumors. Methods: Using PCR-SSCP analysis, 72 colon cancer, 45 ovarian cancer, 14 granulosa cell tumor were screened for LKB1 mutation. Results: no mutation was in sporadic colon and ovarian adenocarcinomas. Two mutations were detected in one of the granulosa cell tumors: a mis-sense mutation affecting the putative start codon (ATG→ACG, MIT); and a silent change in erxon 7 (CTT→CTA, leucine). Conclusion: LKB1 mutations in sporadic colon and ovarian cancers are rare event and LKB1 is not the target gene lost on chromosome 19p13.3 in ovarian cancers.

Case of pseudo-Meigs' syndrome caused by gastric cancer-related metastatic ovarian tumor with prolonged survival

A 48-year-old woman presented with bilateral enlarged ovaries, ascites, bilateral pleural effusion, and advanced gastric cancer. Pleural fluid cytology did not reveal malignant cells. Oophorectomy, performed as a palliative procedure, was followed by rapid resolution of the pleural effusion and ascites. The patient was diagnosed with pseudo-Meigs&rsquo; syndrome, and underwent chemotherapy followed by partial gastrectomy. At the last follow-up, 84 mo following oophorectomy, she was alive, and free of disease recurrence, despite not receiving any further treatment. Pseudo-Meigs&rsquo; syndrome should be considered in patients with bilateral ovarian tumors, ascites and pleural effusion, and treatment such as oophorectomy may result in symptomatic improvement and better prognosis in similar patients.

Is There Re-staging Surgery Necessity for Borderline Ovarian Tumors

Objective:This study assessed the necessity of surgical re-staging in women with borderline ovarian tumors(BOTs)and evaluated the impact of complete surgical staging,lymphadenectomy,and omentectomy on disease recurrence and survival.Methods:We retrospectively reviewed the medical records of patients with BOTs.A total of 901 patients were eligible for inclusion in the study,and we evaluated some of the variables and clinical/surgical characteristics of the cases.The effects of the type of surgical procedure,surgical staging,and complete or incomplete staging on recurrence were calculated.The rates of disease-free survival,overall survival,and recurrence were compared according to complete surgical staging.A Cox regression analysis was performed to identify potential prognostic factors,and survival curves were constructed using the Kaplan-Meier method.Results:The overall recurrence rate was 13.9%,and recurrence was comparable between the complete surgical staging group and the incomplete groups(P>0.05).The performance of complete surgical staging did not show an effect on long-term survival,and complete surgical staging,omentectomy,and lymphadenectomy had no effect on recurrence.In multivariate analyses,only radical surgery and adjuvant chemotherapy were risk factors for the recurrence of BOTs.Furthermore,we found that omentectomy led to a relatively low recurrence rate in patients with International Federation of Gynecology and Obstetrics(FIGO)stage>Ⅰ(P=0.022).Conclusion:Our results suggest that complete surgical staging should be considered a standard treatment for patients with advanced stage BOTs but not for those at FIGO stageⅠ.It might be safe to reduce the scope of surgical procedures in patients with early-stage BOTs.However,it is not necessary to perform re-staging operations for BOTs with a macroscopically normal extra-ovarian appearance.

Develop a nomogram to predict overall survival of patients with borderline ovarian tumors

BACKGROUND The prognosis of borderline ovarian tumors(BOTs)has been the concern of clinicians and patients.It is urgent to develop a model to predict the survival of patients with BOTs.AIM To construct a nomogram to predict the likelihood of overall survival(OS)in patients with BOTs.METHODS A total of 192 patients with histologically verified BOTs and 374 patients with epithelial ovarian cancer(EOC)were retrospectively investigated for clinical characteristics and survival outcomes.A 1:1 propensity score matching(PSM)analysis was performed to eliminate selection bias.Survival was analyzed by using the log-rank test and the restricted mean survival time(RMST).Next,univariate and multivariate Cox regression analyses were used to identify meaningful independent prognostic factors.In addition,a nomogram model was developed to predict the 1-,3-,and 5-year overall survival of patients with BOTs.The predictive performance of the model was assessed by using the concordance index(C-index),calibration curves,and decision curve analysis(DCA).RESULTS For clinical data,there was no significant difference in body mass index,preoperative CA199 concentration,or tumor localization between the BOTs group and EOC group.Women with BOTs were significantly younger than those with EOC.There was a significant difference in menopausal status,parity,preoperative serum CA125 concentration,Federation International of gynecology and obstetrics(FIGO)stage,and whether patients accepted postoperative adjuvant therapy between the BOT and EOC group.After PSM,patients with BOTs had better overall survival than patients with EOC(P value=0.0067);more importantly,the 5-year RMST of BOTs was longer than that of EOC(P value=0.0002,95%CI-1.137 to-0.263).Multivariate Cox regression analysis showed that diagnosed age and surgical type were independent risk factors for BOT patient OS(P value<0.05).A nomogram was developed based on diagnosed age,preoperative serum CA125 and CA199 Levels,surgical type,FIGO stage,and tumor size.Moreover,the c-index(0.959,95%confidence interval 0.8708–1.0472),calibration plot of 1-,3-,and 5-year OS,and decision curve analysis indicated the accurate predictive ability of this model.CONCLUSION Patients with BOTs had a better prognosis than patients with EOC.The nomogram we constructed might be helpful for clinicians in personalized treatment planning and patient counseling.

Premature Puberty Revealing an Ovarian Tumor in a Five-Year-Old Girl

Background: Ovarian tumors in the girl child are sometimes revealed by the development of secondary sexual characteristics. The authors report the case of a five-year-old girl in whom the disease was revealed by early puberty. Case presentation: A five-year-old girl with an enlarged abdomen for about four months. The onset of pain and the sensation of a mass prompted the consultation. The development of secondary sexual characteristics (SSC) noted by the family had not been mentioned. The patient was classified as pubertal stage 2 according to the Tanner classification. An abdominal ultrasound and a CT scan showed a large left ovarian mass, an enlarged uterus for the patient’s age and a normal right ovary. The hormonal workup was not contributive. The treatment consisted only of a left salpingo-ovarectomy, without complementary chemotherapy. Anatomic pathological examination of the surgical specimen concluded to a juvenile tumor of the granulosa. The evolution was good with a beginning of regression of the HSC one month after the ovarectomy. Discussion: Granulosa tumors are sometimes secretory cancers, generally with a low potential for malignancy and therefore a very good prognosis. Surgery based on total adnexectomy is the first-line treatment. The large size of the tumor, the presence of ascites and capsular rupture are factors of poor prognosis, hence the importance of early diagnosis. Conclusion: Routine comprehensive physical examination should be de rigueur for abdominal masses in girls, especially in the context of various beliefs that may impede early referral to care.

Value of ultrasound and magnetic resonance imaging combined with tumor markers in the diagnosis of ovarian tumors

BACKGROUND Compare the diagnostic performance of ultrasound(US),magnetic resonance imaging(MRI),and serum tumor markers alone or in combination for detecting ovarian tumors.AIM To investigate the diagnostic value of US,MRI combined with tumor markers in ovarian tumors.METHODS The data of 110 patients with ovarian tumors,confirmed by surgery and pathology,were collected in our hospital from February 2018 to May 2023.The dataset included 60 cases of benign tumors and 50 cases of malignant tumors.Prior to surgery,all patients underwent preoperative US and MRI examinations,as well as serum tumor marker tests[carbohydrate antigen 125(CA125),human epididymis protein 4(HE4)].The aim of the study was to compare the diagnostic performance of these three methods individually and in combination for ovarian tumors.RESULTS This study found statistically significant differences in the ultrasonic imaging characteristics between benign and malignant tumors.These differences include echo characteristics,presence or absence of a capsule,blood flow resistance index,clear tumor shape,and blood flow signal display rate(P<0.05).The apparent diffusion coefficient values of the solid and cystic parts in benign tumors were found to be higher compared to malignant tumors(P<0.05).Additionally,the time-intensity curve image features of benign and malignant tumors showed significant statistical differences(P<0.05).The levels of serum CA125 and HE4 in benign tumors were lower than those in malignant tumors(P<0.05).The combined use of US,MRI,and tumor markers in the diagnosis of ovarian tumors demonstrates higher accuracy,sensitivity,and specificity compared to using each method individually(P<0.05).CONCLUSION US,MRI,and tumor markers each have their own advantages and disadvantages when it comes to diagnosing ovarian tumors.However,by combining these three methods,we can significantly enhance the accuracy of ovarian tumor diagnosis,enabling early detection and identification of the tumor’s nature,and providing valuable guidance for clinical treatment.

Dock180 expression in epithelial ovarian tumors

t Objective： The aim of our study was to investigate the expression of guanine nucleotide exchange factor Dock180 in ovarian tumor, and its significance in the initiation and progression of ovarian cancer. Methods： Immunohistochemical staining with SP method was conducted to identify the expression of Dock180 protein in epithelial ovarian tumor in 68 cases. Results： Dock180 present with higher expression in ovarian cancer, as compared with than that in low malignant tumor and benign ovarian tumor （P 〈 0,01）, In ovarian cancer, Dock180 expression was increased with the increased FIGO stage and grade. Conclusion： Dock180 overexpression may play an important role in the development and progression of ovarian cancer and it could be used as a new measurement of malignant biological behavior of ovarian cancer.