CLINICOPATHOLOGICAL SIGNIFICANCE OF PLAP,NSE AND WT1 DETECTION IN OVARIAN DYSGERMINOMA

Objective: To evaluate the expression of placental alkaline phosphatase (PLAP), neuron-specific enolase (NSE), prolactin (PRL) and Wilms?tumor gene (WT1) protein in ovarian dysgerminoma and its Clinico- pathological significance. Methods: Clinicopathological data were retrospectively reviewed in a total of 31 patients with pure dysgerminoma who were treated at College Clinical Medicin, Chongqing Medical University from January 1983 to October 2002. Immunohistological staining for PLAP, NSE, PRL and WT1 was performed in all 31 tumor tissues. Results: The age of the patients ranged from 12 to 42 years old (average 25 yrs). According to the clinical staging, eighteen patients (58.1%) had stage I disease, 5 (16.1%) had stage II, 6(19.4%) had stage III, and 2 (6.4%) had stage IV disease. Of the 31 cases, the positive expression rates of PLAP, NSE, PRL and WT1 were 100% (31/31), 70.9%(22/31), 3.2%(1/31) and 12.9(4/31) respectively. There was a significant relation between NSE expression and clinical stages (P<0.05) and 5 years survival rate (P<0.05). The positive expression rate of WT1 was significantly related to histological types (P<0.05). Conclusion: Dysgerminomas in earlier stages (stage I/II) are associated with a favorable prognosis. NSE positive expression is closely related with advanced tumor stage (stage III/IV). PLAP and NSE can be considered as important markers of dysgerminoma tissues, and the tumor tissues are the main resources of serum PLAP and NSE. WT1 expression correlates with poorer differentiation of dysgerminoma. The importance of PRL in dygerminoma was not certified in this study, and remains to be defined.

Application of ovarian transposition during hysterectomy

Objective To study the optimal position and method for ovarian transposition and its benefits and indications.Methods We performed ovarian transposition in 34 patients from August 1989 to December 2000. Twelve patients were diagnosed with stage Ⅰb to Ⅱa cervical cancer, 4 had stage Ⅰa endometrial carcinoma, 12 had stage Ⅲ to Ⅳ endometriosis, 4 had myoma of uterus, 1 had dysfunctional uterine bleeding, and 1 had an ovarian granulosa cell tumor. Surgery went as follows: the ovary was dissociated by clamp, the skin was incised and a tunnel was made, then the ovary was translocated to the subcutaneous site. In the cases of benign lesions, the ovarian vessel pedicel went in through the abdominal cavity, but in malignant tumors, it went out through the peritoneum. Results In both cases (benign lesions or malignant tumors), the short-term and long-term endocrine function of the translocated ovary remained normal. Furthermore, patients could supervise their translocated ovary themselves.Conclusions Subcutaneous ovary transposition might prevent not only implantation of gastrointestinal cancer but also the extension of pelvic carcinoma to the ovary. Because of the shallow transposition and the incision scar, it is easy for patients to supervise themselves. Moreover, the site of the ovary is easy to locate for ultrasound examinations. Thus, it can obtain the goal of early prevention for cancer. Subcutaneous ovarian transposition with skin incision is the optimal selection and suitable for all patients with various gynecologic diseases in which ovary removal is not necessary.