Cyclooxygenase-2 expression is higher in ovarian cancer tissue adjacent to endometriosis than in ovarian cancer without comorbid endometriosis

Functional Gene Clusters in Global Pathogenesis of Clear Cell Carcinoma of the Ovary Discovered by Integrated Analysis of Transcriptomes

Clear cell carcinoma of the ovary (ovarian clear cell carcinoma (OCCC)) is one epithelial ovarian carcinoma that is known to have a poor prognosis and a tendency for being refractory to treatment due to unclear pathogenesis. Published investigations of OCCC have mainly focused only on individual genes and lack of systematic integrated research to analyze the pathogenesis of OCCC in a genome-wide perspective. Thus, we conducted an integrated analysis using transcriptome datasets from a public domain database to determine genes that may be implicated in the pathogenesis involved in OCCC carcinogenesis. We used the data obtained from the National Center for Biotechnology Information (NCBI) Gene Expression Omnibus (GEO) DataSets. We found six interactive functional gene clusters in the pathogenesis network of OCCC, including ribosomal protein, eukaryotic translation initiation factors, lactate, prostaglandin, proteasome, and insulin-like growth factor. This finding from our integrated analysis affords us a global understanding of the interactive network of OCCC pathogenesis.

Impact of endometriosis on risk of ovarian, endometrial and cervical cancers: a meta-analysis

PURPOSE

The risks of gynecologic cancer have not been well established in women with endometriosis. The objective of the present study was to investigate the influence of endometriosis on the risk for three gynecologic cancer (ovarian cancer, endometrial cancer and cervical cancer).

METHODS

We gathered updated evidence about the risk relationship between endometriosis and gynecologic cancers by conducting a comprehensive search of several medical literature electronic databases, including PubMed, Embase and the Cochrane Library. The design and quality of all studies were evaluated using the Newcastle-Ottawa Scale (NOS), and a random-effects model was used to calculate pooled risk ratio (RR).

RESULTS

Of the 8538 articles our search produced, we selected 25 qualified studies, including 16 cohort studies and 9 case-control studies. Patients with endometriosis had both an increased risk of ovarian cancer [RR  1.964; 95% CI (1.685, 2.290)]. The risk of endometrial cancer (EC) is not necessarily higher in patients with endometriosis [RR 1.176, 95% CI (0.878, 1.575)]. Endometriosis was not associated with an increased risk for cervical cancer (CC) [RR 0.670, 95% CI (0.537, 0.838)].

CONCLUSIONS

Patients with endometriosis need to be closely observed and rechecked regularly to prevent malignant changes.

Endometriosis and ovarian cancer: a systematic review

Introduction. Endometriosis is one of the most common benign disorders which affects 10-15% of all women in reproductive age. The association between endometriosis and ovarian cancer has been frequently described in the medical literature. Purpose. To evaluate the literature for evidence of a correlation between endometriosis and ovarian cancer. Method. the English language literature (online MEDLINE and EMBASE database) was searched using the keywords endometriosis combined with cancer, tumour, tumor, carcinoma, or adenocarcinoma. All abstracts between January 1985 and August 2010 were reviewed. Full relevant articles were critically assessed. Reference lists of included studies were checked. Results. Seven out of the eight studies, included in our review, have shown an increased risk of ovarian cancer. However, the effect size is modest (OR, RR, and SIR) ranging between 1.32 and 1.9 (95% CI). A causative relationship between the two incidences cannot be confirmed. There is increasing evidence on the role of genetic mutations in ovarian clear-cell and endometrioid carcinoma developing from endometriosis. Conclusion. More evidence is needed before suggesting any change in the current management of endometriosis.

Immunohistochemical biomarkers of value in distinguishing primary ovarian carcinoma from gastric carcinoma: a systematic review with statistical meta-analysis

AIMS

To compare the relative risk of antigen expression being detected immunohistochemically in ovarian and gastric carcinoma aggregated from studies performed for diagnostic purposes, with the relative risks of their expression in all patients in the English literature.

METHODS AND RESULTS

Both types of series indicated that cytokeratin (CK) 7 expression was greater and that of CK20 and carcinoembryonic antigen less in ovarian than in gastric carcinoma (P < 0.05). Synthesis of all data available for MUC-2 suggested it was more commonly expressed in ovarian carcinoma, whereas the relative risk in papers that directly compared its expression suggested that it was more common in the gastric carcinoma (P = 0.2, NS). Aggregating all possible data suggested villin was more likely to be expressed in ovarian cancers, whereas studies in which its expression was compared directly in both tumours suggested the opposite. Although statistically significant, patient numbers were small.

CONCLUSION

Provided sufficient numbers of cases are studied, analysis of studies comparing antigen expression for diagnostic purposes in tumours from two body sites is likely to be supported in the wider literature. The design of such comparative studies is informed by aggregating data from single tumour studies.

Small primary adenocarcinoma in adenomyosis with nodal metastasis: a case report

Background

Malignant transformation of adenomyosis is a very rare event. Only about 30 cases of this occurrence have been documented till now.

Case presentation

The patient was a 57-year-old woman with a slightly enlarged uterus, who underwent total hysterectomy and unilateral adnexectomy. On gross inspection, the uterine wall displayed a single nodule measuring 5 cm and several small gelatinous lesions. Microscopic examination revealed a common leiomyoma and multiple adenomyotic foci. A few of these glands were transformed into a moderately differentiated adenocarcinoma. The endometrium was completely examined and tumor free. The carcinoma was, therefore, considered to be an endometrioid adenocarcinoma arising from adenomyosis. Four months later, an ultrasound scan revealed enlarged pelvic lymph nodes: a cytological diagnosis of metastatic adenocarcinoma was made.

Immunohistochemical studies showed an enhanced positivity of the tumor site together with the neighbouring adenomyotic foci for estrogen receptors, aromatase, p53 and COX-2 expression when compared to the distant adenomyotic glands and the endometrium. We therefore postulate that the neoplastic transformation of adenomyosis implies an early carcinogenic event involving p53 and COX-2; further tumor growth is sustained by an autocrine-paracrine loop, based on a modulation of hormone receptors as well as aromatase and COX-2 local expression.

Conclusion

Adenocarcinoma in adenomyosis may be affected by local hormonal influence and, despite its small size, may metastasize.

Effect of a selective nonsteroidal anti-inflammatory drug, celecoxib, on the reproductive function of female mice

BACKGROUND

The aim of the present study was to determine if long-term use of a cyclooxygenase-2 (COX-2) inhibitor affects fertility or ovulation in female mice.

METHODS

Twenty-four female mice, 25 days of age, were given a selective COX-2 inhibitor: 3 mg/kg celecoxib (n = 8), 5 mg/kg celecoxib (n = 8),or placebo (n = 8) in a random fashion. Eight female mice, 10-11 weeks old, given 3 mg/kg celecoxib (n = 4) or placebo (n = 4) were subjected to continuous mating studies.

RESULTS

Results from the 24 mice (n = 8 for each group) showed that oocyte number was not significantly different between female mice treated with either 3 mg/kg or 5 mg/kg celecoxib and placebo (21.4 +/- 2.5, 21.5 +/- 3.3, 23.3 +/- 3.8, respectively). From the continuous mating study, the litter size of female mice treated with celecoxib was not significantly different (8.2 +/- 1.3 pups/litter) compared to those treated with placebo (8.3 +/- 1.2 pups/litter). In addition, female mice treated with celecoxib had an average of 2.8 +/- 0.5 litters in a 12-week period, which was similar to female mice treated with placebo (3.0 +/- 0.8 litters/female).

CONCLUSION

This study suggests that use of low-dose (<or= 5 mg/kg) selective COX-2 inhibitor in a mouse model does not significantly impair the female reproductive function.