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López-Botella A, Gómez-Torres MJ, Sánchez R, Todolí-Torró JL, Velasco I, Acién M. Elevated Lead, Nickel, and Bismuth Levels in the Peritoneal Fluid of a Peritoneal Endometriosis Patient without Toxic Habits or Occupational Exposure following a Vegetarian Diet. TOXICS 2023; 11:1009. [PMID: 38133409 PMCID: PMC10747131 DOI: 10.3390/toxics11121009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 11/30/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023]
Abstract
Potentially toxic elements (PTEs), found as environmental contaminants, have been related to endometriosis disease. In this context, the peritoneal fluid (PF) matrix has been poorly studied despite its importance. PF is the environment in which endometriotic lesions reside and communicate with surrounding tissues including tissues and nerve cells. In this work, our investigation group reports the special case of a peritoneal endometriosis patient presenting elevated lead, nickel, and bismuth levels in PF. This patient reported following a vegetarian diet and no toxic habits or occupational exposure. In conclusion, the elevated levels of PTEs found may result from a vegetarian diet or an unidentified environmental exposure source. This report provides new insights regarding the possible etiology of endometriosis disease and potential biomarkers for its diagnosis in early stages, although additional research is needed.
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Affiliation(s)
- Andrea López-Botella
- Service of Obstetrics and Gynecology, Unit of Human Reproduction, FISABIO—San Juan University Hospital, Carretera Alicante-Valencia s/n, 03550 Sant Joan d’Alacant, Alicante, Spain; (A.L.-B.); (M.A.)
- Biotechnology Department, Faculty of Sciences, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig, Alicante, Spain;
- Department of Analytical Chemistry, Nutrition and Food Sciences, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig, Alicante, Spain; (R.S.); (J.-L.T.-T.)
| | - María José Gómez-Torres
- Biotechnology Department, Faculty of Sciences, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig, Alicante, Spain;
| | - Raquel Sánchez
- Department of Analytical Chemistry, Nutrition and Food Sciences, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig, Alicante, Spain; (R.S.); (J.-L.T.-T.)
| | - José-Luis Todolí-Torró
- Department of Analytical Chemistry, Nutrition and Food Sciences, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig, Alicante, Spain; (R.S.); (J.-L.T.-T.)
| | - Irene Velasco
- Service of Obstetrics and Gynecology, Unit of Human Reproduction, FISABIO—San Juan University Hospital, Carretera Alicante-Valencia s/n, 03550 Sant Joan d’Alacant, Alicante, Spain; (A.L.-B.); (M.A.)
- Biotechnology Department, Faculty of Sciences, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 San Vicente del Raspeig, Alicante, Spain;
| | - Maribel Acién
- Service of Obstetrics and Gynecology, Unit of Human Reproduction, FISABIO—San Juan University Hospital, Carretera Alicante-Valencia s/n, 03550 Sant Joan d’Alacant, Alicante, Spain; (A.L.-B.); (M.A.)
- Gynecology Division, Faculty of Medicine, Miguel Hernández University, Carretera Alicante-Valencia s/n, 03202 Elche, Alicante, Spain
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López-Botella A, Sánchez R, Todolí-Torró JL, Gómez-Torres MJ, Velasco I, Acién M. A New Advanced and Validated Method for the Determination of Potentially Toxic Metals and Trace and Ultra-Trace Elements in Peritoneal Fluid to Assess the Health Risks of Women with Gynecological Pathologies. TOXICS 2023; 11:toxics11050399. [PMID: 37235214 DOI: 10.3390/toxics11050399] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023]
Abstract
Toxic metals found in the environment have been linked to female infertility and gynecological illnesses. Reliable analytical methods, such as inductively coupled plasma tandem mass spectrometry (ICP-MS/MS), are necessary to determine the elemental composition of biological samples. Currently, the multielemental profile of peritoneal fluid (PF) samples has not yet been established. Due to the complexity of the PF matrix, an ICP-MS/MS-based method has been optimized to mitigate matrix effects and spectral interferences. A dilution factor of 1:4 was the best option to mitigate matrix effects while keeping sensitivity at an appropriate level. A collision gas (He) was useful to lower the extent of spectral interferences for 56Fe, 52Cr, 63Cu, and 68Zn. An intermediate validation test was performed to evaluate accuracy, achieving recoveries ranging from 90 to 110%. The method was validated in terms of intermediate precision, reproducibility, and trueness, with an expanded uncertainty lower than 15%. Afterward, it was applied to perform the multielemental analysis of 20 PF samples. The concentrations for major analytes were up to 151 µg L-1. Meanwhile,209Bi, 111Cd, 52Cr, 55Mn, 95Mo, 60Ni, 208Pb, 118Sn, and 51V were present at concentrations included within the 1-10 µg L-1 range, while 59Co and 139La were found at concentrations below 1 µg L-1.
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Affiliation(s)
- Andrea López-Botella
- Service of Obstetrics and Gynecology, Unit of Human Reproduction, FISABIO-San Juan University Hospital, Carretera Alicante-Valencia s/n, 03550 Alicante, Spain
- Biotechnology Department, Faculty of Sciences, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 Alicante, Spain
- Department of Analytical Chemistry, Nutrition and Food Sciences, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 Alicante, Spain
| | - Raquel Sánchez
- Department of Analytical Chemistry, Nutrition and Food Sciences, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 Alicante, Spain
| | - José-Luis Todolí-Torró
- Department of Analytical Chemistry, Nutrition and Food Sciences, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 Alicante, Spain
| | - María José Gómez-Torres
- Biotechnology Department, Faculty of Sciences, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 Alicante, Spain
| | - Irene Velasco
- Service of Obstetrics and Gynecology, Unit of Human Reproduction, FISABIO-San Juan University Hospital, Carretera Alicante-Valencia s/n, 03550 Alicante, Spain
- Biotechnology Department, Faculty of Sciences, University of Alicante, Carretera San Vicente del Raspeig s/n, 03690 Alicante, Spain
| | - Maribel Acién
- Service of Obstetrics and Gynecology, Unit of Human Reproduction, FISABIO-San Juan University Hospital, Carretera Alicante-Valencia s/n, 03550 Alicante, Spain
- Gynecology Division, Faculty of Medicine, Miguel Hernández University, Carretera Alicante-Valencia s/n, 03550 Alicante, Spain
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Pandraklakis A, Prodromidou A, Haidopoulos D, Paspala A, Oikonomou MD, Machairiotis N, Rodolakis A, Thomakos N. Clinicopathological Characteristics and Outcomes of Patients With Endometriosis-Related Hemorrhagic Ascites: An Updated Systematic Review of the Literature. Cureus 2022; 14:e26222. [PMID: 35911338 PMCID: PMC9313015 DOI: 10.7759/cureus.26222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2022] [Indexed: 11/16/2022] Open
Abstract
The presence of ascites is a common clinical presentation in gynecologic oncology patients. Hemorrhagic ascites (HA) due to endometriosis is a rare presentation that can be easily misdiagnosed as ovarian malignancies. The present study aims to update the currently available knowledge on the characteristics of patients presenting with HA due to endometriosis. A systematic search was conducted for articles published from January 2000 to July 2020 using the Medline, Scopus, and Google Scholar databases along with the references of the full-text articles retrieved. Papers describing cases of women over 18 years with or without previous history of endometriosis were assessed. Only cases with histologically proven hemorrhagic ascites of endometriosis origin were included. Twenty-nine studies (27 case reports and two case series) comprising 32 patients were evaluated. The mean patients’ age was 32 years, while six of the patients had a previous history of endometriosis. The mean amount of drained ascitic fluid was 4,200 mL, whereas three patients underwent thoracentesis due to pleural effusions. The treatment options included not only medical but also surgical therapies. Fertility preservation was achieved in 27 patients, while two of them achieved pregnancy with in vitro fertilization (IVF) techniques. Endometriosis-related hemorrhagic ascites is a relatively rare expression of the disease. Endometriosis-related hemorrhagic ascites should be considered in the differential diagnosis (DD) of women with ascites and clinical suspicion of endometriosis. The available literature is limited to case reports and case series and thus indicates further research in the field to decode the pathophysiology of the disease and decide on the optimal treatment.
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Sao CH, Lai WA, Lin SC, Chang CM, Chen YJ, Wang PH. Endometriosis-associated epithelial ovarian cancer: Primary synchronous different cellular type on each ovary. Taiwan J Obstet Gynecol 2021; 59:460-463. [PMID: 32416900 DOI: 10.1016/j.tjog.2020.03.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2020] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Endometriosis-associated epithelial ovarian cancer (EOC) is a specific category of EOC, containing either endometrioid or clear cell carcinoma subtype. The characteristic of endometriosis-associated EOC includes an early stage at the diagnosis, presence of single histology type, and better prognosis. The synchronous two subtypes of endometriosis-associated EOC and presentation of far-advanced stage status at the initial diagnosis is rarely reported. CASE REPORT We reported a 60-year-old postmenopausal woman with FIGO IA endometriosis-associated endometrioid carcinoma at right ovary and FIGO IVA endometriosis-associated clear cell carcinoma at left ovary, right tube, omentum, lymph node and cytology of pleural effusion and ascites treated with optimal debulking surgery and dose-intensity taxane/platinum based chemotherapy. CONCLUSION This case report confirms the long-term concept that clear cell carcinoma has much more aggressive behavior than endometrioid cell carcinoma does, regardless of association of endometriosis or not.
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Affiliation(s)
- Chih-Hsuan Sao
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-An Lai
- Department of Pathology and Laboratory Medicine Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Chieh Lin
- Department of Pathology and Laboratory Medicine Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chia-Ming Chang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yi-Jen Chen
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Peng-Hui Wang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan; Female Cancer Foundation, Taipei, Taiwan.
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Abstract
The current standard therapy of epithelial ovarian cancer (EOC) is the combination of surgery and multiagent chemotherapy with/without adding targeted therapy. After treatment, response rate is high and nearly all patients can achieve complete remission, even though they are advanced diseases; however, the majority of patients will relapse and subsequently die of diseases within several years after initial treatment. When treatment options are limited, there is the urgent need for new novel therapeutic approaches for precise cancer control. The development of chemoresistance and evading of the anticancer immune response may be one of the important causes contributing to the therapeutic failure, and therefore, it represents a paradigm shift in cancer research. An individual's immune response and interaction with EOC cells might be one of the key factors for cancer treatment. There are many interventions, including targeting certain type immunogenic EOC-associated antigens, immune checkpoint blockade, and adoptive cellular therapy, which present a profound opportunity to revolutionize EOC treatment. This review will encompass the interaction between EOC and immune system and highlight recent data regarding the research of immunotherapy in EOC.
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Affiliation(s)
- Wen-Ling Lee
- Department of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan, ROC
- Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan, ROC
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Peng-Hui Wang
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC
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Huang CY, Cheng NM, Wang PH. Risk factors associated with epithelial ovarian cancer in women with endometriosis. Taiwan J Obstet Gynecol 2020; 59:353-355. [DOI: 10.1016/j.tjog.2020.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2020] [Indexed: 12/12/2022] Open
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Abstract
Sialylation (the covalent addition of sialic acid to the terminal end of glycoproteins or glycans), tightly regulated cell- and microenvironment-specific process and orchestrated by sialyltransferases and sialidases (neuraminidases) family, is one of the posttranslational modifications, which plays an important biological role in the maintenance of normal physiology and involves many pathological dysfunctions. Glycans have roles in all the cancer hallmarks, referring to capabilities acquired during all steps of cancer development to initiate malignant transformation (a driver of a malignant genotype), enable cancer cells to survive, proliferate, and metastasize (a consequence of a malignant phenotype), which includes sustaining proliferative signaling, evading growth suppressor, resisting cell apoptosis, enabling replicative immortality, inducing angiogenesis, reprogramming of energy metabolism, evading tumor destruction, accumulating inflammatory microenvironment, and activating invasion and accelerating metastases. Regarding the important role of altered sialylation of cancers, further knowledge about the initiation and the consequences of altered sialylation pattern in tumor cells is needed, because all may offer a better chance for developing novel therapeutic strategy. In this review, we would like to update alteration of sialylation in ovarian cancers.
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Affiliation(s)
- Wen-Ling Lee
- Department of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan, ROC
- Department of Nursing, Oriental Institute of Technology, New Taipei City, Taiwan, ROC
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Peng-Hui Wang
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Department of Medical Research, China Medical University Hospital, Taichung, Taiwan, ROC
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Huang CY, Cheng M, Lee NR, Huang HY, Lee WL, Chang WH, Wang PH. Comparing Paclitaxel-Carboplatin with Paclitaxel-Cisplatin as the Front-Line Chemotherapy for Patients with FIGO IIIC Serous-Type Tubo-Ovarian Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072213. [PMID: 32224896 PMCID: PMC7177627 DOI: 10.3390/ijerph17072213] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 12/11/2022]
Abstract
The use of weekly chemotherapy for the treatment of patients with advanced-stage serous-type epithelial Tubo-ovarian cancer (ETOC), and primary peritoneal serous carcinoma (PPSC) is acceptable as the front-line postoperative chemotherapy after primary cytoreductive surgery (PCS). The main component of dose-dense chemotherapy is weekly paclitaxel (80 mg/m2), but it would be interesting to know what is the difference between combination of triweekly cisplatin (20 mg/m2) or triweekly carboplatin (carboplatin area under the curve 5-7 mg/mL per min [AUC 5-7]) in the dose-dense paclitaxel regimen. Therefore, we compared the outcomes of women with Gynecology and Obstetrics (FIGO) stage IIIC ETOC and PPSC treated with PCS and a subsequent combination of dose-dense weekly paclitaxel and triweekly cisplatin (paclitaxel–cisplatin) or triweekly carboplatin using AUC 5 (paclitaxel–carboplatin). Between January 2010 and December 2016, 40 women with International Federation of Gynecology and Obstetrics (FIGO) stage IIIC EOC, FTC, or PPSC were enrolled, including 18 treated with paclitaxel–cisplatin and the remaining 22 treated with paclitaxel–carboplatin. There were no statistically significant differences in disease characteristics of patients between two groups. Outcomes in paclitaxel–cisplatin group seemed to be little better than those in paclitaxel–carboplatin (median progression-free survival [PFS] 30 versus 25 months as well as median overall survival [OS] 58.5 versus 55.0 months); however, neither reached a statistically significant difference. In terms of adverse events (AEs), patients in paclitaxel–carboplatin group had more AEs, with a higher risk of neutropenia and grade 3/4 neutropenia, and the need for a longer period to complete the front-line chemotherapy, and the latter was associated with worse outcome for patients. We found that a period between the first-time chemotherapy to the last dose (6 cycles) of chemotherapy >21 weeks was associated with a worse prognosis in patients compared to that ≤21 weeks, with hazard ratio (HR) of 81.24 for PFS and 9.57 for OS. As predicted, suboptimal debulking surgery (>1 cm) also contributed to a worse outcome than optimal debulking surgery (≤1 cm) with HR of 14.38 for PFS and 11.83 for OS. Based on the aforementioned findings, both regimens were feasible and effective, but maximal efforts should be made to achieve optimal debulking surgery and following the on-schedule administration of dose-dense weekly paclitaxel plus triweekly platinum compounds. Randomized trials validating the findings are warranted.
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Affiliation(s)
- Chen-Yu Huang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-Y.H.); (M.C.)
- Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei 112, Taiwan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei 112, Taiwan;
| | - Min Cheng
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-Y.H.); (M.C.)
- Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei 112, Taiwan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei 112, Taiwan;
| | - Na-Rong Lee
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-Y.H.); (M.C.)
- Department of Nursing, Taipei Veterans General Hospital, Taipei 112, Taiwan
| | - Hsin-Yi Huang
- Biostatics Task Force, Taipei Veterans General Hospital, Taipei 112, Taiwan;
| | - Wen-Ling Lee
- Institute of Clinical Medicine, National Yang-Ming University, Taipei 112, Taiwan;
- Department of Medicine, Cheng-Hsin General Hospital, Taipei 112, Taiwan
- Department of Nursing, Oriental Institute of Technology, New Taipei City 220, Taiwan
| | - Wen-Hsun Chang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-Y.H.); (M.C.)
- Institute of Clinical Medicine, National Yang-Ming University, Taipei 112, Taiwan;
- Department of Nursing, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Correspondence: (W.-H.C.); (P.-H.W.); Tel.: +886-2-2875-7826 (W.-H.C.); +886-2-2875-7566 (P.-H.W.)
| | - Peng-Hui Wang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-Y.H.); (M.C.)
- Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei 112, Taiwan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei 112, Taiwan;
- Department of Medical Research, China Medical University Hospital, Taichung 440, Taiwan
- Female Cancer Foundation, Taipei 104, Taiwan
- Correspondence: (W.-H.C.); (P.-H.W.); Tel.: +886-2-2875-7826 (W.-H.C.); +886-2-2875-7566 (P.-H.W.)
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Chung KC, Lee HH, Su MH, Chang WH, Lai WA, Wang PH. Ovarian fibrothecoma mimicking ovarian cancer: Using laparoscopy to avoid unnecessary exploratory laparotomy. Taiwan J Obstet Gynecol 2019; 58:903-904. [DOI: 10.1016/j.tjog.2019.09.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2019] [Indexed: 01/12/2023] Open
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