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Chang S, Krzyzanowska H, Bowden AK. Label-Free Optical Technologies to Enhance Noninvasive Endoscopic Imaging of Early-Stage Cancers. ANNUAL REVIEW OF ANALYTICAL CHEMISTRY (PALO ALTO, CALIF.) 2024; 17:289-311. [PMID: 38424030 DOI: 10.1146/annurev-anchem-061622-014208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
White light endoscopic imaging allows for the examination of internal human organs and is essential in the detection and treatment of early-stage cancers. To facilitate diagnosis of precancerous changes and early-stage cancers, label-free optical technologies that provide enhanced malignancy-specific contrast and depth information have been extensively researched. The rapid development of technology in the past two decades has enabled integration of these optical technologies into clinical endoscopy. In recent years, the significant advantages of using these adjunct optical devices have been shown, suggesting readiness for clinical translation. In this review, we provide an overview of the working principles and miniaturization considerations and summarize the clinical and preclinical demonstrations of several such techniques for early-stage cancer detection. We also offer an outlook for the integration of multiple technologies and the use of computer-aided diagnosis in clinical endoscopy.
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Affiliation(s)
- Shuang Chang
- 1Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, Tennessee, USA;
- 2Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Halina Krzyzanowska
- 1Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, Tennessee, USA;
- 2Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
| | - Audrey K Bowden
- 1Vanderbilt Biophotonics Center, Vanderbilt University, Nashville, Tennessee, USA;
- 2Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA
- 3Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, Tennessee, USA
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Wiench R, Paliga D, Mertas A, Bobela E, Kuśka-Kiełbratowska A, Bordin-Aykroyd S, Kawczyk-Krupka A, Grzech-Leśniak K, Lukomska-Szymanska M, Lynch E, Skaba D. Red/Orange Autofluorescence in Selected Candida Strains Exposed to 405 nm Laser Light. Dent J (Basel) 2024; 12:48. [PMID: 38534272 DOI: 10.3390/dj12030048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 02/02/2024] [Accepted: 02/20/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Candida albicans and similar species are significant pathogens in immunocompromised and hospitalized individuals, known for mucosal colonization and bloodstream/organ invasion. Many pathogenic fungi, including these species, exhibit autofluorescence (R/OF) under specific light conditions, a feature crucial for their detection. AIM We investigated the use of a 405 nm diode laser for the direct observation of red/orange autofluorescence of Candida spp., common in the oral cavity, exploring its potential in health screenings. METHODS This study utilized cultures of Candida spp. on Sabouraud dextrose agar with Qdot 655 and 685 for fluorescence benchmarking, illuminated using a 405 nm diode laser (continuous wave, power 250 mW, 0.0425 J/cm² fluence, 0.0014 W/cm² power density). Images were captured using a yellow-filter camera at set intervals (48 to 144 h). Visual and computational analyses evaluated the R/OF in terms of presence, intensity, coloration, and intra-colony variation. RESULTS Most Candida strains displayed red/orange autofluorescence at all observation times, characterized by varied coloration and intra-colony distribution. Initially, there was an increase in R/OF intensity, which then stabilized in the later stages of observation. CONCLUSIONS The majority of the Candida strains tested are capable of emitting R/OF under 405 nm laser light. This finding opens up new possibilities for integrating R/OF detection into routine dental screenings for Candida spp.
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Affiliation(s)
- Rafał Wiench
- Department of Periodontal Diseases and Oral Mucosa Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Dariusz Paliga
- Dental Office Reanata and Dariusz Paliga, Aleja Niepodległości 3/lok 2, 35-303 Rzeszów, Poland
| | - Anna Mertas
- Department of Microbiology and Immunology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Elżbieta Bobela
- Department of Microbiology and Immunology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Anna Kuśka-Kiełbratowska
- Department of Periodontal Diseases and Oral Mucosa Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
| | - Sonia Bordin-Aykroyd
- Photomedicine, Leicester School of Pharmacy, De Montfort University, The Gateway, Leicester LE1 9BH, UK
| | - Aleksandra Kawczyk-Krupka
- Department of Internal Diseases, Angiology and Physical Medicine, Center for Laser Diagnostics and Therapy, Medical University of Silesia in Katowice, 41-902 Bytom, Poland
| | - Kinga Grzech-Leśniak
- Laser Laboratory, Dental Surgery Department, Wroclaw Medical University, 50-425 Wroclaw, Poland
- Department of Periodontics, School of Dentistry, Virginia Commonwealth University, Richmond, VA 23284, USA
| | | | - Edward Lynch
- Photomedicine, Leicester School of Pharmacy, De Montfort University, The Gateway, Leicester LE1 9BH, UK
| | - Dariusz Skaba
- Department of Periodontal Diseases and Oral Mucosa Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland
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Howard C, Rice PFS, Keenan M, Dominguez-Cooks J, Heusinkveld J, Hsu CH, Barton JK. Study of fallopian tube anatomy and mechanical properties to determine pressure limits for endoscopic exploration. J Histotechnol 2022; 45:10-20. [PMID: 34496720 PMCID: PMC10566563 DOI: 10.1080/01478885.2021.1972250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Falloposcopy is the endoscopic examination of the fallopian tubes, which are challenging to access due to their deep body location, small opening from the uterus, and lumen filled with plicae. We and others have developed endoscopes that are inserted through the uterus guided by a hysteroscope into the tubal ostium. To better understand how to utilize these endoscopes either as standalone devices or in concert with everting delivery balloons, a preliminary study of anatomy and mechanical behavior was performed ex vivo on porcine and human fallopian tubes. Segments of fallopian tubes from the isthmus, ampulla and infundibulum were inflated with saline either to bursting or held at sub-burst pressures with saline or a saline-filled balloon. Formalin fixed, paraffin embedded tissue sections stained with Masson's trichrome were examined for damage to the mucosa and muscularis. Porcine fallopian tubes tolerated saline pressurization at 15 psi for 1 minute without morphological damage. Balloon inflation to 15 psi caused no apparent damage to the muscle layer or rupture of the fallopian tube, but balloon movement within the tube can denude the mucosal epithelial layer. Human fallopian tubes averaged higher burst pressure values than porcine tubes. Under pressurization, the external tube diameter expanded by minimal to moderate amounts. Human and porcine tissues were similar in histological appearance. These studies suggest that moderate pressurization is acceptable but will not appreciably expand the fallopian tube diameter. The results also indicate that pigs are a reasonable model to study damage from falloscopy as seen in human tissue.
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Affiliation(s)
- Caitlin Howard
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA
| | - Photini F S Rice
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA
| | - Molly Keenan
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA
| | | | - John Heusinkveld
- Department of Obstetrics and Gynecology, University of Arizona, Tucson, AZ, USA
| | - Chiu-Hsieh Hsu
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA
| | - Jennifer K Barton
- Department of Biomedical Engineering, University of Arizona, Tucson, AZ, USA
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Cordova R, Kiekens K, Burrell S, Drake W, Kmeid Z, Rice P, Rocha A, Diaz S, Yamada S, Yozwiak M, Nelson OL, Rodriguez GC, Heusinkveld J, Shih IM, Alberts DS, Barton JK. Sub-millimeter endoscope demonstrates feasibility of in vivo reflectance imaging, fluorescence imaging, and cell collection in the fallopian tubes. JOURNAL OF BIOMEDICAL OPTICS 2021; 26:JBO-200404R. [PMID: 34216135 PMCID: PMC8253554 DOI: 10.1117/1.jbo.26.7.076001] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 06/15/2021] [Indexed: 06/13/2023]
Abstract
SIGNIFICANCE Most cases of high-grade serous ovarian carcinoma originate as serous tubal intraepithelial carcinoma (STIC) lesions in the fallopian tube epithelium (FTE), enabling early endoscopic detection. AIM The cell-acquiring fallopian endoscope (CAFE) was built to meet requirements for locating potentially pathological tissue indicated by an alteration in autofluorescence or presence of a targeted fluorophore. A channel was included for directed scrape biopsy of cells from regions of interest. APPROACH Imaging resolution and fluorescence sensitivity were measured using a standard resolution target and fluorescence standards, respectively. A prototype was tested in ex vivo tissue, and collected cells were counted and processed. RESULTS Measured imaging resolution was 88 μm at a 5-mm distance, and full field of view was ∼45 deg in air. Reflectance and fluorescence images in ex vivo porcine reproductive tracts were captured, and fit through human tracts was verified. Hemocytometry counts showed that on the order of 105 cells per scrape biopsy could be collected from ex vivo porcine tissue. CONCLUSIONS All requirements for viewing STIC in the FTE were met, and collected cell counts exceeded input requirements for relevant analyses. Our benchtop findings suggest the potential utility of the CAFE device for in vivo imaging and cell collection in future clinical trials.
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Affiliation(s)
- Ricky Cordova
- University of Arizona, Department of Biomedical Engineering, Tucson, Arizona, United States
| | - Kelli Kiekens
- University of Arizona, Department of Biomedical Engineering, Tucson, Arizona, United States
| | - Susan Burrell
- University of Arizona, Department of Biomedical Engineering, Tucson, Arizona, United States
| | - William Drake
- University of Arizona, Department of Biomedical Engineering, Tucson, Arizona, United States
| | - Zaynah Kmeid
- University of Arizona, Department of Biomedical Engineering, Tucson, Arizona, United States
| | - Photini Rice
- University of Arizona, Department of Biomedical Engineering, Tucson, Arizona, United States
| | - Andrew Rocha
- University of Arizona, Department of Biomedical Engineering, Tucson, Arizona, United States
| | - Sebastian Diaz
- University of Arizona, Department of Biomedical Engineering, Tucson, Arizona, United States
| | - Shigehiro Yamada
- Johns Hopkins University, Department of Biomedical Engineering, Baltimore, Maryland, United States
| | - Michael Yozwiak
- University of Arizona, Department of Medicine, Tucson, Arizona, United States
| | - Omar L. Nelson
- NorthShore University HealthSystem, Evanston, Illinois, United States
- University of Chicago, Pritzker School of Medicine, Chicago, Illinois, United States
| | - Gustavo C. Rodriguez
- NorthShore University HealthSystem, Evanston, Illinois, United States
- University of Chicago, Pritzker School of Medicine, Chicago, Illinois, United States
| | - John Heusinkveld
- Banner–University Medical Center, Tucson, Arizona, United States
| | - Ie-Ming Shih
- Johns Hopkins University, Department of Biomedical Engineering, Baltimore, Maryland, United States
| | - David S. Alberts
- University of Arizona, Department of Medicine, Tucson, Arizona, United States
| | - Jennifer K. Barton
- University of Arizona, Department of Biomedical Engineering, Tucson, Arizona, United States
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5
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Review of biomarker systems as an alternative for early diagnosis of ovarian carcinoma. Clin Transl Oncol 2021; 23:1967-1978. [PMID: 33840014 DOI: 10.1007/s12094-021-02604-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 03/19/2021] [Indexed: 10/21/2022]
Abstract
Early diagnosis of ovarian carcinoma is bound to boost the long-term endurance rate of the patients. Most ovarian tumors happen post menopause when the ovaries have no vital operation and therefore irregular ovarian role causes no signs. According to Muinao T. et al. (Heliyon. 5(12):e02826, 2019), if we consider the frequency of ovarian carcinoma to be moderate, a screening technique must accomplish a base specificity of 99.6% and sensitivity of over 75%. The classification and approval of early diagnostic biomarkers explicit to ovarian carcinoma are essentially required. Prevailing methods for early diagnosis of ovarian carcinoma incorporate TVS, biological marker examination, or a blend of the two or other. In recent years, it has been revealed that a combination of at least two biomarkers has beaten single biomarkers in measures for early diagnosis of the illness. In the present document, we survey the ongoing exploration of innovative characteristic methodologies and possible panels of carcinoma biological markers for the early diagnosis of ovarian carcinoma and discuss biomarkers as the plausible apparatus for model improvement and other progressed approaches as an effective alternative to the prevailing methods for early diagnosis of this dreadful disease to evade bogus analysis and inordinate expense.
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Kiekens KC, Romano G, Galvez D, Cordova R, Heusinkveld J, Hatch K, Drake W, Kmeid Z, Barton JK. Reengineering a falloposcope imaging system for clinical use. TRANSLATIONAL BIOPHOTONICS 2020. [DOI: 10.1002/tbio.202000011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Kelli C. Kiekens
- Wyant College of Optical Science University of Arizona Tucson Arizona USA
| | | | - Dominique Galvez
- Wyant College of Optical Science University of Arizona Tucson Arizona USA
| | - Ricky Cordova
- Biomedical Engineering University of Arizona Tucson Arizona USA
| | - John Heusinkveld
- Obstetrics and Gynecology University of Arizona Tucson Arizona USA
| | - Kenneth Hatch
- Obstetrics and Gynecology University of Arizona Tucson Arizona USA
| | - William Drake
- Wyant College of Optical Science University of Arizona Tucson Arizona USA
| | - Zaynah Kmeid
- Biomedical Engineering University of Arizona Tucson Arizona USA
| | - Jennifer K. Barton
- Wyant College of Optical Science University of Arizona Tucson Arizona USA
- Biomedical Engineering University of Arizona Tucson Arizona USA
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Ovarian cancer screening: Current status and future directions. Best Pract Res Clin Obstet Gynaecol 2020; 65:32-45. [PMID: 32273169 DOI: 10.1016/j.bpobgyn.2020.02.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 02/26/2020] [Accepted: 02/26/2020] [Indexed: 02/08/2023]
Abstract
Ovarian cancer is the third most common gynaecological malignancy and the most lethal worldwide. Most patients are diagnosed with advanced disease which carries significant mortality. Improvements in treatment have only resulted in modest increases in survival. This has driven efforts to reduce mortality through screening. Multimodal ovarian cancer screening using a longitudinal CA125 algorithm has resulted in diagnosis at an earlier stage, both in average and high risk women in two large UK trials. However, no randomised controlled trial has demonstrated a definitive mortality benefit. Extended follow up is underway in the largest trial to date, UKCTOCS, to explore the delayed reduction in mortality that was noted. Meanwhile, screening is not currently recommended in the general population Some countries offer surveillance of high risk women. Novel screening modalities and longitudinal biomarker algorithms offer potential improvements to future screening strategies as does the development of better risk stratification tools.
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Otsuka I, Matsuura T. Screening and Prevention for High-Grade Serous Carcinoma of the Ovary Based on Carcinogenesis-Fallopian Tube- and Ovarian-Derived Tumors and Incessant Retrograde Bleeding. Diagnostics (Basel) 2020; 10:E120. [PMID: 32098383 PMCID: PMC7168061 DOI: 10.3390/diagnostics10020120] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 02/06/2023] Open
Abstract
High-grade serous carcinoma (HGSC) is the most common and lethal subtype of ovarian carcinoma. Many HGSCs are now believed to originate in the fallopian tube epithelium; ovarian surface epithelium is another possible origin. Thus, current screening methods, i.e., ultrasonography and serum CA-125 measurements, have a limitation in their early detection. Recently, circulating biomarkers, such as tumor DNA, autoantibody, and microRNA, have been investigated to detect HGSCs. As cancer cells in the fallopian tube flow into the endometrial cavity, the detection of exfoliated cells, tumor DNA, and proteome from samples obtained from the endometrial cavity or the cervix may be useful. The risk of ovarian serous carcinoma is affected by the use of oral contraceptive and menopausal hormone therapy (MHT). MHT regimens causing endometrial bleeding increase serous carcinoma risk, hence, incessant retrograde bleeding from the endometrial cavity into the Douglas pouch appears to play an important role in high-grade serous carcinogenesis. In this review, we provide an overview of current and novel screening methods and prevention approaches for ovarian and fallopian tube HGSC.
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Affiliation(s)
- Isao Otsuka
- Department of Obstetrics and Gynecology, Kameda Medical Center, Kamogawa 296-8602, Japan;
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Petruzzi M, Della Vella F, Cassandro A, Mosca A, Di Comite M, Contaldo M, Grassi FR, Lauritano D. Dorsal tongue porphyrin autofluorescence and Candida saprophytism: A prospective observational study. PLoS One 2019; 14:e0223072. [PMID: 31557235 PMCID: PMC6762088 DOI: 10.1371/journal.pone.0223072] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 09/12/2019] [Indexed: 12/12/2022] Open
Abstract
Aim To investigate the correlation between the dorsal tongue porphyrin autofluorescence, revealed using VELscope, and Candida saprophytism. Material and methods Consecutive patients underwent an autofluorescence examination by the VELscope device to establish the presence or absence of porphyrin fluorescence. A tongue swab was collected for the Candida cultural test. Sensitivity, specificity, accuracy, negative predictive value and positive predictive value were calculated considering the oral swab as the gold standard. The degree of agreement between the two tests was calculated using Cohen's K coefficient. Results One hundred twenty-six patients were enrolled. Porphyrin fluorescence method showed a sensitivity of 78%, specificity of 76% and an accuracy of 78%. Negative predictive value and positive predictive value were respectively 90% and 59%. The strength of agreement between the two methods resulted to be moderate (k = 0.551). Conclusions Off-label use of tongue autofluorescence examination to detect the presence of Candida species is characterized by a loss of porphyrin fluorescence. The high negative predictive value of porphyrin fluorescence loss suggests its use in preliminary selection of Candida carriers, in order to plan preventive and therapeutic strategies.
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Affiliation(s)
- Massimo Petruzzi
- Interdisciplinary Department of Medicine, University "Aldo Moro" of Bari, Bari, Italy
| | - Fedora Della Vella
- Interdisciplinary Department of Medicine, University "Aldo Moro" of Bari, Bari, Italy
| | - Andrea Cassandro
- Interdisciplinary Department of Medicine, University "Aldo Moro" of Bari, Bari, Italy
| | - Adriana Mosca
- Interdisciplinary Department of Medicine, University "Aldo Moro" of Bari, Bari, Italy
| | - Mariasevera Di Comite
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Maria Contaldo
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Felice Roberto Grassi
- Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari "Aldo Moro", Bari, Italy
| | - Dorina Lauritano
- Department of Medicine and Surgery, University Milano-Bicocca, Monza, Italy
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Cheng A, Li L, Wu M, Lang J. Pathological findings following risk-reducing salpingo-oophorectomy in BRCA mutation carriers: A systematic review and meta-analysis. Eur J Surg Oncol 2019; 46:139-147. [PMID: 31521389 DOI: 10.1016/j.ejso.2019.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/23/2019] [Accepted: 09/04/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To evaluate the benefit of risk-reducing salpingo-oophorectomy (RRSO) by estimating the pathological positive rate of occult lesions, including serous tubal intraepithelial carcinoma (STIC) and occult cancers (OCCs). METHODS BRCA1/2 mutation carriers who underwent RRSO in a Chinese study center between 2014 and 2018 were included. A literature review was performed, followed by a meta-analysis of the literature to further validate the findings. RESULTS Twenty-four BRCA1/2 mutation carriers who underwent RRSO were identified; one patient (4.2%) had STIC, and one patient (4.2%) had occult fallopian tube cancer complicated by STIC. Thirty-four articles were ultimately included in the meta-analysis. Of the reported cases of OCC, 61.3% occurred in the fallopian tubes and 32.3% in the ovaries, and 81.5% were in the early stages. The estimated rate of overall pathological positive events was 5%. The estimated rates of overall STIC events and OCC were 1% and 3%, respectively. The rates of STIC and OCC were 1% and 3%, respectively, for BRCA1 mutation carriers and 1% and 1%, respectively, for BRCA2 mutation carriers. No significant difference was observed between the results of a routine examination of pathological sections and those of the Sectioning and Extensively Examining the Fimbriae (SEE-FIM) protocol. CONCLUSIONS This study is the first report of RRSO results in China. In this systematic review, the positive rates of STIC or OCC after RRSO were no more than 3%, which are 200-fold higher than the risk of the general population. The use of a strict SEE-FIM protocol would likely increase positive results.
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Affiliation(s)
- Aoshuang Cheng
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, 100730, China.
| | - Lei Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, 100730, China.
| | - Ming Wu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, 100730, China.
| | - Jinghe Lang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Science, Beijing, 100730, China.
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Abstract
PURPOSE OF REVIEW Both conventional and novel approaches to early detection of ovarian cancer are reviewed in the context of new developments in our understanding of ovarian cancer biology. RECENT FINDINGS While CA125 as a single value lacks adequate specificity or sensitivity for screening, large studies have shown that a 2-stage strategy which tracks CA125 change over time and prompts transvaginal ultrasound (TVS) for a small subset of women with abnormally rising biomarker values achieves adequate specificity and detects a higher fraction of early-stage disease. Sensitivity could clearly be improved in both blood tests and in imaging. Metastasis can occur from ovarian cancers too small to increase blood levels of protein antigens and a significant fraction of ovarian cancers arise from the fimbriae of fallopian tubes that cannot be imaged with TVS. Autoantibodies, miRNA, ctDNA, DNA methylation in blood, and cervical mucus might improve sensitivity of the initial phase and magnetic relaxometry and autofluorescence could improve imaging in the second phase. Enhancing the sensitivity of two-stage strategies for early detection could reduce mortality from ovarian cancer.
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Affiliation(s)
- Denise R Nebgen
- Division of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Karen H Lu
- Division of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA
| | - Robert C Bast
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA.
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Carver GE, Locknar SA, Weaver DL, Stein JL, Stein GS. Real-time detection of breast cancer at the cellular level. J Cell Physiol 2018; 234:5413-5419. [PMID: 30362286 DOI: 10.1002/jcp.27451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 08/29/2018] [Indexed: 11/05/2022]
Abstract
Novel optoelectronic instrumentation has been developed for the multispectral imaging of autofluorescence emitted by metabolic fluorophores. The images resolve individual cells while spectra are collected for each pixel in the images. These datacubes are generated at a rate of 10 per second-fast enough for surgical guidance. The data is processed in real time to provide a single color-coded image to the surgeon. To date, the system has been applied to fresh, ex vivo, human surgical specimens and has distinguished breast cancer from benign tissue. The approach is applicable to in vivo measurements of surgical margins and needle-based optical biopsies. Ongoing work demonstrates that the system has great potential for translation to a hand-held probe with high sensitivity and specificity.
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Affiliation(s)
| | | | - Donald L Weaver
- Department of Pathology and Laboratory Medicine, University of Vermont Cancer Center, Burlington, Vermont
| | - Janet L Stein
- Department of Biochemistry, University of Vermont Cancer Center, Burlington, Vermont
| | - Gary S Stein
- Department of Pathology and Laboratory Medicine, University of Vermont Cancer Center, Burlington, Vermont
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13
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Mathieu MC, Toullec A, Benoit C, Berry R, Validire P, Beaumel P, Vincent Y, Maroun P, Vielh P, Alchab L, Farcy R, Moniz-Koum H, Fontaine-Aupart MP, Delaloge S, Balleyguier C. Preclinical ex vivo evaluation of the diagnostic performance of a new device for in situ label-free fluorescence spectral analysis of breast masses. Eur Radiol 2018; 28:2507-2515. [PMID: 29305733 DOI: 10.1007/s00330-017-5228-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 11/07/2017] [Accepted: 11/30/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES To assess the diagnostic performance of a new device for in situ label-free fluorescence spectral analysis of breast masses in freshly removed surgical specimens, in preparation for its clinical development. METHODS Sixty-four breast masses from consenting patients who had undergone either a lumpectomy or a mastectomy were included. Label-free fluorescence spectral acquisitions were obtained with a 25G fibre-containing needle inserted into the mass. Data from benign and malignant masses were compared to establish the most discriminating thresholds and measurement algorithms. Accuracy was verified using the bootstrap method. RESULTS The final histological examination revealed 44 invasive carcinomas and 20 benign lesions. The maximum intensity of fluorescence signal was discriminant between benign and malignant masses (p < .0001) whatever their sizes. Statistical analysis indicated that choosing five random measurements per mass was the best compromise to obtain high sensitivity and high negative predictive value with the fewest measurements. Thus, malignant tumours were identified with a mean sensitivity, specificity, negative and positive predictive value of 98.8%, 85.4%, 97.2% and 93.5%, respectively. CONCLUSION This new in situ tissue autofluorescence evaluation device allows accurate discrimination between benign and malignant breast masses and deserves clinical development. KEY POINTS • A new device allows in situ label-free fluorescence analysis of ex vivo breast masses • Maximum fluorescence intensity discriminates benign from malignant masses (p < .0001) • Five random measurements allow a high negative predictive value (97.2%).
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Affiliation(s)
| | - Alexis Toullec
- Institut des Sciences Moléculaires d'Orsay (ISMO), CNRS, Univ. Paris-Sud, Université Paris-Saclay, F-91405, Orsay, France
| | - Charlotte Benoit
- Nodea Medical, 1 mail du Pr Georges Mathé, 94800, Villejuif, France
| | - Richard Berry
- Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France
| | - Pierre Validire
- Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France
| | - Pauline Beaumel
- Nodea Medical, 1 mail du Pr Georges Mathé, 94800, Villejuif, France
| | - Yves Vincent
- Hôpital Privé d'Antony, 1 Rue Velpeau, 92160, Antony, France
| | - Pierre Maroun
- Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France
| | - Philippe Vielh
- Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France
| | - Lama Alchab
- Institut des Sciences Moléculaires d'Orsay (ISMO), CNRS, Univ. Paris-Sud, Université Paris-Saclay, F-91405, Orsay, France
| | - René Farcy
- Laboratoire Aimé Cotton, Université Paris-Sud, ENS Cachan, CNRS, Université Paris-Saclay, 91405, Orsay Cedex, France
| | | | - Marie-Pierre Fontaine-Aupart
- Institut des Sciences Moléculaires d'Orsay (ISMO), CNRS, Univ. Paris-Sud, Université Paris-Saclay, F-91405, Orsay, France
| | - Suzette Delaloge
- Gustave Roussy, 114 rue Edouard Vaillant, 94805, Villejuif, France
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In vivo confocal laser endomicroscopy during laparoscopy for gynecological surgery: A promising tool. J Gynecol Obstet Hum Reprod 2017; 46:565-569. [DOI: 10.1016/j.jogoh.2017.06.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 06/07/2017] [Accepted: 06/12/2017] [Indexed: 01/27/2023]
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15
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Dynamic real-time in vivo confocal laser endomicroscopy of the fallopian tube during laparoscopy in the prevention of ovarian cancer. Eur J Obstet Gynecol Reprod Biol 2017; 216:18-23. [PMID: 28692889 DOI: 10.1016/j.ejogrb.2017.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 06/07/2017] [Accepted: 07/04/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Recently it has been postulated that most ovarian cancers have a tubal origin. The identification of preinvasive tubal lesions would be of great interest in the early diagnosis of ovarian cancer. Optical biopsy has been developed and validated in the detection of precancerous lesions (such as Barrett's oesophagus). The first objective of this study was to assess the feasibility of optical biopsy in the study of fallopian tubes during laparoscopy. The second objective was to describe the images in benign premalignant and malignant tubes with a histopathological and immunohistochemical (p53 and Ki67 expressions) correlation. STUDY DESIGN In this prospective study, 40 patients undergoing laparoscopic salpingectomy for benign conditions (benign hysterectomy), prophylactic conditions (BRCA mutation) or in case of pelvic cancers were included after obtaining informed and signed consent prior to surgery. The optical biopsy was performed on the fimbria of each tube in and ex vivo. A correlation was made with the histopathological and immunohistochemical analysis. RESULTS The feasibility of optical biopsy was always confirmed during laparoscopy. The optical biopsy iconography revealed different images in benign tubal epithelium (well-defined black and grey structure), in adenomatoid tumour (tortuous architectural organization), in STIC precancerous lesion (enlarged, irregular and pleomorphic cells, dilated and distorted vessels) and in tubal metastasis of high grade serous ovarian cancer (dark neoplastic cells irregular in size and shape) CONCLUSIONS: Optical biopsy may be the first emerging mini-invasive technology that could detect tubal lesions and may be considered as a promising tool in the early detection of ovarian cancer.
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Madore WJ, De Montigny E, Deschênes A, Benboujja F, Leduc M, Mes-Masson AM, Provencher DM, Rahimi K, Boudoux C, Godbout N. Morphologic three-dimensional scanning of fallopian tubes to assist ovarian cancer diagnosis. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:76012. [PMID: 28727868 DOI: 10.1117/1.jbo.22.7.076012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 06/29/2017] [Indexed: 05/11/2023]
Abstract
The majority of high-grade serous ovarian cancers is now believed to originate in the fallopian tubes. Therefore, current practices include the pathological examination of excised fallopian tubes. Detection of tumors in the fallopian tubes using current clinical approaches remains difficult but is of critical importance to achieve accurate staging and diagnosis. Here, we present an intraoperative imaging system for the detection of human fallopian tube lesions. The system is based on optical coherence tomography (OCT) to access subepithelial tissue architecture. To demonstrate that OCT could identify lesions, we analyzed 180 OCT volumes taken from five different ovarian lesions and from healthy fallopian tubes, and compared them to standard pathological review. We demonstrated that qualitative features could be matched to pathological conditions. We then determined the feasibility of intraluminal imaging of intact human fallopian tubes by building a dedicated endoscopic single-fiber OCT probe to access the mucosal layer inside freshly excised specimens from five patients undergoing prophylactic surgeries. The probe insertion into the lumen acquired images over the entire length of the tubes without damaging the mucosa, providing the first OCT images of intact human fallopian tubes.
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Affiliation(s)
- Wendy-Julie Madore
- École Polytechnique Montréal, Centre d'Optique, Photonique et Lasers (COPL), Montreal, CanadabCentre de recherche du Centre hospitalier de l'Université (CRCHUM), Cancer and Imaging and Engineering Departments, Montreal, CanadacInstitut du cancer de Montréal, Montreal, Canada
| | - Etienne De Montigny
- École Polytechnique Montréal, Centre d'Optique, Photonique et Lasers (COPL), Montreal, CanadabCentre de recherche du Centre hospitalier de l'Université (CRCHUM), Cancer and Imaging and Engineering Departments, Montreal, Canada
| | - Andréanne Deschênes
- École Polytechnique Montréal, Centre d'Optique, Photonique et Lasers (COPL), Montreal, Canada
| | - Fouzi Benboujja
- École Polytechnique Montréal, Centre d'Optique, Photonique et Lasers (COPL), Montreal, Canada
| | - Mikaël Leduc
- École Polytechnique Montréal, Centre d'Optique, Photonique et Lasers (COPL), Montreal, Canada
| | - Anne-Marie Mes-Masson
- Centre de recherche du Centre hospitalier de l'Université (CRCHUM), Cancer and Imaging and Engineering Departments, Montreal, CanadacInstitut du cancer de Montréal, Montreal, CanadadUniversité de Montréal, Department of Medicine, Montreal, Canada
| | - Diane M Provencher
- Centre de recherche du Centre hospitalier de l'Université (CRCHUM), Cancer and Imaging and Engineering Departments, Montreal, CanadacInstitut du cancer de Montréal, Montreal, CanadaeUniversité de Montréal, Division of Gynecologic Oncology, Montreal, Canada
| | - Kurosh Rahimi
- Centre de recherche du Centre hospitalier de l'Université (CRCHUM), Cancer and Imaging and Engineering Departments, Montreal, CanadacInstitut du cancer de Montréal, Montreal, Canada
| | - Caroline Boudoux
- École Polytechnique Montréal, Centre d'Optique, Photonique et Lasers (COPL), Montreal, Canada
| | - Nicolas Godbout
- École Polytechnique Montréal, Centre d'Optique, Photonique et Lasers (COPL), Montreal, Canada
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Yang WL, Lu Z, Bast RC. The role of biomarkers in the management of epithelial ovarian cancer. Expert Rev Mol Diagn 2017; 17:577-591. [PMID: 28468520 DOI: 10.1080/14737159.2017.1326820] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Despite advances in surgery and chemotherapy for ovarian cancer, 70% of women still succumb to the disease. Biomarkers have contributed to the management of ovarian cancer by monitoring response to treatment, detecting recurrence, distinguishing benign from malignant pelvic masses and attempting to detect disease at an earlier stage. Areas covered: This review focuses on recent advances in biomarkers and imaging for management of ovarian cancer with particular emphasis on early detection. Relevant literature has been reviewed and analyzed. Expert commentary: Rising or persistent CA125 blood levels provide a highly specific biomarker for epithelial ovarian cancer, but not an optimally sensitive biomarker. Addition of HE4, CA 72.4, anti-TP53 autoantibodies and other biomarkers can increase sensitivity for detecting early stage or recurrent disease. Detecting disease recurrence will become more important as more effective therapy is developed. Early detection will require the development not only of biomarker panels, but also of more sensitive and specific imaging strategies. Effective biomarker strategies are already available for distinguishing benign from malignant pelvic masses, but their use in identifying and referring patients with probable ovarian cancer to gynecologic oncologists for cytoreductive operations must be encouraged.
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Affiliation(s)
- Wei-Lei Yang
- a Department of Experimental Therapeutics , The University of Texas MD Anderson Cancer Center , Houston , TX , USA.,b Odyssey Program , The University of Texas MD Anderson Cancer Center , Houston , TX , USA
| | - Zhen Lu
- a Department of Experimental Therapeutics , The University of Texas MD Anderson Cancer Center , Houston , TX , USA
| | - Robert C Bast
- a Department of Experimental Therapeutics , The University of Texas MD Anderson Cancer Center , Houston , TX , USA
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18
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Yang WL, Lu Z, Bast RC. The role of biomarkers in the management of epithelial ovarian cancer. Expert Rev Mol Diagn 2017. [PMID: 28468520 DOI: 10.1080/14737159.2017.1326820] [] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Despite advances in surgery and chemotherapy for ovarian cancer, 70% of women still succumb to the disease. Biomarkers have contributed to the management of ovarian cancer by monitoring response to treatment, detecting recurrence, distinguishing benign from malignant pelvic masses and attempting to detect disease at an earlier stage. Areas covered: This review focuses on recent advances in biomarkers and imaging for management of ovarian cancer with particular emphasis on early detection. Relevant literature has been reviewed and analyzed. Expert commentary: Rising or persistent CA125 blood levels provide a highly specific biomarker for epithelial ovarian cancer, but not an optimally sensitive biomarker. Addition of HE4, CA 72.4, anti-TP53 autoantibodies and other biomarkers can increase sensitivity for detecting early stage or recurrent disease. Detecting disease recurrence will become more important as more effective therapy is developed. Early detection will require the development not only of biomarker panels, but also of more sensitive and specific imaging strategies. Effective biomarker strategies are already available for distinguishing benign from malignant pelvic masses, but their use in identifying and referring patients with probable ovarian cancer to gynecologic oncologists for cytoreductive operations must be encouraged.
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Affiliation(s)
- Wei-Lei Yang
- a Department of Experimental Therapeutics , The University of Texas MD Anderson Cancer Center , Houston , TX , USA.,b Odyssey Program , The University of Texas MD Anderson Cancer Center , Houston , TX , USA
| | - Zhen Lu
- a Department of Experimental Therapeutics , The University of Texas MD Anderson Cancer Center , Houston , TX , USA
| | - Robert C Bast
- a Department of Experimental Therapeutics , The University of Texas MD Anderson Cancer Center , Houston , TX , USA
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Yang WL, Lu Z, Bast RC. The role of biomarkers in the management of epithelial ovarian cancer. Expert Rev Mol Diagn 2017. [PMID: 28468520 DOI: 10.1080/14737159.2017.1326820]+[] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
INTRODUCTION Despite advances in surgery and chemotherapy for ovarian cancer, 70% of women still succumb to the disease. Biomarkers have contributed to the management of ovarian cancer by monitoring response to treatment, detecting recurrence, distinguishing benign from malignant pelvic masses and attempting to detect disease at an earlier stage. Areas covered: This review focuses on recent advances in biomarkers and imaging for management of ovarian cancer with particular emphasis on early detection. Relevant literature has been reviewed and analyzed. Expert commentary: Rising or persistent CA125 blood levels provide a highly specific biomarker for epithelial ovarian cancer, but not an optimally sensitive biomarker. Addition of HE4, CA 72.4, anti-TP53 autoantibodies and other biomarkers can increase sensitivity for detecting early stage or recurrent disease. Detecting disease recurrence will become more important as more effective therapy is developed. Early detection will require the development not only of biomarker panels, but also of more sensitive and specific imaging strategies. Effective biomarker strategies are already available for distinguishing benign from malignant pelvic masses, but their use in identifying and referring patients with probable ovarian cancer to gynecologic oncologists for cytoreductive operations must be encouraged.
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Affiliation(s)
- Wei-Lei Yang
- a Department of Experimental Therapeutics , The University of Texas MD Anderson Cancer Center , Houston , TX , USA.,b Odyssey Program , The University of Texas MD Anderson Cancer Center , Houston , TX , USA
| | - Zhen Lu
- a Department of Experimental Therapeutics , The University of Texas MD Anderson Cancer Center , Houston , TX , USA
| | - Robert C Bast
- a Department of Experimental Therapeutics , The University of Texas MD Anderson Cancer Center , Houston , TX , USA
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20
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Tate TH, Keenan M, Black J, Utzinger U, Barton JK. Ultraminiature optical design for multispectral fluorescence imaging endoscopes. JOURNAL OF BIOMEDICAL OPTICS 2017; 22:36013. [PMID: 28334332 PMCID: PMC5363790 DOI: 10.1117/1.jbo.22.3.036013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 03/06/2017] [Indexed: 05/21/2023]
Abstract
A miniature wide-field multispectral endoscopic imaging system was developed enabling reflectance and fluorescence imaging over a broad wavelength range. At 0.8-mm diameter, the endoscope can be utilized for natural orifice imaging in small lumens such as the fallopian tubes. Five lasers from 250 to 642 nm are coupled into a 125 - ? m diameter multimode fiber and transmitted to the endoscope distal tip for illumination. Ultraviolet and blue wavelengths excite endogenous fluorophores, which can provide differential fluorescence emission images for health and disease. Visible wavelengths provide reflectance images that can be combined for pseudo-white-light imaging and navigation. Imaging is performed by a 300 - ? m diameter three-element lens system connected to a 3000-element fiber. The lens system was designed for a 70-deg full field of view, working distance from 3 mm to infinity, and 40% contrast at the Nyquist cutoff of the fiber bundle. Measured performance characteristics are near design goals. The endoscope was utilized to obtain example monochromatic, pseudo-white-light, and composite fluorescence images of phantoms and porcine reproductive tract. This work shows the feasibility of packaging a highly capable multispectral fluorescence imaging system into a miniature endoscopic system that may have applications in early detection of cancer.
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Affiliation(s)
- Tyler H. Tate
- University of Arizona, College of Optical Sciences, Tucson, Arizona, United States
| | - Molly Keenan
- University of Arizona, Biomedical Engineering, Tucson, Arizona, United States
| | - John Black
- Glannaventa Inc., San Mateo, California, United States
| | - Urs Utzinger
- University of Arizona, College of Optical Sciences, Tucson, Arizona, United States
- University of Arizona, Biomedical Engineering, Tucson, Arizona, United States
| | - Jennifer K. Barton
- University of Arizona, College of Optical Sciences, Tucson, Arizona, United States
- University of Arizona, Biomedical Engineering, Tucson, Arizona, United States
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21
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Keenan M, Tate TH, Kieu K, Black JF, Utzinger U, Barton JK. Design and characterization of a combined OCT and wide field imaging falloposcope for ovarian cancer detection. BIOMEDICAL OPTICS EXPRESS 2017; 8:124-136. [PMID: 28101406 PMCID: PMC5231286 DOI: 10.1364/boe.8.000124] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Revised: 12/02/2016] [Accepted: 12/05/2016] [Indexed: 05/02/2023]
Abstract
Early detection of ovarian cancer is only achieved in around 20% of women due to lack of effective screening. We propose a method for surveillance of high risk women based on a microendoscope introduced transvaginally to image the fallopian tubes and ovaries. This requires extreme miniaturization of the optics and catheter sheath. We describe the design of a falloposcope that combines optical coherence tomography (OCT) and wide field imaging into a sub-1 mm diameter package. We characterize the systems and show that they provide contrast on ex-vivo samples of ovary and fallopian tube. In addition, we show the mechanical performance of the endoscope in an anatomically correct model of the female reproductive tract.
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Affiliation(s)
- Molly Keenan
- University of Arizona, Biomedical Engineering, 1127 James E Rogers Way, Tucson, AZ 85721, USA
| | - Tyler H. Tate
- University of Arizona, College of Optical Sciences, 1630 East University Blvd., Tucson, AZ 85721, USA
| | - Khanh Kieu
- University of Arizona, College of Optical Sciences, 1630 East University Blvd., Tucson, AZ 85721, USA
| | - John F. Black
- Glannaventa Inc., 2276 Allegheny Way, San Mateo, CA 94402, USA
| | - Urs Utzinger
- University of Arizona, Biomedical Engineering, 1127 James E Rogers Way, Tucson, AZ 85721, USA
- University of Arizona, College of Optical Sciences, 1630 East University Blvd., Tucson, AZ 85721, USA
| | - Jennifer K. Barton
- University of Arizona, Biomedical Engineering, 1127 James E Rogers Way, Tucson, AZ 85721, USA
- University of Arizona, College of Optical Sciences, 1630 East University Blvd., Tucson, AZ 85721, USA
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22
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Risi MD, Rouse AR, Chambers SK, Hatch KD, Zheng W, Gmitro AF. Pilot Clinical Evaluation of a Confocal Microlaparoscope for Ovarian Cancer Detection. Int J Gynecol Cancer 2016; 26:248-54. [PMID: 26745695 DOI: 10.1097/igc.0000000000000595] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The aim of this study is to evaluate the performance of a confocal fluorescence microlaparoscope for in vivo detection of ovarian cancer. METHODS/MATERIALS Seventy-one patients scheduled for open or laparoscopic oophorectomy were consented for the imaging study. High-resolution confocal microlaparoscopic images of the epithelial surface of the ovary were acquired in vivo or ex vivo after tissue staining using acridine orange. Standard histologic evaluation of extracted tissue samples was performed and used as the gold standard of disease diagnosis. Trained human observers from different specialties viewed the microlaparoscopic images, rating each image on a 6-point scale ranging from "definitely not cancer" to "definitely cancer." Receiver operating characteristic curves were generated using these scores and the gold standard histopathologic diagnosis. Area under the receiver operating characteristic curve (AUC) was calculated as a performance metric. RESULTS Forty-five of the consented patients were used in the final evaluation study. From these 45 patients, 63 tissue locations or samples were identified and imaged with the confocal microlaparoscope. Twenty of the samples were high-grade cancers, and the remaining 43 samples were normal or noncancerous. Twenty-three of the samples were imaged in vivo, and the remaining 40 samples were imaged ex vivo. The average AUC score and standard error (SE) for detection of cancer in all images were 0.88 and 0.02, respectively. An independent-samples t test was conducted to compare AUC scores for in vivo and ex vivo conditions. No statistically significant difference in the AUC score for in vivo (AUC, 0.850; SE, 0.049) and ex vivo (AUC, 0.888; SE, 0.027) conditions was observed, t(6) = 1.318, P = 0.2355. CONCLUSIONS Area under the receiver operating characteristic curve scores indicate that high-resolution in vivo images obtained by the confocal laparoscope can distinguish between normal and malignant ovarian surface epithelium. In addition, in vivo performance is similar to that which can be obtained from ex vivo tissue.
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Affiliation(s)
- Matthew D Risi
- *College of Optical Sciences, University of Arizona; †University of Arizona Cancer Center; and Departments of ‡Medical Imaging, §Obstetrics and Gynecology, and ∥Pathology, College of Medicine, and ¶Department of Biomedical Engineering, University of Arizona, Tucson, AZ
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23
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Weinberger V, Bednarikova M, Cibula D, Zikan M. Serous tubal intraepithelial carcinoma (STIC) – clinical impact and management. Expert Rev Anticancer Ther 2016; 16:1311-1321. [DOI: 10.1080/14737140.2016.1247699] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Vit Weinberger
- Department of Gynecology and Obstetrics, University Hospital Brno, Masaryk University, Faculty of Medicine, Brno, Czech Republic
| | - Marketa Bednarikova
- Department of Hematology and Oncology, University Hospital Brno, Masaryk University, Faculty of Medicine, Brno, Czech Republic
| | - David Cibula
- Gynecological Oncology Center, Department of Obstetrics and Gynecology, Charles University in Prague – First Faculty of Medicine, Prague 2, Czech Republic
| | - Michal Zikan
- Gynecological Oncology Center, Department of Obstetrics and Gynecology, Charles University in Prague – First Faculty of Medicine, Prague 2, Czech Republic
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24
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Salpingectomy and prevention of ovarian carcinoma. Gynecol Minim Invasive Ther 2016. [DOI: 10.1016/j.gmit.2015.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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25
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Guerriero S, Saba L, Alcazar JL, Pascual MA, Ajossa S, Perniciano M, Piras A, Sedda F, Peddes C, Fabbri P, Pilla F, Zajicek M, Giuseppina P, Melis GB. Past, present and future ultrasonographic techniques for analyzing ovarian masses. ACTA ACUST UNITED AC 2016; 11:369-83. [PMID: 26102474 DOI: 10.2217/whe.15.11] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Ultrasonography is today the method of choice for distinguishing between benign and malignant adnexal pathologies. Using pattern recognition several types of tumors can be recognized according to their characteristic appearance on gray-scale imaging. Color Doppler imaging should be used only to perform a semiquantitative color score or evaluate the flow location. International Ovarian Tumor Analysis group had standardized definitions characterizing adnexal masses and suggested the use of 'simple rules' in premenopausal women. Recently, the use of 3D vascular indices has been proposed but its potential use in clinical practice is debated. Also computerized aided diagnosis algorithms showed encouraging results to be confirmed in the future.
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Affiliation(s)
- Stefano Guerriero
- Department of Obstetrics & Gynecology, University of Cagliari, Cagliari, Italy
| | - Luca Saba
- Department of Obstetrics & Gynecology, University of Cagliari, Cagliari, Italy
| | - Juan Luis Alcazar
- Department of Obstetrics & Gynecology, University of Navarra, Pamplona, Spain
| | | | - Silvia Ajossa
- Department of Obstetrics & Gynecology, University of Cagliari, Cagliari, Italy
| | - Maura Perniciano
- Department of Obstetrics & Gynecology, University of Cagliari, Cagliari, Italy
| | - Alba Piras
- Department of Obstetrics & Gynecology, University of Cagliari, Cagliari, Italy
| | - Federica Sedda
- Department of Obstetrics & Gynecology, University of Cagliari, Cagliari, Italy
| | - Cristina Peddes
- Department of Obstetrics & Gynecology, University of Cagliari, Cagliari, Italy
| | - Paola Fabbri
- Department of Obstetrics & Gynecology, University of Cagliari, Cagliari, Italy
| | - Federica Pilla
- Department of Obstetrics & Gynecology, University of Cagliari, Cagliari, Italy
| | - Michal Zajicek
- Department of Obstetrics & Gynecology, Chaim Sheba Medical Center, Tel-Hashomer, Israel
| | - Parodo Giuseppina
- Department of Obstetrics & Gynecology, University of Cagliari, Cagliari, Italy
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Tate TH, Baggett B, Rice PFS, Koevary JW, Orsinger GV, Nymeyer AC, Welge WA, Saboda K, Roe DJ, Hatch KD, Chambers SK, Utzinger U, Barton JK. Multispectral fluorescence imaging of human ovarian and fallopian tube tissue for early-stage cancer detection. JOURNAL OF BIOMEDICAL OPTICS 2016; 21:56005. [PMID: 27220626 PMCID: PMC5996865 DOI: 10.1117/1.jbo.21.5.056005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 04/25/2016] [Indexed: 05/17/2023]
Abstract
With early detection, 5-year survival rates for ovarian cancer exceed 90%, yet no effective early screening method exists. Emerging consensus suggests over 50% of the most lethal form of the disease originates in the fallopian tube. Twenty-eight women undergoing oophorectomy or debulking surgery provided informed consent for the use of surgical discard tissue samples for multispectral fluorescence imaging. Using multiple ultraviolet and visible excitation wavelengths and emissions bands, 12 fluorescence and 6 reflectance images of 47 ovarian and 31 fallopian tube tissue samples were recorded. After imaging, each sample was fixed, sectioned, and stained for pathological evaluation. Univariate logistic regression showed cancerous tissue samples had significantly lower intensity than noncancerous tissue for 17 image types. The predictive power of multiple image types was evaluated using multivariate logistic regression (MLR) and quadratic discriminant analysis (QDA). Two MLR models each using two image types had receiver operating characteristic curves with area under the curve exceeding 0.9. QDA determined 56 image type combinations with perfect resubstituting using as few as five image types. Adaption of the system for future in vivo fallopian tube and ovary endoscopic imaging is possible, which may enable sensitive detection of ovarian cancer with no exogenous contrast agents.
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Affiliation(s)
- Tyler H. Tate
- University of Arizona, College of Optical Sciences, 1630 East University Boulevard, Tucson, Arizona 85721, United States
| | - Brenda Baggett
- University of Arizona, Department of Biomedical Engineering, 1657 East Helen Street, Tucson, Arizona 85721, United States
| | - Photini F. S. Rice
- University of Arizona, Department of Biomedical Engineering, 1657 East Helen Street, Tucson, Arizona 85721, United States
| | - Jennifer Watson Koevary
- University of Arizona, Department of Biomedical Engineering, 1657 East Helen Street, Tucson, Arizona 85721, United States
| | - Gabriel V. Orsinger
- University of Arizona, Department of Biomedical Engineering, 1657 East Helen Street, Tucson, Arizona 85721, United States
| | - Ariel C. Nymeyer
- University of Arizona, Department of Biomedical Engineering, 1657 East Helen Street, Tucson, Arizona 85721, United States
| | - Weston A. Welge
- University of Arizona, College of Optical Sciences, 1630 East University Boulevard, Tucson, Arizona 85721, United States
| | - Kathylynn Saboda
- University of Arizona Cancer Center, 1515 North Campbell Avenue, Tucson, Arizona 85724, United States
| | - Denise J. Roe
- University of Arizona Cancer Center, 1515 North Campbell Avenue, Tucson, Arizona 85724, United States
| | - Kenneth D. Hatch
- University of Arizona Cancer Center, 1515 North Campbell Avenue, Tucson, Arizona 85724, United States
| | - Setsuko K. Chambers
- University of Arizona Cancer Center, 1515 North Campbell Avenue, Tucson, Arizona 85724, United States
| | - Urs Utzinger
- University of Arizona, College of Optical Sciences, 1630 East University Boulevard, Tucson, Arizona 85721, United States
- University of Arizona, Department of Biomedical Engineering, 1657 East Helen Street, Tucson, Arizona 85721, United States
| | - Jennifer Kehlet Barton
- University of Arizona, College of Optical Sciences, 1630 East University Boulevard, Tucson, Arizona 85721, United States
- University of Arizona, Department of Biomedical Engineering, 1657 East Helen Street, Tucson, Arizona 85721, United States
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Katabathina VS, Amanullah FS, Menias CO, Chen MM, Valente PT, Chintapalli KN, Prasad SR. Extrauterine Pelvic Serous Carcinomas: Current Update on Pathology and Cross-sectional Imaging Findings. Radiographics 2016; 36:918-32. [DOI: 10.1148/rg.2016150130] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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28
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Bowtell DD, Böhm S, Ahmed AA, Aspuria PJ, Bast RC, Beral V, Berek JS, Birrer MJ, Blagden S, Bookman MA, Brenton JD, Chiappinelli KB, Martins FC, Coukos G, Drapkin R, Edmondson R, Fotopoulou C, Gabra H, Galon J, Gourley C, Heong V, Huntsman DG, Iwanicki M, Karlan BY, Kaye A, Lengyel E, Levine DA, Lu KH, McNeish IA, Menon U, Narod SA, Nelson BH, Nephew KP, Pharoah P, Powell DJ, Ramos P, Romero IL, Scott CL, Sood AK, Stronach EA, Balkwill FR. Rethinking ovarian cancer II: reducing mortality from high-grade serous ovarian cancer. Nat Rev Cancer 2015; 15:668-79. [PMID: 26493647 PMCID: PMC4892184 DOI: 10.1038/nrc4019] [Citation(s) in RCA: 788] [Impact Index Per Article: 87.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
High-grade serous ovarian cancer (HGSOC) accounts for 70-80% of ovarian cancer deaths, and overall survival has not changed significantly for several decades. In this Opinion article, we outline a set of research priorities that we believe will reduce incidence and improve outcomes for women with this disease. This 'roadmap' for HGSOC was determined after extensive discussions at an Ovarian Cancer Action meeting in January 2015.
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Affiliation(s)
- David D Bowtell
- Cancer Genomics and Genetics Program, Peter MacCallum Cancer Centre, Melbourne, Victoria 8006, Australia; and the Kinghorn Cancer Centre, Garvan Institute for Medical Research, Darlinghurst, Sydney, 2010 New South Wales, Australia
| | - Steffen Böhm
- Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London EC1M6BQ, UK
| | - Ahmed A Ahmed
- Nuffield Department of Obstetrics and Gynaecology and the Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford OX3 9DS, UK
| | - Paul-Joseph Aspuria
- Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, California 90048, USA
| | - Robert C Bast
- MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030-4009, USA
| | - Valerie Beral
- University of Oxford, Headington, Oxford, OX3 7LF, UK
| | | | | | - Sarah Blagden
- Ovarian Cancer Action Research Centre, Imperial College London, Hammersmith Campus, London W12 0NN, UK
| | | | - James D Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge CB2 0RE, UK
| | | | - Filipe Correia Martins
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge CB2 0RE, UK
| | - George Coukos
- University Hospital of Lausanne, Lausanne, Switzerland
| | - Ronny Drapkin
- University of Pennsylvania, Penn Ovarian Cancer Research Center, Philadelphia, Pennsylvania 19104, USA
| | | | - Christina Fotopoulou
- Ovarian Cancer Action Research Centre, Imperial College London, Hammersmith Campus, London W12 0NN, UK
| | - Hani Gabra
- Ovarian Cancer Action Research Centre, Imperial College London, Hammersmith Campus, London W12 0NN, UK
| | - Jérôme Galon
- Institut National de la Santé et de la Recherche Médicale, UMRS1138, Laboratory of Integrative Cancer Immunology, Cordeliers Research Center, Université Paris Descartes, Sorbonne Paris Cité, Sorbonne Universités, UPMC Univ Paris 06, 75006 Paris, France
| | - Charlie Gourley
- Cancer Research Centre, University of Edinburgh, Edinburgh EH4 2XR, UK
| | - Valerie Heong
- Walter and Eliza Hall Institute, Parkville, Victoria 3052, Australia
| | - David G Huntsman
- University of British Columbia, Departments of Pathology and Laboratory Medicine and Obstetrics and Gynecology, Faculty of Medicine, Vancouver, British Columbia V6T 2B5, Canada
| | | | - Beth Y Karlan
- Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, California 90048, USA
| | | | | | - Douglas A Levine
- Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Karen H Lu
- MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030-4009, USA
| | | | - Usha Menon
- Women's Cancer, Institute for Women's Health, University College London, London WC1E 6BT, UK
| | - Steven A Narod
- Women's College Research Institute, Toronto, Ontario M5G 1N8, Canada
| | - Brad H Nelson
- British Columbia Cancer Agency, Victoria, British Columbia V8R 6V5, Canada
| | - Kenneth P Nephew
- Indiana University School of Medicine &Simon Cancer Center, Bloomington, IN 47405-4401, USA
| | - Paul Pharoah
- University of Cambridge, Strangeways Research Laboratory, Cambridge CB1 8RN, UK
| | - Daniel J Powell
- University of Pennsylvania, Philadelphia, PA 19104-5156, USA
| | - Pilar Ramos
- Translational Genomics Research Institute (Tgen), Phoenix, Arizona 85004, USA
| | | | - Clare L Scott
- Walter and Eliza Hall Institute, Parkville, Victoria 3052, Australia
| | - Anil K Sood
- MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030-4009, USA
| | - Euan A Stronach
- Ovarian Cancer Action Research Centre, Imperial College London, Hammersmith Campus, London W12 0NN, UK
| | - Frances R Balkwill
- Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London EC1M6BQ, UK
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Rethinking ovarian cancer II: reducing mortality from high-grade serous ovarian cancer. NATURE REVIEWS. CANCER 2015. [PMID: 26493647 DOI: 10.1038/nrc4019]+[] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
High-grade serous ovarian cancer (HGSOC) accounts for 70-80% of ovarian cancer deaths, and overall survival has not changed significantly for several decades. In this Opinion article, we outline a set of research priorities that we believe will reduce incidence and improve outcomes for women with this disease. This 'roadmap' for HGSOC was determined after extensive discussions at an Ovarian Cancer Action meeting in January 2015.
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30
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Bowtell DD, Böhm S, Ahmed AA, Aspuria PJ, Bast RC, Beral V, Berek JS, Birrer MJ, Blagden S, Bookman MA, Brenton JD, Chiappinelli KB, Martins FC, Coukos G, Drapkin R, Edmondson R, Fotopoulou C, Gabra H, Galon J, Gourley C, Heong V, Huntsman DG, Iwanicki M, Karlan BY, Kaye A, Lengyel E, Levine DA, Lu KH, McNeish IA, Menon U, Narod SA, Nelson BH, Nephew KP, Pharoah P, Powell DJ, Ramos P, Romero IL, Scott CL, Sood AK, Stronach EA, Balkwill FR. Rethinking ovarian cancer II: reducing mortality from high-grade serous ovarian cancer. NATURE REVIEWS. CANCER 2015. [PMID: 26493647 DOI: 10.1038/nrc4019] [] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
High-grade serous ovarian cancer (HGSOC) accounts for 70-80% of ovarian cancer deaths, and overall survival has not changed significantly for several decades. In this Opinion article, we outline a set of research priorities that we believe will reduce incidence and improve outcomes for women with this disease. This 'roadmap' for HGSOC was determined after extensive discussions at an Ovarian Cancer Action meeting in January 2015.
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Affiliation(s)
- David D Bowtell
- Cancer Genomics and Genetics Program, Peter MacCallum Cancer Centre, Melbourne, Victoria 8006, Australia; and the Kinghorn Cancer Centre, Garvan Institute for Medical Research, Darlinghurst, Sydney, 2010 New South Wales, Australia
| | - Steffen Böhm
- Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London EC1M6BQ, UK
| | - Ahmed A Ahmed
- Nuffield Department of Obstetrics and Gynaecology and the Weatherall Institute of Molecular Medicine, John Radcliffe Hospital, Headington, Oxford OX3 9DS, UK
| | - Paul-Joseph Aspuria
- Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, California 90048, USA
| | - Robert C Bast
- MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030-4009, USA
| | - Valerie Beral
- University of Oxford, Headington, Oxford, OX3 7LF, UK
| | | | | | - Sarah Blagden
- Ovarian Cancer Action Research Centre, Imperial College London, Hammersmith Campus, London W12 0NN, UK
| | | | - James D Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge CB2 0RE, UK
| | | | - Filipe Correia Martins
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge CB2 0RE, UK
| | - George Coukos
- University Hospital of Lausanne, Lausanne, Switzerland
| | - Ronny Drapkin
- University of Pennsylvania, Penn Ovarian Cancer Research Center, Philadelphia, Pennsylvania 19104, USA
| | | | - Christina Fotopoulou
- Ovarian Cancer Action Research Centre, Imperial College London, Hammersmith Campus, London W12 0NN, UK
| | - Hani Gabra
- Ovarian Cancer Action Research Centre, Imperial College London, Hammersmith Campus, London W12 0NN, UK
| | - Jérôme Galon
- Institut National de la Santé et de la Recherche Médicale, UMRS1138, Laboratory of Integrative Cancer Immunology, Cordeliers Research Center, Université Paris Descartes, Sorbonne Paris Cité, Sorbonne Universités, UPMC Univ Paris 06, 75006 Paris, France
| | - Charlie Gourley
- Cancer Research Centre, University of Edinburgh, Edinburgh EH4 2XR, UK
| | - Valerie Heong
- Walter and Eliza Hall Institute, Parkville, Victoria 3052, Australia
| | - David G Huntsman
- University of British Columbia, Departments of Pathology and Laboratory Medicine and Obstetrics and Gynecology, Faculty of Medicine, Vancouver, British Columbia V6T 2B5, Canada
| | | | - Beth Y Karlan
- Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, California 90048, USA
| | | | | | - Douglas A Levine
- Memorial Sloan Kettering Cancer Center, New York, New York 10065, USA
| | - Karen H Lu
- MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030-4009, USA
| | | | - Usha Menon
- Women's Cancer, Institute for Women's Health, University College London, London WC1E 6BT, UK
| | - Steven A Narod
- Women's College Research Institute, Toronto, Ontario M5G 1N8, Canada
| | - Brad H Nelson
- British Columbia Cancer Agency, Victoria, British Columbia V8R 6V5, Canada
| | - Kenneth P Nephew
- Indiana University School of Medicine &Simon Cancer Center, Bloomington, IN 47405-4401, USA
| | - Paul Pharoah
- University of Cambridge, Strangeways Research Laboratory, Cambridge CB1 8RN, UK
| | - Daniel J Powell
- University of Pennsylvania, Philadelphia, PA 19104-5156, USA
| | - Pilar Ramos
- Translational Genomics Research Institute (Tgen), Phoenix, Arizona 85004, USA
| | | | - Clare L Scott
- Walter and Eliza Hall Institute, Parkville, Victoria 3052, Australia
| | - Anil K Sood
- MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030-4009, USA
| | - Euan A Stronach
- Ovarian Cancer Action Research Centre, Imperial College London, Hammersmith Campus, London W12 0NN, UK
| | - Frances R Balkwill
- Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London EC1M6BQ, UK
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Abstract
PURPOSE OF REVIEW As more women with an inherited increased risk of gynecologic cancer are identified, the clinician will be challenged to counsel these women on risk-reducing strategies. RECENT FINDINGS Although there are some recent studies that show potential for ovarian cancer surveillance strategies, there remains no definitive evidence that surveillance leads to a stage shift or a reduction in mortality. Recent studies support the following conclusions: first, oral contraceptive use reduces ovarian cancer risk without significantly increasing breast cancer risk, second, salpingo-oophorectomy leads to a reduction in ovarian cancer, breast cancer, and overall mortality for women who are carriers of BRCA1 and BRCA2 mutations, and third, the 'ovarian cancers' associated with BRCA mutations actually include fallopian tube and peritoneal cancer and may have a precursor lesion in the fallopian tube; this observation has prompted the provocative suggestion of removing the fallopian tube to reduce ovarian cancer risk. SUMMARY Because of the interplay between the hormonal impact of ovarian function on breast cancer risk, the risk reduction associated with oophorectomy, and the impact of early menopause on other health outcomes, an integrated multidisciplinary approach is required to aid in the increasingly complex decisions faced by women with high inherited risk of developing gynecologic cancers.
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32
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Tibbetts KM, Tan M. Role of Advanced Laryngeal Imaging in Glottic Cancer. Otolaryngol Clin North Am 2015; 48:565-84. [DOI: 10.1016/j.otc.2015.04.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Early preinvasive lesions in ovarian cancer. BIOMED RESEARCH INTERNATIONAL 2014; 2014:639252. [PMID: 24804229 PMCID: PMC3997076 DOI: 10.1155/2014/639252] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2013] [Revised: 03/02/2014] [Accepted: 03/03/2014] [Indexed: 01/15/2023]
Abstract
Faced with the catastrophic prognosis for ovarian cancer due to the fact that it is most often diagnosed late at the peritoneal carcinomatosis stage, screening and early detection could probably reduce the mortality rate. A better understanding of the molecular characteristics of the different ovarian cancer subtypes and their specific molecular signatures is indispensable prior to development of new screening strategies. We discuss here the early natural history of ovarian cancer and its origins.
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Menon U, Griffin M, Gentry-Maharaj A. Ovarian cancer screening--current status, future directions. Gynecol Oncol 2013; 132:490-5. [PMID: 24316306 PMCID: PMC3991859 DOI: 10.1016/j.ygyno.2013.11.030] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 11/22/2013] [Accepted: 11/25/2013] [Indexed: 01/06/2023]
Abstract
Evidence of a mortality benefit continues to elude ovarian cancer (OC) screening. Data from the US Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial which used a screening strategy incorporating CA125 cut-off and transvaginal ultrasound has not shown mortality benefit. The United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) is using the Risk of Ovarian Cancer (ROC) time series algorithm to interpret CA125, which has shown an encouraging sensitivity and specificity however the mortality data will only be available in 2015. The article explores the impact of growing insights into disease aetiology and evolution and biomarker discovery on future screening strategies. A better understanding of the target lesion, improved design of biomarker discovery studies, a focus on detecting low volume disease using cancer specific markers, novel biospecimens such as cervical cytology and targeted imaging and use of time series algorithms for interpreting markers profile suggests that a new era in screening is underway.
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Affiliation(s)
- Usha Menon
- Gynaecological Cancer Research Centre, Women's Cancer, UCL EGA Institute for Women's Health, Maple House, 149 Tottenham Court Road, London W1T 7DN, UK.
| | - Michelle Griffin
- Gynaecological Cancer Research Centre, Women's Cancer, UCL EGA Institute for Women's Health, Maple House, 149 Tottenham Court Road, London W1T 7DN, UK
| | - Aleksandra Gentry-Maharaj
- Gynaecological Cancer Research Centre, Women's Cancer, UCL EGA Institute for Women's Health, Maple House, 149 Tottenham Court Road, London W1T 7DN, UK.
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35
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Caffier PP, Schmidt B, Gross M, Karnetzky K, Nawka T, Rotter A, Seipelt M, Sedlmaier B. A comparison of white light laryngostroboscopy versus autofluorescence endoscopy in the evaluation of vocal fold pathology. Laryngoscope 2013; 123:1729-34. [DOI: 10.1002/lary.23931] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 10/25/2012] [Accepted: 11/13/2012] [Indexed: 11/05/2022]
Affiliation(s)
- Philipp P. Caffier
- Department of Audiology and Phoniatrics; Charité - University Medicine Berlin; Berlin; Germany
| | - Bernd Schmidt
- Clinic for Internal Medicine; Department of Pneumology; University Clinic Halle; Halle; (Saale); Germany
| | - Manfred Gross
- Department of Audiology and Phoniatrics; Charité - University Medicine Berlin; Berlin; Germany
| | - Klaus Karnetzky
- Department of Otorhinolaryngology-Head and Neck Surgery; Charité - University Medicine Berlin; Berlin; Germany
| | - Tadeus Nawka
- Department of Audiology and Phoniatrics; Charité - University Medicine Berlin; Berlin; Germany
| | - Andreas Rotter
- Department of Otorhinolaryngology-Head and Neck Surgery; Charité - University Medicine Berlin; Berlin; Germany
| | - Matthias Seipelt
- Department of Audiology and Phoniatrics; Charité - University Medicine Berlin; Berlin; Germany
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Chene G, Penault-Llorca F, Robin N, Cayre A, Provencher D, Dauplat J. Vers un dépistage possible du cancer de l’ovaire ? ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.jgyn.2012.10.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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37
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Chene G, Rahimi K, Mes-Masson AM, Provencher D. Surgical implications of the potential new tubal pathway for ovarian carcinogenesis. J Minim Invasive Gynecol 2013; 20:153-9. [PMID: 23332575 DOI: 10.1016/j.jmig.2012.11.010] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 11/21/2012] [Accepted: 11/30/2012] [Indexed: 12/14/2022]
Abstract
Since 2001, many studies by different investigators have demonstrated that the fallopian tube might be at the origin of most high-grade ovarian and peritoneal serous carcinomas. Simple changes in surgical practice (ie, prophylactic bilateral salpingectomy instead of salpingo-oophorectomy) could have significant implications for death from ovarian cancer and, on the other hand, for the morbidity caused by ovariectomy (surgical menopause). In this review, we describe the new tubal carcinogenic sequence, the advantages and disadvantages of exclusive use of salpingectomy in the general population, and in cases of hereditary predisposition to ovarian cancer such as for carriers of BRCA mutation.
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Affiliation(s)
- Gautier Chene
- Research Centre of the University of Montreal Hospital Centre (CRCHUM), Montreal Cancer Institute, Montreal, Quebec, Canada.
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38
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The oviduct and ovarian cancer: causality, clinical implications, and "targeted prevention". Clin Obstet Gynecol 2012; 55:24-35. [PMID: 22343226 DOI: 10.1097/grf.0b013e31824b1725] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
A novel origin for pelvic serous cancer (ovarian cancer) has been proposed in the distal oviduct. This has important implications, including both early detection in high-risk women and wisdom of relying on serological tests to detect a disease that begins so close to the peritoneal surfaces. With the recent discovery of premalignant disturbances in gene function in the tubal mucosa, the concept of targeted prevention is emerging whereby the interruption of a portion of the carcinogenic pathway will prevent cancer. This alternative to detect early malignancy is a new paradigm in the quest to prevent this deadly disease.
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BRCA, the Oviduct, and the Space and Time Continuum of Pelvic Serous Carcinogenesis. Int J Gynecol Cancer 2012; 22 Suppl 1:S29-34. [DOI: 10.1097/igc.0b013e31824d7269] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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La venue de « l’année de la trompe ». JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2011. [DOI: 10.1016/s1701-2163(16)35010-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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