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Razia S, Nakayama K, Yamashita H, Ishibashi T, Ishikawa M, Kanno K, Sato S, Kyo S. Histological and Genetic Diversity in Ovarian Mucinous Carcinomas: A Pilot Study. Curr Oncol 2023; 30:4052-4059. [PMID: 37185420 PMCID: PMC10137024 DOI: 10.3390/curroncol30040307] [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: 02/10/2023] [Revised: 03/31/2023] [Accepted: 04/01/2023] [Indexed: 05/17/2023] Open
Abstract
Tumor heterogeneity remains an ongoing challenge in the field of cancer therapy. Intratumor heterogeneity significantly complicates the diagnosis of cancer and presents challenging clinical problems due to resistance to drug therapy. This study aimed to elucidate the genetic changes histologically (mucinous cystadenoma (MCA), mucinous borderline tumor (MBT), and mucinous ovarian carcinoma (MOC)) in a portion of mucinous ovarian tumors within the same sample. Seven tumor samples obtained from different patients were used to evaluate the genetic mutations in each component. Intratumor genetic heterogeneity was observed in all patients; among them, BRAF (V600E) and p53 (T118I, P142S, T150I, and T170M) point mutations were observed in the MBT component, while KRAS (G12D and G13D) and PIK3CA (E545K) mutations were found in the MOC component. The current findings suggest that diverse genetic alterations occur in mucinous tumors, according to tumor histology. Tumor heterogeneity and genetic diversity in mucinous ovarian tumors might be the cause of treatment failure. Knowledge of intertumor heterogeneity may lead to an increased understanding of the tumor response to treatment.
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Affiliation(s)
- Sultana Razia
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo 6938501, Japan
| | - Kentaro Nakayama
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo 6938501, Japan
| | - Hitomi Yamashita
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo 6938501, Japan
| | - Tomoka Ishibashi
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo 6938501, Japan
| | - Masako Ishikawa
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo 6938501, Japan
| | - Kosuke Kanno
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo 6938501, Japan
| | - Seiya Sato
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo 6938501, Japan
| | - Satoru Kyo
- Department of Obstetrics and Gynecology, Shimane University School of Medicine, Izumo 6938501, Japan
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Nanthamongkolkul K, Wattanapaisal P, Boonyapipat S, Suphasynth Y, Pichatechaiyoot A, Geater AF, Kayasut K, Peeyananjarassri K. Appendiceal tumors in patients undergoing primary surgery for mucinous ovarian tumors in a tertiary hospital, in Southern Thailand. Taiwan J Obstet Gynecol 2022; 61:657-662. [PMID: 35779917 DOI: 10.1016/j.tjog.2022.03.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To evaluate the prevalence of appendiceal tumors in patients diagnosed with mucinous ovarian tumors and to determine factors associated with coexisting appendiceal tumors. MATERIALS AND METHODS Retrospective review of all patients who were diagnosed with mucinous ovarian tumors and underwent an appendectomy during surgery between January 2002 and June 2017 was performed. Univariate and multivariate logistic regression analyses were used to identify risk factors for coexisting appendiceal tumors. RESULTS A total of 303 patients with mucinous ovarian tumors who underwent appendectomy were identified, including 77 (25.4%) mucinous cystadenoma and 226 (74.6%) mucinous borderline tumor or carcinoma. Twenty-one (6.9%) had coexisting appendiceal tumors including 8 that were primary appendiceal mucinous adenocarcinomas, 6 low-grade appendiceal mucinous neoplasms, 6 secondary appendiceal metastasis from the ovary, and one hyperplastic polyp. None of mucinous cystadenoma had coexisting appendiceal tumors. Multivariate analysis revealed advanced age ≥50 years, previous rupture of ovarian tumors, abdominal extension of tumors, and grossly abnormal appendix were independent factors for coexisting appendiceal tumors. CONCLUSION Prevalence of coexisting appendiceal tumors in mucinous ovarian tumors was not uncommon. The risk factors were grossly abnormal appendix, abdominal extension of tumor, previous rupture of ovarian tumors, and advanced age.
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Affiliation(s)
- Kulisara Nanthamongkolkul
- Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110, Thailand
| | - Panote Wattanapaisal
- Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110, Thailand
| | - Sathana Boonyapipat
- Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110, Thailand
| | - Yuthasak Suphasynth
- Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110, Thailand
| | - Aroontorn Pichatechaiyoot
- Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110, Thailand
| | - Alan Frederick Geater
- Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110, Thailand
| | - Kanita Kayasut
- Department of Pathology, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110, Thailand
| | - Krantarat Peeyananjarassri
- Department of Obstetrics and Gynecology, Faculty of Medicine, Prince of Songkla University, Songkhla, 90110, Thailand.
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Shoji T, Tatsuki S, Abe M, Tomabechi H, Takatori E, Kaido Y, Nagasawa T, Kagabu M, Baba T, Itamochi H. Novel Therapeutic Strategies for Refractory Ovarian Cancers: Clear Cell and Mucinous Carcinomas. Cancers (Basel) 2021; 13:6120. [PMID: 34885229 PMCID: PMC8656608 DOI: 10.3390/cancers13236120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/24/2021] [Accepted: 11/30/2021] [Indexed: 12/13/2022] Open
Abstract
Ovarian cancer has the worst prognosis among gynecological cancers. In particular, clear cell and mucinous carcinomas are less sensitive to chemotherapy. The establishment of new therapies is necessary to improve the treatment outcomes for these carcinomas. In previous clinical studies, chemotherapy with cytotoxic anticancer drugs has failed to demonstrate better treatment outcomes than paclitaxel + carboplatin therapy. In recent years, attention has been focused on treatment with molecular target drugs and immune checkpoint inhibitors that target newly identified biomarkers. The issues that need to be addressed include the most appropriate combination of therapies, identifying patients who may benefit from each therapy, and how results should be incorporated into the standard of care for ovarian clear cell and mucinous carcinomas. In this article, we have reviewed the most promising therapies for ovarian clear cell and mucinous carcinomas, which are regarded as intractable, with an emphasis on therapies currently being investigated in clinical studies.
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Affiliation(s)
- Tadahiro Shoji
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Shunsuke Tatsuki
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Marina Abe
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Hidetoshi Tomabechi
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Eriko Takatori
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Yoshitaka Kaido
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Takayuki Nagasawa
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Masahiro Kagabu
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Tsukasa Baba
- Department of Obstetrics and Gynecology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan; (S.T.); (M.A.); (H.T.); (E.T.); (Y.K.); (T.N.); (M.K.); (T.B.)
| | - Hiroaki Itamochi
- Department of Clinical Oncology, Iwate Medical University School of Medicine, Iwate 028-3695, Japan;
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Abstract
OPINION STATEMENT Complete surgical resection is the gold-standard treatment for all mucinous ovarian carcinoma (MOC) cases. Advanced-stage disease is often additionally treated with adjuvant platinum-based chemotherapy; however, these were developed largely against the more common high-grade serous ovarian carcinoma and have low efficacy in treating MOC. More effective therapeutics are needed to treat late-stage and platinum-resistant tumors; however, traditional drug development and clinical trial paradigms are a major challenge for such a rare disease. New approaches to support evidence-based treatment decisions are required, such as registry trials. Recently, a number of targeted therapies have emerged as viable treatment options in other cancer types, and for some of these, the actionable tumor mutations are also seen in MOC. Thus, a promising alternative approach to provide benefit to current MOC patients involves DNA sequencing to identify a tumor's unique mutational profile and allow matching to available targeted agents. Such a pipeline can involve special approval to administer a drug already approved for clinical use in other cancer types to a given MOC patient, or their inclusion in existing ongoing clinical trials, such as basket trials encompassing patients with tumors from a range of anatomical sites. Implementation of such personalized medicine can be boosted using improved pre-clinical models, where through a clinical research collaboration a patient's own tumor cells can be used to a test a range of putative therapies prior to administration in the clinic, enabling selection of the available pharmaceutical/s that give any given patient the best possible chance of cancer remission.
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Rao S, Smith DA, Guler E, Kikano EG, Rajdev MA, Yoest JM, Ramaiya NH, Tirumani SH. Past, Present, and Future of Serum Tumor Markers in Management of Ovarian Cancer: A Guide for the Radiologist. Radiographics 2021; 41:1839-1856. [PMID: 34597221 DOI: 10.1148/rg.2021210005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The ability to accurately detect early ovarian cancer and subsequently monitor treatment response is essential to improving survival for patients with ovarian malignancies. Several serum tumor markers (STMs)-including cancer antigen 125 (CA-125), human epididymis protein 4 (HE4), cancer antigen 19-9 (CA 19-9), and carcinoembryonic antigen (CEA)-have been used as a noninvasive method of identifying ovarian cancer in conjunction with imaging. Although current guidelines do not recommend use of STMs as screening tools for ovarian cancer, these markers have clinical utility in both diagnosis and surveillance for women with ovarian cancer. CA-125 is the most commonly used STM; its level may be elevated in several types of ovarian cancer, including epithelial cell tumors, carcinosarcoma, teratomas, and secondary ovarian malignancies. An elevated level of CA 19-9 is associated with clear cell tumors, teratomas, and secondary malignancies. CEA is most commonly associated with mucinous ovarian cancers. Finally, HE4 is being increasingly used to identify certain subtypes of epithelial ovarian cancers, particularly serous and endometrioid tumors. Diagnosis of ovarian cancers relies on a combination of CA-125 levels and US findings, which include a large adnexal mass or high-risk features, including septa and increased vascularity. CT is preferred for staging and is used along with PET and STM monitoring for surveillance. Increasingly, MRI is being used to characterize ovarian lesions that are indeterminate at US or CT. The future of STM testing involves development of "liquid biopsies," in which plasma samples are analyzed for evidence of tumors, including circulating tumor DNA or tumor cells and tumor micro-RNA. When combined with traditional imaging techniques, liquid biopsies may lead to earlier diagnosis and improved survival. An invited commentary by Shinagare is available online. ©RSNA, 2021.
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Affiliation(s)
- Sanjay Rao
- From the Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Ave, B114, Cleveland, OH 44106-4915 (S.R., D.A.S., E.G., E.G.K., M.A.R., N.H.R., S.H.T.); and Department of Pathology, Case Western Reserve University, Cleveland, Ohio (J.M.Y.)
| | - Daniel A Smith
- From the Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Ave, B114, Cleveland, OH 44106-4915 (S.R., D.A.S., E.G., E.G.K., M.A.R., N.H.R., S.H.T.); and Department of Pathology, Case Western Reserve University, Cleveland, Ohio (J.M.Y.)
| | - Ezgi Guler
- From the Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Ave, B114, Cleveland, OH 44106-4915 (S.R., D.A.S., E.G., E.G.K., M.A.R., N.H.R., S.H.T.); and Department of Pathology, Case Western Reserve University, Cleveland, Ohio (J.M.Y.)
| | - Elias G Kikano
- From the Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Ave, B114, Cleveland, OH 44106-4915 (S.R., D.A.S., E.G., E.G.K., M.A.R., N.H.R., S.H.T.); and Department of Pathology, Case Western Reserve University, Cleveland, Ohio (J.M.Y.)
| | - Maharshi A Rajdev
- From the Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Ave, B114, Cleveland, OH 44106-4915 (S.R., D.A.S., E.G., E.G.K., M.A.R., N.H.R., S.H.T.); and Department of Pathology, Case Western Reserve University, Cleveland, Ohio (J.M.Y.)
| | - Jennifer M Yoest
- From the Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Ave, B114, Cleveland, OH 44106-4915 (S.R., D.A.S., E.G., E.G.K., M.A.R., N.H.R., S.H.T.); and Department of Pathology, Case Western Reserve University, Cleveland, Ohio (J.M.Y.)
| | - Nikhil H Ramaiya
- From the Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Ave, B114, Cleveland, OH 44106-4915 (S.R., D.A.S., E.G., E.G.K., M.A.R., N.H.R., S.H.T.); and Department of Pathology, Case Western Reserve University, Cleveland, Ohio (J.M.Y.)
| | - Sree Harsha Tirumani
- From the Department of Radiology, University Hospitals Cleveland Medical Center, Case Western Reserve University, 11100 Euclid Ave, B114, Cleveland, OH 44106-4915 (S.R., D.A.S., E.G., E.G.K., M.A.R., N.H.R., S.H.T.); and Department of Pathology, Case Western Reserve University, Cleveland, Ohio (J.M.Y.)
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Mann EK, Lee KJ, Chen D, da Silva LM, Dal Zotto VL, Scalici J, Gassman NR. Associations between DNA Damage and PD-L1 Expression in Ovarian Cancer, a Potential Biomarker for Clinical Response. BIOLOGY 2021; 10:biology10050385. [PMID: 33946684 PMCID: PMC8146974 DOI: 10.3390/biology10050385] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/20/2021] [Accepted: 04/27/2021] [Indexed: 02/08/2023]
Abstract
Simple Summary This work establishes that ovarian tumors contain persistent oxidative DNA damage levels that can be measured using Repair Assisted Damage Detection (RADD). The persistent DNA damage correlates with increased protein expression of PD-L1, establishing a link between genomic instability and PD-L1 expression across ovarian tumors. DNA damage may be a potential biomarker for immunotherapy. Abstract Programmed death ligand-1 (PD-L1) inhibitors are currently under investigation as a potential treatment option for ovarian cancer. Although this therapy has shown promise, its efficacy is highly variable among patients. Evidence suggests that genomic instability influences the expression of PD-L1, but little is known about this relationship in ovarian cancer. To examine the relationship between PD-L1 expression and genomic instability, we measured DNA damage using Repair Assisted Damage Detection (RADD). We then correlated the presence of persistent DNA damage in the ovarian tumor with protein expression of PD-L1 using immunohistochemistry. Ovarian tumors showed a high prevalence of oxidative DNA damage. As the level of oxidative DNA damage increased, we saw a significant correlation with PD-L1 expression. The highest correlation between DNA damage and PD-L1 expression was observed for mucinous ovarian tumors (r = 0.82), but a strong correlation was also observed for high grade serous and endometrioid tumors (r = 0.67 and 0.69, respectively). These findings link genomic instability to PD-L1 protein expression in ovarian cancer and suggest that persistent DNA damage can be used as a potential biomarker for patient selection for immunotherapy treatment.
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Affiliation(s)
- Elise K. Mann
- Department of Physiology and Cell Biology, College of Medicine, University of South Alabama, Mobile, AL 36688, USA; (E.K.M.); (K.J.L.)
- Mitchell Cancer Institute, University of South Alabama, Mobile, AL 36604, USA; (L.M.d.S.); (J.S.)
| | - Kevin J. Lee
- Department of Physiology and Cell Biology, College of Medicine, University of South Alabama, Mobile, AL 36688, USA; (E.K.M.); (K.J.L.)
- Mitchell Cancer Institute, University of South Alabama, Mobile, AL 36604, USA; (L.M.d.S.); (J.S.)
| | - Dongquan Chen
- Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Luciana Madeira da Silva
- Mitchell Cancer Institute, University of South Alabama, Mobile, AL 36604, USA; (L.M.d.S.); (J.S.)
| | - Valeria L. Dal Zotto
- Department of Pathology, College of Medicine, University of South Alabama, Mobile, AL 36688, USA;
| | - Jennifer Scalici
- Mitchell Cancer Institute, University of South Alabama, Mobile, AL 36604, USA; (L.M.d.S.); (J.S.)
| | - Natalie R. Gassman
- Department of Physiology and Cell Biology, College of Medicine, University of South Alabama, Mobile, AL 36688, USA; (E.K.M.); (K.J.L.)
- Mitchell Cancer Institute, University of South Alabama, Mobile, AL 36604, USA; (L.M.d.S.); (J.S.)
- Correspondence:
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Huang Y, Ming X, Li B, Li Z. Histological Characteristics and Early-Stage Diagnosis Are Associated With Better Survival in Young Patients With Epithelial Ovarian Cancer: A Retrospective Analysis Based on Surveillance Epidemiology and End Results Database. Front Oncol 2020; 10:595789. [PMID: 33425749 PMCID: PMC7787102 DOI: 10.3389/fonc.2020.595789] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 11/19/2020] [Indexed: 02/05/2023] Open
Abstract
PURPOSE To analyze the potential prognostic factors of epithelial ovarian cancer (EOC) in women aged under 35 compared to those aged 60-79. METHODS Cases were retrospectively obtained from SEER database. Clinical characteristics, such as race, histological type, AJCC stage, laterality of tumors, CA125 results, and surgical strategies, were analyzed in < 35 years group and 60-79 years group. Kaplan-Meier survival curves were used to evaluate overall survival (OS) and cause-specific survival (CSS). Cox proportional hazard model was used to identify the predictors for CSS. RESULTS Sixteen thousand eight hundred forty-seven EOC patients diagnosed in 2004-2015 were identified from SEER database, with 1,015 aged under 35 and 15,833 aged 60-79. In < 35 years group, mucinous (32.2%) was the most common histological type, followed by high-grade serous (26.6%) and endometrioid (18.3%), while in 60-79 years group, high-grade serous (68.3%) represented the leading histological type. Most young women were diagnosed at stage I (57.7%), while most old women were diagnosed at stage (48.1%). Both 5-year OS and 5-year CSS were higher in < 35 years group (5-year OS: 76.00% vs 40.18%, p < 0.001; 5-year CSS: 83.56% vs 55.18%, p < 0.001). The multivariate analysis identified histological type and stage as prognostic factors for CSS in both groups. Endometrioid represented a positive predictor for CSS, while carcinosarcoma and malignant Brenner were related to a worse CSS. (< 35 years group: carcinosarcoma vs endometrioid: HR 5.630, p=0.024; malignant Brenner vs endometrioid: HR 4.005, p < 0.001; 60-79 years group: carcinosarcoma vs endometrioid: HR 3.606, p < 0.001; malignant Brenner vs endometrioid: HR 2.291, p < 0.001). Tumors laterality, CA125 levels, surgery and lymphadenectomy failed to be associated with the CSS in < 35 years group, while found to be independent risk factors in 60-79 years group. CONCLUSION EOC women aged under 35 had a better survival outcome over EOC women aged 60-79, owing to high proportion of endometrioid and mucinous types in histology, as well as early-stage diagnosis. Identification of histological types and gene profiles should be underscored in young EOC patients.
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Affiliation(s)
- Yue Huang
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Xiu Ming
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Bingjie Li
- Department of Biotherapy, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, and Collaborative Innovation Center, Chengdu, China
| | - Zhengyu Li
- Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
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Ansardamavandi A, Tafazzoli-Shadpour M, Omidvar R, Nili F. An AFM-Based Nanomechanical Study of Ovarian Tissues with Pathological Conditions. Int J Nanomedicine 2020; 15:4333-4350. [PMID: 32606681 PMCID: PMC7311358 DOI: 10.2147/ijn.s254342] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 06/02/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Different diseases affect both mechanical and chemical features of the involved tissue, enhancing the symptoms. METHODS In this study, using atomic force microscopy, we mechanically characterized human ovarian tissues with four distinct pathological conditions: mucinous, serous, and mature teratoma tumors, and non-tumorous endometriosis. Mechanical elasticity profiles were quantified and the resultant data were categorized using K-means clustering method, as well as fuzzy C-means, to evaluate elastic moduli of cellular and non-cellular parts of diseased tissues and compare them among four disease conditions. Samples were stained by hematoxylin-eosin staining to further study the content of different locations of tissues. RESULTS Pathological state vastly influenced the mechanical properties of the ovarian tissues. Significant alterations among elastic moduli of both cellular and non-cellular parts were observed. Mature teratoma tumors commonly composed of multiple cell types and heterogeneous ECM structure showed the widest range of elasticity profile and the stiffest average elastic modulus of 14 kPa. Samples of serous tumors were the softest tissues with elastic modulus of only 400 Pa for the cellular part and 5 kPa for the ECM. Tissues of other two diseases were closer in mechanical properties as mucinous tumors were insignificantly stiffer than endometriosis in cellular part, 1300 Pa compared to 1000 Pa, with the ECM average elastic modulus of 8 kPa for both. CONCLUSION The higher incidence of carcinoma out of teratoma and serous tumors may be related to the intense alteration of mechanical features of the cellular and the ECM, serving as a potential risk factor which necessitates further investigation.
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Affiliation(s)
- Arian Ansardamavandi
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | | | - Ramin Omidvar
- Faculty of Biology, Centre for Biological Signalling Studies (BIOSS), Albert Ludwigs University Freiburg, Freiburg, Germany
| | - Fatemeh Nili
- Department of Pathology, Tehran University of Medical Sciences, Tehran, Iran
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Moioli M, Barra F, Maramai M, Valenzano Menada M, Vellone VG, Costantini S, Ferrero S. Mucinous ovarian cancer: current therapeutic targets, preclinical progress, and experimental drugs. Expert Opin Investig Drugs 2019; 28:1025-1029. [DOI: 10.1080/13543784.2019.1693999] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Melita Moioli
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - Fabio Barra
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - Mattia Maramai
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - Mario Valenzano Menada
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - Valerio Gaetano Vellone
- Department of Surgical and Diagnostic Sciences, Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
| | - Sergio Costantini
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
| | - Simone Ferrero
- Academic Unit of Obstetrics and Gynecology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy
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Gall Bladder Carcinoma Masquerading as Primary Ovarian Mass: A Case Report. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2019. [DOI: 10.1007/s40944-019-0285-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Gore M, Hackshaw A, Brady WE, Penson RT, Zaino R, McCluggage WG, Ganesan R, Wilkinson N, Perren T, Montes A, Summers J, Lord R, Dark G, Rustin G, Mackean M, Reed N, Kehoe S, Frumovitz M, Christensen H, Feeney A, Ledermann J, Gershenson DM. An international, phase III randomized trial in patients with mucinous epithelial ovarian cancer (mEOC/GOG 0241) with long-term follow-up: and experience of conducting a clinical trial in a rare gynecological tumor. Gynecol Oncol 2019; 153:541-548. [PMID: 31005287 PMCID: PMC6559214 DOI: 10.1016/j.ygyno.2019.03.256] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 03/26/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVES We evaluated four different treatment regimens for advanced-stage mucinous epithelial ovarian cancer. METHODS We conducted a multicenter randomized factorial trial (UK and US). Patients were diagnosed with primary mEOC: FIGO stage II-IV or recurrence after stage I disease. Treatment arms were paclitaxel-carboplatin, oxaliplatin-capecitabine, paclitaxel-carboplatin-bevacizumab, or oxaliplatin-capecitabine-bevacizumab. Chemotherapy was given 3-weekly for 6 cycles, and bevacizumab (3-weekly) was continued as maintenance (for 12 cycles). Endpoints included overall-survival (OS), progression-free survival (PFS), toxicity and quality of life (QoL). RESULTS The trial stopped after 50 patients were recruited due to slow accrual. Median follow-up was 59 months. OS hazard ratios (HR) for the two main comparisons were: 0.78 (p = 0.48) for Oxal-Cape vs. Pac-Carbo (each with/without bevacizumab), and 1.04 (p = 0.92) for bevacizumab vs. no bevacizumab. Corresponding PFS HRs were: 0.84 and 0.80. Retrospective central pathology review revealed only 45% (18/40) cases with available material had confirmed primary mEOC. Among these, OS HR for Oxal-Cape vs. Pac-Carbo was 0.36 (p = 0.14); PFS HR = 0.62 (p = 0.40). Grade 3-4 toxicity was seen in 61% Pac-Carbo, 61% Oxal-Cape, 54% Pac-Carbo-Bev, and 85% Oxal-Cape-Bev. QoL was similar between the four arms. CONCLUSION mEOC/GOG0241 represents an example of a randomized rare tumor trial. Logistical challenges led to early termination, including difficulties in local histopathological diagnosis and accessing drugs outside their labelled indication. There was misalignment between central funders who support clinical trials in rare cancers and the deprioritisation of such work by those managing and funding research at a local level. Rare cancer trials should include centralised pathology review before treatment. Clinical trial registry number: ISRCTN83438782.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Antineoplastic Combined Chemotherapy Protocols/adverse effects
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Bevacizumab/administration & dosage
- Capecitabine/administration & dosage
- Carboplatin/administration & dosage
- Carcinoma, Ovarian Epithelial/drug therapy
- Carcinoma, Ovarian Epithelial/secondary
- Female
- Follow-Up Studies
- Humans
- Internationality
- Middle Aged
- Neoplasm Recurrence, Local/drug therapy
- Neoplasms, Cystic, Mucinous, and Serous/drug therapy
- Neoplasms, Cystic, Mucinous, and Serous/secondary
- Ovarian Neoplasms/drug therapy
- Ovarian Neoplasms/pathology
- Oxaliplatin/administration & dosage
- Paclitaxel/administration & dosage
- Progression-Free Survival
- Quality of Life
- Response Evaluation Criteria in Solid Tumors
- Survival Rate
- Young Adult
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Affiliation(s)
- Martin Gore
- Royal Marsden NHS Foundation Trust, London, UK
| | - Allan Hackshaw
- Cancer Research UK & UCL Cancer Trials Centre, London, UK.
| | | | | | - Richard Zaino
- Penn State Health Milton S. Hershey Medical Centre, PA, USA
| | | | | | - Nafisa Wilkinson
- University College London Hospitals NHS Foundation Trust, London, UK
| | | | - Ana Montes
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Jeffrey Summers
- Maidstone and Tunbridge Wells NHS Foundation Trust, Kent, UK
| | - Rosemary Lord
- Clatterbridge Cancer Centre NHS Foundation Trust, Liverpool, UK
| | - Graham Dark
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | | | | | - Sean Kehoe
- Institute of Cancer and Genomics, University of Birmingham, Birmingham, UK
| | | | | | - Amanda Feeney
- Cancer Research UK & UCL Cancer Trials Centre, London, UK
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12
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Lin W, Cao D, Shen K. Prognostic significance of preoperative serum CEA in primary mucinous ovarian carcinoma: a retrospective cohort study. Cancer Manag Res 2018; 10:6913-6920. [PMID: 30588097 PMCID: PMC6300373 DOI: 10.2147/cmar.s186258] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Purpose The purpose of this study was to evaluate the prognostic significance of preoperative serum carcinoembryonic antigen (CEA) in primary mucinous ovarian carcinoma (MOC). Patients and methods We reviewed 57 patients with primary MOC, in whom preoperative serum CEA had been measured. All patients were treated at Peking Union Medical College Hospital between June 1996 and September 2016. Results Preoperative serum CEA was elevated (>5.0 ng/mL) in 10 patients (17.5%), with a median serum CEA of 9.6 ng/mL (5.4–111.7 ng/mL). CEA was significantly associated with preoperative serum cancer antigen 125 (P=0.002), surgical debulking status (P=0.015), and tumor stage (P=0.001). Univariate analysis showed that patients with elevated CEA had significantly worse overall survival (OS) than patients with normal CEA (5-year OS: 50.8% vs 91.9%, respectively; P=0.013), but there was no significant difference in progression-free survival between the two groups (P=0.307). Multivariate analysis further demonstrated that advanced stage was an independent prognostic predictor for OS (P=0.002, HR: 15.925, 95% CI: 2.745–92.404). Conclusion Elevated preoperative serum CEA was strongly correlated with advanced stage in primary MOC, which may indicate a poorer prognosis. Further investigation of the intrinsic relationship between CEA and primary MOC is now required.
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Affiliation(s)
- Wei Lin
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China,
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China,
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China,
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13
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Coan M, Rampioni Vinciguerra GL, Cesaratto L, Gardenal E, Bianchet R, Dassi E, Vecchione A, Baldassarre G, Spizzo R, Nicoloso MS. Exploring the Role of Fallopian Ciliated Cells in the Pathogenesis of High-Grade Serous Ovarian Cancer. Int J Mol Sci 2018; 19:ijms19092512. [PMID: 30149579 PMCID: PMC6163198 DOI: 10.3390/ijms19092512] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 08/20/2018] [Accepted: 08/20/2018] [Indexed: 12/22/2022] Open
Abstract
High-grade serous epithelial ovarian cancer (HGSOC) is the fifth leading cause of cancer death in women and the first among gynecological malignancies. Despite an initial response to standard chemotherapy, most HGSOC patients relapse. To improve treatment options, we must continue investigating tumor biology. Tumor characteristics (e.g., risk factors and epidemiology) are valuable clues to accomplish this task. The two most frequent risk factors for HGSOC are the lifetime number of ovulations, which is associated with increased oxidative stress in the pelvic area caused by ovulation fluid, and a positive family history due to genetic factors. In the attempt to identify novel genetic factors (i.e., genes) associated with HGSOC, we observed that several genes in linkage with HGSOC are expressed in the ciliated cells of the fallopian tube. This finding made us hypothesize that ciliated cells, despite not being the cell of origin for HGSOC, may take part in HGSOC tumor initiation. Specifically, malfunction of the ciliary beat impairs the laminar fluid flow above the fallopian tube epithelia, thus likely reducing the clearance of oxidative stress caused by follicular fluid. Herein, we review the up-to-date findings dealing with HGSOC predisposition with the hypothesis that fallopian ciliated cells take part in HGSOC onset. Finally, we review the up-to-date literature concerning genes that are located in genomic loci associated with epithelial ovarian cancer (EOC) predisposition that are expressed by the fallopian ciliated cells.
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Affiliation(s)
- Michela Coan
- Division of Molecular Oncology, Department of Translational Research, IRCCS CRO Aviano-National Cancer Institute, Via Franco Gallini, 2 33081 Aviano PN, Italy.
| | - Gian Luca Rampioni Vinciguerra
- Division of Molecular Oncology, Department of Translational Research, IRCCS CRO Aviano-National Cancer Institute, Via Franco Gallini, 2 33081 Aviano PN, Italy.
| | - Laura Cesaratto
- Division of Molecular Oncology, Department of Translational Research, IRCCS CRO Aviano-National Cancer Institute, Via Franco Gallini, 2 33081 Aviano PN, Italy.
| | - Emanuela Gardenal
- Azienda Ospedaliera Universitaria Integrata, University of Verona, 37129 Verona, Italy.
| | - Riccardo Bianchet
- Scientific Direction, CRO Aviano Italy, Via Franco Gallini, 2 33081 Aviano, Italy.
| | - Erik Dassi
- Centre for Integrative Biology, University of Trento, 38122 Trento, Italy.
| | - Andrea Vecchione
- Department of clinical and molecular medicine, university of Rome "Sapienza", c/o sant andrea hospital, Via di Grottarossa 1035, 00189 Rome, Italy.
| | - Gustavo Baldassarre
- Division of Molecular Oncology, Department of Translational Research, IRCCS CRO Aviano-National Cancer Institute, Via Franco Gallini, 2 33081 Aviano PN, Italy.
| | - Riccardo Spizzo
- Division of Molecular Oncology, Department of Translational Research, IRCCS CRO Aviano-National Cancer Institute, Via Franco Gallini, 2 33081 Aviano PN, Italy.
| | - Milena Sabrina Nicoloso
- Division of Molecular Oncology, Department of Translational Research, IRCCS CRO Aviano-National Cancer Institute, Via Franco Gallini, 2 33081 Aviano PN, Italy.
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14
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Lin M, Xia B, Qin L, Chen H, Lou G. S100A7 Regulates Ovarian Cancer Cell Metastasis and Chemoresistance Through MAPK Signaling and Is Targeted by miR-330-5p. DNA Cell Biol 2018; 37:491-500. [PMID: 29485916 DOI: 10.1089/dna.2017.3953] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- Mei Lin
- Department of Gynecology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Bairong Xia
- Department of Gynecology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Ling Qin
- Department of Pathology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Hong Chen
- Department of Gynecology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Ge Lou
- Department of Gynecology, Harbin Medical University Cancer Hospital, Harbin, China
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15
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Niiro E, Morioka S, Iwai K, Yamada Y, Ogawa K, Kawahara N, Kobayashi H. Potential signaling pathways as therapeutic targets for overcoming chemoresistance in mucinous ovarian cancer. Biomed Rep 2018; 8:215-223. [PMID: 29564122 DOI: 10.3892/br.2018.1045] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 01/10/2018] [Indexed: 12/14/2022] Open
Abstract
Cases of mucinous ovarian cancer are predominantly resistant to chemotherapies. The present review summarizes current knowledge of the therapeutic potential of targeting the Wingless (WNT) pathway, with particular emphasis on preclinical and clinical studies, for improving the chemoresistance and treatment of mucinous ovarian cancer. A review was conducted of English language literature published between January 2000 and October 2017 that concerned potential signaling pathways associated with the chemoresistance of mucinous ovarian cancer. The literature indicated that aberrant activation of growth factor and WNT signaling pathways is specifically observed in mucinous ovarian cancer. An evolutionarily conserved signaling cascade system including epidermal growth factor/RAS/RAF/mitogen-activated protein kinase kinase/extracellular signal-regulated protein kinase, phosphoinositide 3-kinase/Akt and WNT signaling regulates a variety of cellular functions; their crosstalk mutually enhances signaling activity and induces chemoresistance. Novel antagonists, modulators and inhibitors have been developed for targeting the components of the WNT signaling pathway, namely Frizzled, low-density lipoprotein receptor-related protein 5/6, Dishevelled, casein kinase 1, AXIN, glycogen synthase kinase 3β and β-catenin. Targeted inhibition of WNT signaling represents a rational and promising novel approach to overcome chemoresistance, and several WNT inhibitors are being evaluated in preclinical studies. In conclusion, the WNT receptors and their downstream components may serve as novel therapeutic targets for overcoming chemoresistance in mucinous ovarian cancer.
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Affiliation(s)
- Emiko Niiro
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Sachiko Morioka
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Kana Iwai
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Yuki Yamada
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Kenji Ogawa
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Naoki Kawahara
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara 634-8522, Japan
| | - Hiroshi Kobayashi
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara 634-8522, Japan
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16
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Synergistic antitumor effects of combination PI3K/mTOR and MEK inhibition (SAR245409 and pimasertib) in mucinous ovarian carcinoma cells by fluorescence resonance energy transfer imaging. Oncotarget 2018; 7:29577-91. [PMID: 27102436 PMCID: PMC5045418 DOI: 10.18632/oncotarget.8807] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 03/29/2016] [Indexed: 11/25/2022] Open
Abstract
The aim of this study was to clarify the synergistic effects of dual inhibition of the PI3K/mTOR and MAPK pathways in ovarian mucinous carcinoma (OMC) cells, using fluorescence resonance energy transfer (FRET) imaging. We exposed 6 OMC cell lines to a PI3K/mTOR inhibitor (voxtalisib, SAR245409) and/or a MEK inhibitor (pimasertib), and evaluated synergistic effects using the Chou-Talalay method. Then, S6K (PI3K pathway) and ERK (MAPK pathway) kinase activities, and their individual proliferative or cytotoxic effects were calculated by time-lapse FRET imaging. In combination with SAR245409, pimasertib (30 nM) synergistically inhibited cell growth (combination indexes: 0.03-0.5) and induced apoptosis in all 6 OMC cell lines. FRET-imaging results demonstrated that ERK inhibition induced both anti-proliferation and apoptosis in a dose-dependent manner in both MCAS and OAW42 cells. However, S6K inhibition suppressed proliferation in a threshold manner in both cell lines, although apoptosis was only induced in OAW42 cells. These results demonstrated that combined PI3K/mTOR and MEK inhibition exhibited synergistic antitumor effects in OMC cells and that FRET imaging is useful for analyzing kinase activities in live cells and elucidating their cytostatic and cytotoxic effects.
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17
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Wei W, Li N, Sun Y, Li B, Xu L, Wu L. Clinical outcome and prognostic factors of patients with early-stage epithelial ovarian cancer. Oncotarget 2017; 8:23862-23870. [PMID: 27852043 PMCID: PMC5410350 DOI: 10.18632/oncotarget.13317] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 10/14/2016] [Indexed: 11/25/2022] Open
Abstract
Some subsets of early stage ovarian cancer patients experience more recurrences than others. Studies on prognostics factors gave conflicting results. We investigated consecutive 221 patients with stage I/II ovarian cancer at our institution from 1999 to 2010. Univariate and multivariate analysis of progression free survival (PFS) and overall survival (OS) were performed. After a median follow-up of 79 months, the 5-year/10-year PFS and 5-year/10-year OS were 78% /76% and 90% /87% respectively. Multivariate analysis revealed that stage as the most prominent independent prognostic factor in terms of PFS (stage I vs stage IIA vs stage IIB, Hazard Ratio (HR): 1 vs 4 vs 6.1, P < 0.05) and OS (stage I vs stage II, HR: 1 vs 2.1, P < 0.05). Peritoneal biopsy reduced the risk of recurrence by 29% (95% CI: 0.15-0.58, P < 0.05). Ascites (HR = 2.8, 95% CI: 1.2-6.6, P < 0.05) and not the first-line chemotherapy (HR = 2.6, 95% CI: 1.1-6.5, P < 0.05) contributed to decreased OS. Overall, early-stage ovarian cancer had a favorable outcome, stage was the most powerful prognostic factor.
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Affiliation(s)
- Wei Wei
- Department of Gynecologic Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ning Li
- Department of Gynecologic Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yangchun Sun
- Department of Gynecologic Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bin Li
- Department of Gynecologic Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lily Xu
- Chemistry Department, Wellesley College, Wellesley, MA, USA
| | - Lingying Wu
- Department of Gynecologic Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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18
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Matz M, Coleman MP, Sant M, Chirlaque MD, Visser O, Gore M, Allemani C. The histology of ovarian cancer: worldwide distribution and implications for international survival comparisons (CONCORD-2). Gynecol Oncol 2017; 144:405-413. [PMID: 27931752 PMCID: PMC6195192 DOI: 10.1016/j.ygyno.2016.10.019] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 10/12/2016] [Accepted: 10/14/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Ovarian cancers comprise several histologically distinct tumour groups with widely different prognosis. We aimed to describe the worldwide distribution of ovarian cancer histology and to understand what role this may play in international variation in survival. METHODS The CONCORD programme is the largest population-based study of global trends in cancer survival. Data on 681,759 women diagnosed during 1995-2009 with cancer of the ovary, fallopian tube, peritoneum and retroperitonum in 51 countries were included. We categorised ovarian tumours into six histological groups, and explored the worldwide distribution of histology. RESULTS During 2005-2009, type II epithelial tumours were the most common. The proportion was much higher in Oceania (73.1%), North America (73.0%) and Europe (72.6%) than in Central and South America (65.7%) and Asia (56.1%). By contrast, type I epithelial tumours were more common in Asia (32.5%), compared with only 19.4% in North America. From 1995 to 2009, the proportion of type II epithelial tumours increased from 68.6% to 71.1%, while the proportion of type I epithelial tumours fell from 23.8% to 21.2%. The proportions of germ cell tumours, sex cord-stromal tumours, other specific non-epithelial tumours and tumours of non-specific morphology all remained stable over time. CONCLUSIONS The distribution of ovarian cancer histology varies widely worldwide. Type I epithelial, germ cell and sex cord-stromal tumours are generally associated with higher survival than type II tumours, so the proportion of these tumours may influence survival estimates for all ovarian cancers combined. The distribution of histological groups should be considered when comparing survival between countries and regions.
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Affiliation(s)
- Melissa Matz
- Cancer Survival Group, London School of Hygiene & Tropical Medicine, London, UK.
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene & Tropical Medicine, London, UK
| | - Milena Sant
- Department of Preventive and Predictive Medicine, Analytical Epidemiology and Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Maria Dolores Chirlaque
- Department of Epidemiology, Regional Health Council, IMIB, Arrixaca, Murcia, Spain, CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain, Department of Health and Social Sciences, Murcia University, Murcia, Spain
| | - Otto Visser
- Department of Registration, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Martin Gore
- The Royal Marsden NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene & Tropical Medicine, London, UK
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19
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Mehner C, Oberg AL, Kalli KR, Nassar A, Hockla A, Pendlebury D, Cichon MA, Goergen KM, Maurer MJ, Goode EL, Keeney GL, Jatoi A, Sahin-Tóth M, Copland JA, Radisky DC, Radisky ES. Serine protease inhibitor Kazal type 1 (SPINK1) drives proliferation and anoikis resistance in a subset of ovarian cancers. Oncotarget 2016; 6:35737-54. [PMID: 26437224 PMCID: PMC4742138 DOI: 10.18632/oncotarget.5927] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 09/14/2015] [Indexed: 01/08/2023] Open
Abstract
Ovarian cancer represents the most lethal tumor type among malignancies of the female reproductive system. Overall survival rates remain low. In this study, we identify the serine protease inhibitor Kazal type 1 (SPINK1) as a potential therapeutic target for a subset of ovarian cancers. We show that SPINK1 drives ovarian cancer cell proliferation through activation of epidermal growth factor receptor (EGFR) signaling, and that SPINK1 promotes resistance to anoikis through a distinct mechanism involving protease inhibition. In analyses of ovarian tumor specimens from a Mayo Clinic cohort of 490 patients, we further find that SPINK1 immunostaining represents an independent prognostic factor for poor survival, with the strongest association in patients with nonserous histological tumor subtypes (endometrioid, clear cell, and mucinous). This study provides novel insight into the fundamental processes underlying ovarian cancer progression, and also suggests new avenues for development of molecularly targeted therapies.
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Affiliation(s)
- Christine Mehner
- Department of Cancer Biology, Mayo Clinic, Jacksonville, FL, USA
| | - Ann L Oberg
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | - Aziza Nassar
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, USA
| | - Alexandra Hockla
- Department of Cancer Biology, Mayo Clinic, Jacksonville, FL, USA
| | - Devon Pendlebury
- Department of Cancer Biology, Mayo Clinic, Jacksonville, FL, USA
| | | | - Krista M Goergen
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Matthew J Maurer
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Ellen L Goode
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Gary L Keeney
- Division of Anatomic Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Aminah Jatoi
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | - Miklós Sahin-Tóth
- Department of Molecular and Cell Biology, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - John A Copland
- Department of Cancer Biology, Mayo Clinic, Jacksonville, FL, USA
| | - Derek C Radisky
- Department of Cancer Biology, Mayo Clinic, Jacksonville, FL, USA
| | - Evette S Radisky
- Department of Cancer Biology, Mayo Clinic, Jacksonville, FL, USA
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20
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Survival of Patients With Mucinous Ovarian Carcinoma and Ovarian Metastases: A Population-Based Cancer Registry Study. Int J Gynecol Cancer 2016; 25:1208-15. [PMID: 25978291 DOI: 10.1097/igc.0000000000000473] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Patients with mucinous ovarian carcinoma (MOC) generally have a favorable prognosis, although in advanced stage, prognosis is significantly worse compared to patients with serous ovarian carcinomas (SOCs). This might be due to the difficulties in distinguishing MOC from metastatic tumors. In the current study, we investigate prognosis of MOC compared to other types of ovarian cancer and to synchronous metastases to the ovary (sMO). MATERIALS AND METHODS Age, laterality, International Federation of Gynecology and Obstetrics stage, tumor grade, treatment, and survival were extracted from the Eindhoven Cancer registry for all patients diagnosed with ovarian carcinomas or sMO between 1990 and 2012. Five-year survival analysis and Cox proportional hazards analysis were conducted. RESULTS A total of 3556 patients with primary ovarian carcinoma (of which 474 mucinous) and 289 with sMO were identified. In advanced stage, 5-year survival of patients with MOC was comparable to survival of patients with sMO (11% vs 11%, P = 0.32) and decreased compared to patients with SOC (26%, P < 0.01). For MOC, there was no clinically significant effect on 5-year survival of either debulking (12% vs 8%, P < 0.01) or chemotherapy (12% vs 10%, P = 0.02). CONCLUSIONS Patients with advanced stage MOC have a worse prognosis than advanced stage SOC. Survival is almost identical to that of patients with sMO. Effects of chemotherapy and debulking are limited in patients with MOC, which may be explained by suboptimal treatment due to the admixture of metastases in advanced stage MOC. Methods to differentiate between primary MOC and metastatic disease are needed to provide optimal treatment and insight in prognosis.
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21
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Xu W, Rush J, Rickett K, Coward JIG. Mucinous ovarian cancer: A therapeutic review. Crit Rev Oncol Hematol 2016; 102:26-36. [PMID: 27083591 DOI: 10.1016/j.critrevonc.2016.03.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 03/01/2016] [Accepted: 03/09/2016] [Indexed: 12/18/2022] Open
Abstract
Mucinous ovarian cancer represents approximately 3% of epithelial ovarian cancers (EOC). Despite this seemingly low prevalence, it remains a diagnostic and therapeutic conundrum that has resulted in numerous attempts to adopt novel strategies in managing this disease. Anecdotally, there has been a prevailing notion that established gold standard systemic regimens should be substituted for those utilised in cancers such as gastrointestinal (GI) malignancies; tumours that share more biological similarities than other EOC subtypes. This review summarises the plethora of small studies which have adopted this philosophy and influenced the design of the multinational GOG142 study, which was ultimately terminated due to poor accrual. To date, there is a paucity of evidence to support delivering 'GI style' chemotherapy for mucinous ovarian cancer over and above carboplatin-paclitaxel doublet therapy. Hence there is an urge to develop studies focused on targeted therapeutic agents driven by refined mutational analysis and conducted within the context of harmonised international collaborations.
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Affiliation(s)
- Wen Xu
- Mater Health Services, Raymond Terrace, Brisbane, QLD 4101, Australia
| | - Jack Rush
- School of Medicine, University of Queensland, St Lucia, QLD 4072, Australia
| | - Kirsty Rickett
- UQ/Mater McAuley Library, The University of Queensland Library, Brisbane 4101, Australia
| | - Jermaine I G Coward
- Mater Health Services, Raymond Terrace, Brisbane, QLD 4101, Australia; School of Medicine, University of Queensland, St Lucia, QLD 4072, Australia; Princess Alexandra Hospital, Ipswich Road, Woolloongabba, QLD 4102, Australia.
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Tian Q, Lu B, Ye J, Lu W, Xie X, Wang X. Early stage primary ovarian mucinous carcinoma: Outcome-based clinicopathological study in comparison with serous carcinoma. J Int Med Res 2016; 44:357-66. [PMID: 26880793 PMCID: PMC5580051 DOI: 10.1177/0300060515597930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 06/25/2015] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To compare clinicopathological characteristics and survival rates between patients with primary ovarian mucinous carcinoma and those with primary ovarian serous carcinoma. METHODS This retrospective study reviewed archival tumour specimens, originally diagnosed as primary ovarian mucinous carcinoma, using refined histological criteria. All patients were contacted to establish survival status. Clinicopathological characteristics and patient survival data were compared with a group of control patients with primary ovarian serous carcinoma. RESULTS Of the 33 patients originally diagnosed with primary ovarian mucinous carcinoma, this diagnosis was only confirmed in 18. Primary ovarian mucinous carcinoma was more commonly associated with early International Federation of Gynecology and Obstetrics tumour stages and low-grade histology than primary ovarian serous carcinoma. Patients with primary ovarian mucinous carcinoma had a significantly higher overall 5-year survival rate than those with primary ovarian serous carcinoma (12/12 [100%] versus 14/24 [58%]). Kaplan-Meier survival plots demonstrated that patients with primary ovarian mucinous carcinoma had a survival advantage over patients with primary ovarian serous carcinoma. CONCLUSIONS Primary ovarian mucinous carcinomas are frequently low-grade, stage I tumours and have an excellent prognosis.
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Affiliation(s)
- Qifang Tian
- Department of Gynaecological Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China Department of Gynaecology, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, Zhejiang Province, China
| | - Bingjian Lu
- Department of Pathology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Jing Ye
- Department of Gynaecological Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Weiguo Lu
- Department of Gynaecological Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Xing Xie
- Department of Gynaecological Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China Women's Reproductive Health Laboratory of Zhejiang Province, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
| | - Xinyu Wang
- Department of Gynaecological Oncology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China Department of Gynaecology, The Fourth Affiliated Hospital, School of Medicine, Zhejiang University, Yiwu, Zhejiang Province, China
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Laurent PE, Thomassin-Piana J, Jalaguier-Coudray A. Mucin-producing tumors of the ovary: MR imaging appearance. Diagn Interv Imaging 2015; 96:1125-32. [DOI: 10.1016/j.diii.2014.11.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 11/25/2014] [Accepted: 11/26/2014] [Indexed: 11/29/2022]
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Cont NT, Ferrero A, Peccatori FA, D'Alonzo M, Codacci-Pisanelli G, Colombo N, Biglia N. Medical treatment of early stage and rare histological variants of epithelial ovarian cancer. Ecancermedicalscience 2015; 9:584. [PMID: 26557882 PMCID: PMC4631577 DOI: 10.3332/ecancer.2015.584] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Indexed: 01/07/2023] Open
Abstract
Epithelial ovarian cancer is often considered a single pathological entity, but increasing evidence suggests that it is rather a group of different neoplasms, each with unique pathological characteristics, molecular features, and clinical behaviours. This heterogeneity accounts for the different sensitivity to antineoplastic drugs and makes the treatment of ovarian tumours a challenge. For early-stage disease, as well as for heavily pre-treated patients with recurrent ovarian cancer, the benefit of chemotherapy remains uncertain. Clear-cell, mucinous, low-grade serous, and endometrioid carcinomas show different molecular characteristics, which require different therapeutic approaches. In the era of personalised cancer medicine, understanding the pathogenesis and the genetic background of each subtype of epithelial ovarian tumour may lead to a tailored therapy, maximising the benefits of specific treatments and possibly reducing the side effects. Furthermore, personal factors, such as the patient's performance status, should be taken into account in the management of ovarian cancer, with the aim of safeguarding the patients' quality of life.
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Affiliation(s)
- Nicoletta Tomasi Cont
- Academic Division of Gynaecology and Obstetrics, Mauriziano Hospital, University of Turin, Italy
| | - Annamaria Ferrero
- Academic Division of Gynaecology and Obstetrics, Mauriziano Hospital, University of Turin, Italy
| | - Fedro Alessandro Peccatori
- Fertility and Pregnancy Unit, Medical Gynaecologic Oncology Division, European Institute of Oncology, Milan, Italy
| | - Marta D'Alonzo
- Academic Division of Gynaecology and Obstetrics, Mauriziano Hospital, University of Turin, Italy
| | - Giovanni Codacci-Pisanelli
- Fertility and Pregnancy Unit, Medical Gynaecologic Oncology Division, European Institute of Oncology, Milan, Italy ; Department of Medical and Surgical Science and Biotechnology, University of Rome 'La Sapienza', Italy
| | - Nicoletta Colombo
- Medical Gynaecologic Oncology Division, European Institute of Oncology, University of Milan-Bicocca, Italy
| | - Nicoletta Biglia
- Academic Division of Gynaecology and Obstetrics, Mauriziano Hospital, University of Turin, Italy
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Jalaguier-Coudray A, Jacquemier J, Villard-Mahjoub R, Delarbre B, Thomassin-Piana J. Pourquoi la macroscopie est-elle essentielle pour comprendre et analyser les tumeurs ovariennes ? IMAGERIE DE LA FEMME 2015. [DOI: 10.1016/j.femme.2015.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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26
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Rouzbahman M, Chetty R. Republished: Mucinous tumours of appendix and ovary: an overview and evaluation of current practice. Postgrad Med J 2015; 91:41-5. [DOI: 10.1136/postgradmedj-2013-202023rep] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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27
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Kajiyama H, Mizuno M, Shibata K, Umezu T, Suzuki S, Yamamoto E, Mitsui H, Sekiya R, Niimi K, Kawai M, Nagasaka T, Kikkawa F. Oncologic outcome after recurrence in patients with stage I epithelial ovarian cancer: are clear-cell and mucinous histological types a different entities? Eur J Obstet Gynecol Reprod Biol 2014; 181:305-10. [DOI: 10.1016/j.ejogrb.2014.07.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 07/27/2014] [Accepted: 07/29/2014] [Indexed: 01/18/2023]
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28
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Lee JY, Jo YR, Kim TH, Kim HS, Kim MA, Kim JW, Park NH, Song YS. Safety of fertility-sparing surgery in primary mucinous carcinoma of the ovary. Cancer Res Treat 2014; 47:290-7. [PMID: 25287480 PMCID: PMC4398117 DOI: 10.4143/crt.2014.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Accepted: 02/05/2014] [Indexed: 11/27/2022] Open
Abstract
Purpose The aim of this study is to evaluate the safety of fertility-sparing surgery as the treatment for patients with primary mucinous epithelial ovarian cancer. Materials and Methods A retrospective study of patients with mucinous ovarian cancer between 1991 and 2010 was performed. The demographics and survival outcomes were compared between patients who underwent fertility-sparing surgery and those who underwent radical surgery. Results A total of 110 patients underwent primary surgery. At the time of surgery, tumors appeared to be grossly confined to the ovaries in 90 patients, and evidence of metastasis was definite in 20 patients. Of the 90 patients with tumors that appeared to be grossly confined to the ovaries at surgical exploration, 35 (38.9%) underwent fertility-sparing surgery. The Kaplan- Meier curve and the log rank test showed no difference in either recurrence-free survival (p=0.792) or disease-specific survival (p=0.706) between the two groups. Furthermore, there was no significant difference in recurrence-free survival (p=0.126) or disease-specific survival (p=0.377) between the two groups, even when the analysis was limited to women below the age of 40. In a multivariate Cox model, fertility-sparing surgery had no effect on either recurrence-free survival (recurrence hazard ratio [HR], 1.20; 95% confidence interval [CI], 0.25 to 5.71) or disease-specific survival (death HR, 0.88; 95% CI, 0.17 to 4.60). Conclusion Fertility-sparing surgery in primary mucinous cancer grossly confined to the ovaries may be a safe option and one not associated with an increase in recurrence or mortality.
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Affiliation(s)
- Jung-Yun Lee
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Yu Ri Jo
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Tae Hun Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Hee Seung Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Min A Kim
- Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Weon Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Noh Hyun Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea
| | - Yong-Sang Song
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea ; Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea ; Major in Biomodulation, World Class University, Seoul National University, Seoul, Korea
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29
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Li X, Chew SH, Chay WY, Lim-Tan SK, Goh LK. Optimizing Ventana chromogenic dual in-situ hybridization for mucinous epithelial ovarian cancer. BMC Res Notes 2013; 6:562. [PMID: 24373486 PMCID: PMC3892083 DOI: 10.1186/1756-0500-6-562] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 12/18/2013] [Indexed: 11/10/2022] Open
Abstract
Background Dual in-situ hybridization (DISH) assay is a relatively new assay for evaluating Human Epidermal Growth Factor Receptor 2 (HER2) genomic amplification. Optimization protocol for the assay is not yet well established, especially for archival tissues. Although there is a recommended nominal protocol, it is not suited for formalin-fixed and paraffin-embedded (FFPE) samples that were archived for long periods. Findings In a study on local population of mucinous epithelial ovarian cancer, we developed a series of optimization protocols based on the age of samples to improve success of the DISH assay. A decision workflow was generated to facilitate individualization of further optimization protocols. The optimizations were evaluated on 92 whole tissue sections of FFPE mucinous ovarian tumors dating from 1990 to 2011. Overall, 79 samples were successfully assayed for DISH using the series of optimization protocols. We found samples older than 1 year required further optimization beyond the nominal protocol recommended. Thirteen samples were not further assayed after first DISH assay due to inadequately preserved nuclear morphology with no ISH signals throughout the tissue section. Conclusion The study revealed age of samples and storage conditions were major factors in successful DISH assays. Samples that were ten years or less in age, and archived in-house were successfully optimized, whereas older samples, which were also archived off-site, have a higher frequency of unsuccessful optimizations. The study provides practical and important guidelines for the new DISH assay which can facilitate successful HER2 evaluation in ovarian cancers and possibly other cancers as well.
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Affiliation(s)
| | | | | | | | - Liang-Kee Goh
- Cancer & Stem Cell Biology, Duke-National University of Singapore, Singapore, Singapore.
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30
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He YF, Zhang MY, Wu X, Sun XJ, Xu T, He QZ, Di W. High MUC2 expression in ovarian cancer is inversely associated with the M1/M2 ratio of tumor-associated macrophages and patient survival time. PLoS One 2013; 8:e79769. [PMID: 24324582 PMCID: PMC3855613 DOI: 10.1371/journal.pone.0079769] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 09/26/2013] [Indexed: 11/21/2022] Open
Abstract
Mucin 2 (MUC2) is a mucin molecule aberrantly expressed by ovarian cancer cells. Previous in vitro studies have indicated that MUC2 promotes cancer growth and metastasis through a tumor-associated macrophage (TAM)-dependent mechanism. However, this mechanism has never been linked to clinical oncology, and its prognostic significance needed to be clarified. Here, we collected 102 consecutive ovarian cancer specimens and used the multiple immuno-histo-chemical/-fluorescent technique to determine the correlations between the MUC2 expression status, the ratio of M1/M2 TAMs and the densities of cyclooxygenase-2 (COX-2)+ TAMs and COX-2+ cancer cells. The Kaplan-Meier survival analysis and multivariate Cox regression analysis were used to evaluate the prognostic influences of these parameters. As a result, we found that the MUC2 overexpression (immunostaining ++/+++) was significantly correlated with a reduced ratio of M1/M2 TAMs (p<0.001), an increased density of COX-2+ TAMs (p<0.001) and an increased density of COX-2+ cancer cells (p=0.017). Moreover, most of the M2 TAMs (93%-100%) and COX-2+ TAMs (63%-89%) overlapped; and the COX-2+ cancer cells were frequently observed near the COX-2+ TAMs. In the Cox regression analysis, MUC2 overexpression was found to be an independent prognostic factor for ovarian cancer patients, of which the hazard ratio (HR) was 2.354 (95% confidence interval (CI): 1.031-10.707, p=0.005). Also, the reduced ratio of M1/M2 TAMs and the increased densities of COX-2+ TAMs and COX-2+ cancer cells were demonstrated to be the predictors of poor prognosis, among which the reduced M1/M2 ratio possessed the highest HR (1.767, 95% CI: 1.061-6.957, p=0.019). All these findings revealed that MUC2 can concurrently exert M2-polarizing and COX-2-inducing effects on TAMs, by which it causes an imbalanced TAM M1-/M2-polarization pattern and induces local PGE2 synthesis (in both TAMs and cancer cells). The positive feedback between local PGE2 synthesis and TAM M2-polarization accelerates ovarian cancer progression.
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MESH Headings
- Adenocarcinoma, Mucinous/genetics
- Adenocarcinoma, Mucinous/metabolism
- Adenocarcinoma, Mucinous/mortality
- Adenocarcinoma, Mucinous/pathology
- Aged
- Cyclooxygenase 2/genetics
- Cyclooxygenase 2/metabolism
- Cystadenocarcinoma, Serous/genetics
- Cystadenocarcinoma, Serous/metabolism
- Cystadenocarcinoma, Serous/mortality
- Cystadenocarcinoma, Serous/pathology
- Dinoprostone/metabolism
- Feedback, Physiological
- Female
- Gene Expression Regulation, Neoplastic
- Humans
- Immunohistochemistry
- Macrophages/classification
- Macrophages/metabolism
- Macrophages/pathology
- Middle Aged
- Mucin-2/genetics
- Mucin-2/metabolism
- Neoplasm Staging
- Ovarian Neoplasms/genetics
- Ovarian Neoplasms/metabolism
- Ovarian Neoplasms/mortality
- Ovarian Neoplasms/pathology
- Prognosis
- Proportional Hazards Models
- Signal Transduction
- Survival Analysis
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Affiliation(s)
- Yi-feng He
- Shanghai Key Laboratory of Gynecologic Oncology, Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Mei-ying Zhang
- Shanghai Key Laboratory of Gynecologic Oncology, Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Xin Wu
- Department of Gynecology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Xiang-jun Sun
- Shanghai Key Laboratory of Gynecologic Oncology, Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Ting Xu
- Department of Pathology, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China
| | - Qi-zhi He
- Department of Pathology, First Maternity and Infant Health Hospital, Tongji University, Shanghai, China
| | - Wen Di
- Shanghai Key Laboratory of Gynecologic Oncology, Department of Obstetrics and Gynecology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
- * E-mail:
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31
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Rouzbahman M, Chetty R. Mucinous tumours of appendix and ovary: an overview and evaluation of current practice. J Clin Pathol 2013; 67:193-7. [DOI: 10.1136/jclinpath-2013-202023] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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32
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33
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Smolle E, Taucher V, Pichler M, Petru E, Lax S, Haybaeck J. Targeting signaling pathways in epithelial ovarian cancer. Int J Mol Sci 2013; 14:9536-55. [PMID: 23644885 PMCID: PMC3676798 DOI: 10.3390/ijms14059536] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2013] [Revised: 04/13/2013] [Accepted: 04/22/2013] [Indexed: 12/16/2022] Open
Abstract
Ovarian carcinoma (OC) is the most lethal gynecological malignancy. Response to platinum-based chemotherapy is poor in some patients and, thus, current research is focusing on new therapy options. The various histological types of OC are characterized by distinctive molecular genetic alterations that are relevant for ovarian tumorigenesis. The understanding of these molecular pathways is essential for the development of novel therapeutic strategies.
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Affiliation(s)
- Elisabeth Smolle
- Institute of Pathology, Medical University Graz, Auenbruggerplatz 25, A-8036 Graz, Austria; E-Mails: (E.S.); (V.T.)
| | - Valentin Taucher
- Institute of Pathology, Medical University Graz, Auenbruggerplatz 25, A-8036 Graz, Austria; E-Mails: (E.S.); (V.T.)
| | - Martin Pichler
- Department of Internal Medicine, Division of Clinical Oncology, Medical University Graz, A-8036 Graz, Austria; E-Mail:
| | - Edgar Petru
- Department of Obstetrics and Gynecology, Medical University Graz, A-8036 Graz, Austria; E-Mail:
| | - Sigurd Lax
- Department of Pathology, General Hospital Graz West, Goestinger Straße 22, A-8020 Graz, Austria
- Authors to whom correspondence should be addressed; E-Mails: (S.L.); (J.H.); Tel.: +43-316-5466-4652 (S.L.); +43-316-385-80594 (J.H.); Fax: +43-316-5466-74652 (S.L.); +43-316-384-329 (J.H.)
| | - Johannes Haybaeck
- Institute of Pathology, Medical University Graz, Auenbruggerplatz 25, A-8036 Graz, Austria; E-Mails: (E.S.); (V.T.)
- Authors to whom correspondence should be addressed; E-Mails: (S.L.); (J.H.); Tel.: +43-316-5466-4652 (S.L.); +43-316-385-80594 (J.H.); Fax: +43-316-5466-74652 (S.L.); +43-316-384-329 (J.H.)
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Zimmermann AK, Imig J, Klar A, Renner C, Korol D, Fink D, Stadlmann S, Singer G, Knuth A, Moch H, Caduff R. Expression of MAGE-C1/CT7 and selected cancer/testis antigens in ovarian borderline tumours and primary and recurrent ovarian carcinomas. Virchows Arch 2013; 462:565-74. [PMID: 23529156 DOI: 10.1007/s00428-013-1395-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Revised: 03/03/2013] [Accepted: 03/07/2013] [Indexed: 11/28/2022]
Abstract
MAGE-C1/CT7, NY-ESO-1, GAGE and MAGE-A4 are members of the cancer/testis (CT) antigen family, which have been proposed as potential targets for cancer immunotherapy. To determine the prevalence and biologic relevance of the novel CT antigen MAGE-C1/CT7 and other antigens, 36 ovarian borderline tumours (BTs), 230 primary ovarian carcinomas (OCs) and 80 recurrent OCs were immunohistochemically analysed using the monoclonal antibodies CT7-33 (MAGE-C1/CT7), E978 (NY-ESO-1), clone 26 (GAGE) and 57B (MAGE-A4). Positivity of at least one CT antigen was present in 39.5 % (81/205) of primary OC and in 50 % (26/52) of all recurrences. Expression of the novel CT antigen MAGE-C1/CT7 was most commonly seen with positivity in 24.5 % of primary and 35.1 % of recurrent OC. MAGE-A4, GAGE and NY-ESO-1 expressions were seen in 22.7, 13.9 and 7.1 % of primary and 22.6, 17.5 and 8.9 % of recurrent OC, respectively. Analysis of histological subtypes (serous, endometrioid, clear cell, mucinous and transitional) exhibited variable expression with negativity in all mucinous OC. High-grade serous OC revealed CT antigen expression in 5.6 to 28 % with MAGE-C1/CT7 being the most frequent, but without correlation with stage or overall survival. MAGE-C1/CT7 expression and coexpression of CT antigens were significantly correlated with grade of endometrioid OC. None of the BT showed CT antigen expression. No significant correlation was seen with stage, overall survival or response to chemotherapy. In summary, CT antigens are expressed in a certain subset of OC with no expression in BT or OC of mucinous histology. These findings may have implications for the design of polyvalent vaccination strategies for ovarian carcinomas.
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Affiliation(s)
- Anne-Katrin Zimmermann
- Institute of Surgical Pathology, University Hospital Zurich, Schmelzbergstrasse 12, 8091, Zurich, Switzerland.
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35
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Anglesio MS, Kommoss S, Tolcher MC, Clarke B, Galletta L, Porter H, Damaraju S, Fereday S, Winterhoff BJ, Kalloger SE, Senz J, Yang W, Steed H, Allo G, Ferguson S, Shaw P, Teoman A, Garcia JJ, Schoolmeester JK, Bakkum-Gamez J, Tinker AV, Bowtell DD, Huntsman DG, Gilks CB, McAlpine JN. Molecular characterization of mucinous ovarian tumours supports a stratified treatment approach with HER2 targeting in 19% of carcinomas. J Pathol 2013; 229:111-20. [PMID: 22899400 DOI: 10.1002/path.4088] [Citation(s) in RCA: 145] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 07/31/2012] [Accepted: 08/04/2012] [Indexed: 12/11/2022]
Abstract
Mucinous ovarian carcinomas (MCs) typically do not respond to current conventional therapy. We have previously demonstrated amplification of HER2 in 6 of 33 (18.2%) mucinous ovarian carcinomas (MCs) and presented anecdotal evidence of response with HER2-targeted treatment in a small series of women with recurrent HER2-amplified (HER2+) MC. Here, we explore HER2 amplification and KRAS mutation status in an independent cohort of 189 MCs and 199 mucinous borderline ovarian tumours (MBOTs) and their association to clinicopathological features. HER2 status was assessed by immunohistochemistry (IHC), FISH, and CISH, and interpreted per ASCO/CAP guidelines, with intratumoural heterogeneity assessment on full sections, where available. KRAS mutation testing was performed with Sanger sequencing. Stage and grade were associated with recurrence on both univariate and multivariate analysis (p < 0.001). Assessment of HER2 status revealed overexpression/amplification of HER2 in 29/154 (18.8%) MCs and 11/176 (6.2%) MBOTs. There was excellent agreement between IHC, FISH, and CISH assessment of HER2 status (perfect concordance of HER2 0 or 1+ IHC with non-amplified status, and 3+ IHC with amplified status). KRAS mutations were seen in 31/71 (43.6%) MCs and 26/33 (78.8%) MBOTs, and were near mutually exclusive of HER2 amplification. In the 189 MC cases, a total of 54 recurrences and 59 deaths (53 of progressive disease) were observed. Within MCs, either HER2 amplification/overexpression or KRAS mutation was associated with decreased likelihood of disease recurrence (p = 0.019) or death (p = 0.0041) when compared to cases with neither feature. Intratumoural heterogeneity was noted in 26% of HER2-overexpressing cases. These data support the stratification of MCs for the testing of new treatments, with HER2-targeted therapy as a viable option for HER2+ advanced or recurrent disease. Further research is required to delineate the molecular and clinical features of the ∼34% of MC cases with neither HER2 amplification nor KRAS mutations.
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Affiliation(s)
- Michael S Anglesio
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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36
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Kajiyama H, Mizuno M, Shibata K, Kawai M, Nagasaka T, Kikkawa F. Extremely poor postrecurrence oncological outcome for patients with recurrent mucinous ovarian cancer. Int J Clin Oncol 2013; 19:121-6. [PMID: 23392995 DOI: 10.1007/s10147-013-0522-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Accepted: 01/14/2013] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study was conducted to assess the long-term clinical outcome for patients with recurrent mucinous epithelial ovarian cancer (RmOC) in comparison with recurrent serous epithelial ovarian cancer (RsOC). METHODS Three hundred and eighty-four patients with recurrent ovarian cancer, including 340 RsOC and 44 RmOC patients, were analyzed in this study. The pathological slides were evaluated under central pathological review. The prognostic significance of clinicopathological factors was evaluated employing both uni- and multivariable analysis. RESULTS The 3- and 5-year postrecurrence survival (PRS) rates of patients with RmOC were 17.3, and 6.9 %, respectively. In contrast, those of patients with RsOC were 29.8 and 18.8 %, respectively. The PRS of patients with RmOC was significantly poorer than that of patients with RsOC (PRS: P = 0.0006). Moreover, either in the presence or absence of a residual tumor (RT) at initial surgery, the PRS of patients with RmOC was markedly poorer than that of patients with RsOC [RT (-): P < 0.0001: RT (+): P = 0.0912]. In multivariable analysis, a mucinous histology predicted a significantly poorer PRS (RmOC vs. RsOC: hazard ratio (HR) 2.080, 95 % confidence interval (CI) 1.434-3.016, P = 0.0001). Confining analysis to deceased patients (N = 302), the proportion of RmOC patients who died within 12 months following recurrence was markedly higher than that of RsOC [RmOC 69.2 %, RsOC: 41.1 % (P < 0.0001)]. CONCLUSIONS The clinical outcome after recurrence in patients with RmOC was extremely poor. This confirms that RmOC should be considered a different entity from other epithelial ovarian cancers.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Bridged-Ring Compounds/administration & dosage
- Female
- Humans
- Middle Aged
- Neoplasm Recurrence, Local/drug therapy
- Neoplasm Recurrence, Local/mortality
- Neoplasm Recurrence, Local/pathology
- Neoplasm Staging
- Neoplasms, Cystic, Mucinous, and Serous/drug therapy
- Neoplasms, Cystic, Mucinous, and Serous/mortality
- Neoplasms, Cystic, Mucinous, and Serous/pathology
- Ovarian Neoplasms/drug therapy
- Ovarian Neoplasms/mortality
- Ovarian Neoplasms/pathology
- Prognosis
- Survival Rate
- Taxoids/administration & dosage
- Treatment Outcome
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Affiliation(s)
- Hiroaki Kajiyama
- Department of Obstetrics and Gynecology, Nagoya University Graduate School of Medicine, Tsuruma-cho 65, Showa-ku, Nagoya, 466-8550, Japan,
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Abstract
Recent years have seen a dramatic change in the pathological approach to ovarian mucinous neoplasms. A substantial proportion of tumours previously considered to be ovarian primaries actually represent secondary ovarian involvement by tumours elsewhere in the body. Two major categories of tumour have completely disappeared from the diagnostic spectrum: ovarian ‘borderline’ mucinous tumour associated with pseudomyxoma peritonei, and widely disseminated mucinous carcinomas. The emergent picture of true ovarian primary carcinoma of pure mucinous morphology is that this is a rare malignancy that is low grade and low stage at presentation in the vast majority of cases, with a very low likelihood of aggressive clinical behaviour. A large volume of literature has appeared concerning the pathological distinction of primary from metastatic ovarian mucinous neoplasms in view of the dramatically different prognosis and treacherously similar morphology. Clinicopathological parameters useful in the distinction of primary from metastatic mucinous ovarian carcinomas are reviewed. Major features favouring metastases are bilaterality, size <10 cm, surface involvement, extensive intra-abdominal spread and an extensive infiltrative pattern with desmoplasia. Two morphological patterns essentially exclude ovarian origin: colloid and signet ring carcinomas. Features favouring primary ovarian origin are unilaterality, large size >12 cm, smooth external surface and association with other ovarian pathology. An admixture of benign, borderline and malignant patterns in the same tumour favour primary origin, but can be misleading as a ‘maturation’ pattern in metastases can result in the same appearance.
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38
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Matsuo K, Nishimura M, Bottsford-Miller JN, Huang1 J, Komurov K, Armaiz-Pena GN, Shahzad MMK, Stone RL, Roh JW, Sanguino AM, Lu C, Im DD, Rosenshien NB, Sakakibara A, Nagano T, Yamasaki M, Enomoto T, Kimura T, Ram PT, Schmeler KM, Gallick GE, Wong KK, Frumovitz M, Sood AK. Targeting SRC in mucinous ovarian carcinoma. Clin Cancer Res 2011; 17:5367-78. [PMID: 21737505 PMCID: PMC4028171 DOI: 10.1158/1078-0432.ccr-10-3176] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE Mucinous ovarian carcinomas have a distinct clinical pattern compared with other subtypes of ovarian carcinoma. Here, we evaluated (i) stage-specific clinical significance of mucinous ovarian carcinomas in a large cohort and (ii) the functional role of Src kinase in preclinical models of mucinous ovarian carcinoma. EXPERIMENTAL DESIGN A total of 1,302 ovarian cancer patients including 122 (9.4%) cases of mucinous carcinoma were evaluated for survival analyses. Biological effects of Src kinase inhibition were tested using dasatinib-based therapy in a novel orthotopic mucinous ovarian cancer model (RMUG-S-ip2). RESULTS Patients with advanced-stage mucinous ovarian cancer had significantly worse survival than those with serous histology: median overall survival, 1.67 versus 3.41 years, P = 0.002; median survival time after recurrence of 0.53 versus 1.66 years, P < 0.0001. Among multiple ovarian cancer cell lines, RMUG-S-ip2 mucinous ovarian cancer cells showed the highest Src kinase activity. Moreover, oxaliplatin treatment induced phosphorylation of Src kinase. This induced activity by oxaliplatin therapy was inhibited by concurrent administration of dasatinib. Targeting Src with dasatinib in vivo showed significant antitumor effects in the RMUG-S-ip2 model but not in the serous ovarian carcinoma (SKOV3-TR) model. Combination therapy of oxaliplatin with dasatinib further showed significant effects on reducing cell viability, increasing apoptosis, and in vivo antitumor effects in the RMUG-S-ip2 model. CONCLUSIONS Our results suggest that poor survival of women with mucinous ovarian carcinoma is associated with resistance to cytotoxic therapy. Targeting Src kinase with a combination of dasatinib and oxaliplatin may be an attractive approach for this disease.
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Affiliation(s)
- Koji Matsuo
- Department of Gynecologic Oncology and Reproductive Medicine, MD-Anderson Cancer Center, University of Texas, Houston, TX, USA
- Department of Obstetrics and Gynecology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Masato Nishimura
- Department of Gynecologic Oncology and Reproductive Medicine, MD-Anderson Cancer Center, University of Texas, Houston, TX, USA
- Department of Obstetrics and Gynecology, University of Tokushima, Japan
| | - Justin N. Bottsford-Miller
- Department of Gynecologic Oncology and Reproductive Medicine, MD-Anderson Cancer Center, University of Texas, Houston, TX, USA
| | | | - Kakajan Komurov
- Systems Biology, MD-Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Guillermo N. Armaiz-Pena
- Department of Gynecologic Oncology and Reproductive Medicine, MD-Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Mian M. K. Shahzad
- Department of Gynecologic Oncology and Reproductive Medicine, MD-Anderson Cancer Center, University of Texas, Houston, TX, USA
- Department of Obstetrics and Gynecology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Rebecca L. Stone
- Department of Gynecologic Oncology and Reproductive Medicine, MD-Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Ju Won Roh
- Department of Gynecologic Oncology and Reproductive Medicine, MD-Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Angela M. Sanguino
- Department of Gynecologic Oncology and Reproductive Medicine, MD-Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Chunhua Lu
- Department of Gynecologic Oncology and Reproductive Medicine, MD-Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Dwight D. Im
- The Gynecologic Oncology Center, Mercy Medical Center, Baltimore, MD, USA
| | - Neil B. Rosenshien
- The Gynecologic Oncology Center, Mercy Medical Center, Baltimore, MD, USA
| | - Atsuko Sakakibara
- Department of Obstetrics and Gynecology, Kitano Hospital, Osaka, Japan
| | - Tadayoshi Nagano
- Department of Obstetrics and Gynecology, Kitano Hospital, Osaka, Japan
| | - Masato Yamasaki
- Department of Obstetrics and Gynecology, Osaka Rosai Hospital, Osaka, Japan
| | - Takayuki Enomoto
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Prahlad T. Ram
- Systems Biology, MD-Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Kathleen M. Schmeler
- Department of Gynecologic Oncology and Reproductive Medicine, MD-Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Gary E. Gallick
- Cancer Biology, MD-Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Kwong K. Wong
- Department of Gynecologic Oncology and Reproductive Medicine, MD-Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Michael Frumovitz
- Department of Gynecologic Oncology and Reproductive Medicine, MD-Anderson Cancer Center, University of Texas, Houston, TX, USA
| | - Anil K. Sood
- Department of Gynecologic Oncology and Reproductive Medicine, MD-Anderson Cancer Center, University of Texas, Houston, TX, USA
- Cancer Biology, MD-Anderson Cancer Center, University of Texas, Houston, TX, USA
- Center for RNA Interference and non-Coding RNA, University of Texas, Houston, TX, USA
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Singh R, Stockard CR, Grizzle WE, Lillard JW, Singh S. Expression and histopathological correlation of CCR9 and CCL25 in ovarian cancer. Int J Oncol 2011; 39:373-81. [PMID: 21637913 DOI: 10.3892/ijo.2011.1059] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2011] [Accepted: 03/30/2011] [Indexed: 01/22/2023] Open
Abstract
Ovarian carcinoma is the most lethal gynecological malignancy among women and its poor prognosis is mainly due to metastasis. Chemokine receptor CCR9 is primarily expressed by a small subset of immune cells. The interactions between CCL25 and CCR9 have been implicated in leukocyte trafficking to the small bowel, a frequent metastatic site for ovarian cancer cells. We have previously shown that ovarian cancer cells express CCR9 and play an important role in cell migration, invasion and survival in the presence of its natural ligand in vitro. In this study, we have evaluated the expression of CCR9 and CCL25 in ovarian cancer cells and clinical samples. Ovarian cancer tissue microarrays from University of Alabama at Birmingham and AccuMax were stained for CCR9 and CCL25. Aperio ScanScope was used to acquire 80X digital images and expression analysis of CCR9 and CCL25. Flow cytometry and the Image stream system were used to conform the expression of CCR9 and CCL25 in ovarian cancer cells. Our results show significantly higher (p<0.001) expression of CCR9 and CCL25 in serous adenocarcinoma followed by serous papillary cystadenoma, endometrioid adenocarcinoma, mucinous adenocarcinoma, cystadenoma, mucinous boderline adenocarcinoma, clear cell carcinoma, granulosa cell tumor, dysgerminoma, transitional cell carcinoma, Brenner tumor, yolk sac tumor, adenocarcinoma and fibroma cases, compared to non-neoplastic ovarian tissue. Similar to tissue expression, CCR9 was also significantly expressed by the ovarian cancer cell lines (OVCAR-3 and SK-OV-3) in comparison to normal adult ovarian epithelial cell. We provide the first evidence that CCR9 and its natural ligand CCL25 are highly expressed by ovarian cancer tissue and their expression correlates with histological subtypes. Expression of this chemokine receptor and its ligand CCL25 within primary tumor tissue further suggests a potential role of this chemokine-receptor axis in ovarian cancer progression.
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Affiliation(s)
- Rajesh Singh
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, GA 30310, USA
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40
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Dickkopf-1 is frequently overexpressed in ovarian serous carcinoma and involved in tumor invasion. Clin Exp Metastasis 2011; 28:581-91. [PMID: 21607803 DOI: 10.1007/s10585-011-9393-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Accepted: 05/09/2011] [Indexed: 11/27/2022]
Abstract
Dickkopf-1 (DKK1) was known as a negative regulator of the Wnt signaling pathway, which played a crucial role in carcinogenesis. However, its function in human cancers remained elusive. In this study, we aimed to investigate the role of DKK1 in ovarian serous papillary adenocarcinoma (OSC) tumor progression and invasion. Quantitative real-time RT-PCR and Western blot analysis showed that the expression of DKK1 mRNA and protein in 32 OSC tissues were elevated as compared with those in 10 normal ovarian tissues (P = 0.005, P = 0.003, respectively). Immunohistochemical analysis in 178 clinical OSC samples showed that the expression of DKK1 was positively associated with FIGO stage (P = 0.016). Furthermore, the expression of DKK1 protein was positively associated with P-JNK1 protein expression in 178 OSC tissues. DKK1, P-JNK1 and the co-expression of DKK1 and P-JNK1 were all unfavorable prognosis factors for OSC patients (P < 0.0001). DKK1, alone or combined with P-JNK1, was an independent predictor for the 5 year survival (P = 0.015, P < 0.0001, respectively). DKK1 could promote OSC cells invasion and the growth of OSC nude mice xenograft. DKK1 in OSC cells could activate P-JNK1 expression and significantly promote formations of actin filaments and filopodia. Thus, DKK1, alone or combined with P-JNK1, was a novel prognostic predictor for OSC patients and contributed to the invasion of OSC.
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41
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Fertility-sparing surgery in young women with mucinous adenocarcinoma of the ovary. Gynecol Oncol 2011; 122:334-8. [PMID: 21575985 DOI: 10.1016/j.ygyno.2011.04.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2011] [Revised: 04/09/2011] [Accepted: 04/14/2011] [Indexed: 11/22/2022]
Abstract
OBJECTIVES The purpose of this study was to clarify the clinical outcome of patients with stage IA mucinous epithelial ovarian cancer (mEOC) treated with fertility-sparing surgery (FSS). METHODS After a central pathological review and search of the medical records from multiple institutions, a total of 148 stage I mEOC patients were retrospectively evaluated in the current study. All mEOC patients were divided into three groups: group A (FSS; age, 40≥); groups B and C {radical surgery; age, 40≥ (B); 40< (C)}. Survival analysis was performed among these three groups using Kaplan-Meier methods. RESULTS The median follow-up time of all mEOC patients was 71.6 (4.8-448.3) months. Among the 41 patients in group A, 27 patients (65.9%) had IA disease, and 14 (34.1%) had IC disease. Five-year overall survival (OS) and disease-free survival (DFS) rates of patients in the groups were as follows: group A, 97.3% (OS)/90.5% (DFS); group B, 94.4% (OS)/94.4% (DFS); group C; 97.3% (OS)/89.3% (DFS). Collectively, there was no significant difference in OS or DFS among these groups even though they were stratified to each substage (IA/IC) (OS, P=0.180; DFS, P=0.445, respectively). Furthermore, in multivariate analyses, the surgical procedure was not an independent prognostic factor for either OS or DFS (OS, HR: 0.340, 95% CI: 0.034-3.775, P=0.352; DFS, HR: 0.660, 95% CI: 0.142-3.070, P=0.596). CONCLUSIONS Patients with stage I mEOC treated with FSS did not necessarily show a poorer prognosis than those receiving radical surgery.
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Hafezi-Bakhtiari S, Morava-Protzner I, Burnell MJ, Reardon E, Colgan TJ. Choriocarcinoma arising in a serous carcinoma of ovary: an example of histopathology driving treatment. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2010; 32:698-702. [PMID: 20707961 DOI: 10.1016/s1701-2163(16)34574-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Choriocarcinoma within an ovarian carcinoma is exceptionally rare. Nevertheless, recognition of this mixed tumour is important for administration of appropriate chemotherapy. CASE A 65-year-old woman underwent resection of an ovarian mass after presenting with a pelvic mass and breast tenderness. On pathologic examination the mass showed a choriocarcinoma in association with a serous carcinoma. This pathologic diagnosis led to a specific chemotherapy regimen with cisplatin, etoposide, and bleomycin, suitable for both types of malignancy. CONCLUSION Both gynaecologists and pathologists should be aware that the histopathologic classification of ovarian epithelial carcinoma and its variants, such as this one, may have an increasing role in the management of this disease.
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Affiliation(s)
- Sara Hafezi-Bakhtiari
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, University of Toronto, Toronto, ON
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43
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Tang L, Yang J, Ng SK, Rodriguez N, Choi PW, Vitonis A, Wang K, McLachlan GJ, Caiazzo RJ, Liu BCS, Welch WR, Cramer DW, Berkowitz RS, Ng SW. Autoantibody profiling to identify biomarkers of key pathogenic pathways in mucinous ovarian cancer. Eur J Cancer 2010; 46:170-9. [PMID: 19926475 DOI: 10.1016/j.ejca.2009.10.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2009] [Accepted: 10/01/2009] [Indexed: 01/19/2023]
Abstract
Mucinous epithelial ovarian cancers are clinically and morphologically distinct from the other histopathologic subtypes of ovarian cancer. Unlike other ovarian subtypes, epidemiologic studies have indicated that tobacco exposure is a significant risk factor for developing mucinous ovarian cancer. Detection of autoantibody reactivity is useful in biomarker discovery and for explaining the role of important pathophysiologic pathways in disease. In order to study if there are specific antibody biomarkers in the plasma samples of mucinous ovarian cancer patients, we have initiated a screen by employing a 'reverse capture antibody microarray' platform that uses native host antigens derived from mucinous ovarian tissues as 'baits' for the capture of differentially labelled patient and control autoantibodies. Thirty-five autoantibodies that were significantly elevated in the cancer plasma samples compared with healthy controls, and six autoantibodies that segregated smoking and non-smoking patients were identified. Functional annotation of the antibody targets has identified nine target antigens involved in integrin and Wnt signalling pathways. Immunohistochemistry of archived ovarian specimens showed significant overexpression of eight of the nine target antigens in mucinous ovarian tumour tissues, suggesting that plasma autoantibodies from mucinous ovarian cancer patients might have heightened reactivities with epitopes presented by these overexpressed antigens. Autoantibody profiling may have an unexpected utility in uncovering key signalling pathways that are dysregulated in the system of interest.
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Affiliation(s)
- Liangdan Tang
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women's Hospital, Boston, MA 02115, USA
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44
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Jung ES, Bae JH, Lee A, Choi YJ, Park JS, Lee KY. Mucinous adenocarcinoma involving the ovary: comparative evaluation of the classification algorithms using tumor size and laterality. J Korean Med Sci 2010; 25:220-5. [PMID: 20119573 PMCID: PMC2811287 DOI: 10.3346/jkms.2010.25.2.220] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2008] [Accepted: 03/20/2009] [Indexed: 02/03/2023] Open
Abstract
For intraoperative consultation of mucinous adenocarcinoma involving the ovary, it would be useful to have approaching methods in addition to the traditional limited microscopic findings in order to determine the nature of the tumors. Mucinous adenocarcinomas involving the ovaries were evaluated in 91 cases of metastatic mucinous adenocarcinomas and 19 cases of primary mucinous adenocarcinomas using both an original algorithm (unilateral >or=10 cm tumors were considered primary and unilateral <10 cm tumors or bilateral tumors were considered metastatic) and a modified cut-off size algorithm. With 10 cm, 13 cm, and 15 cm size cut-offs, the algorithm correctly classified primary and metastatic tumors in 82.7%, 87.3%, and 89.1% of cases and in 80.6%, 84.9%, and 87.1% of signet ring cell carcinoma (SRC) excluded cases. In total cases and SRC excluded cases, 98.0% and 97.2% of bilateral tumors were metastatic and 100% and 100% of unilateral tumors <10 cm were metastatic, respectively. In total cases and SRC excluded cases, 68.4% and 68.4% of unilateral tumors >or=15 cm were primary, respectively. The diagnostic algorithm using size and laterality, in addition to clinical history, preoperative image findings, and operative findings, is a useful adjunct tool for differentiation of metastatic mucinous adenocarcinomas from primary mucinous adenocarcinomas of the ovary.
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Affiliation(s)
- Eun Sun Jung
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jeong Hoon Bae
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ahwon Lee
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yeong Jin Choi
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jong-Sup Park
- Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyo-Young Lee
- Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Korea
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45
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Lee JH, Zhang X, Shin BK, Lee ES, Kim I. Mac-2 binding protein and galectin-3 expression in mucinous tumours of the ovary: an annealing control primer system and immunohistochemical study. Pathology 2009; 41:229-33. [PMID: 19291534 DOI: 10.1080/00313020902756279] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
AIM We used a new differential display method, the annealing control primer (ACP) system, to analyse the differentially expressed genes in mucinous ovarian tumours. To verify the corresponding target gene, immunohistochemical staining was performed on various epithelial tumours of the ovary. METHODS AND RESULTS The ACP-based reverse transcriptase-polymerase chain reaction revealed that 21 genes were upregulated in the mucinous ovarian adenoma and 14 genes were upregulated in the mucinous ovarian carcinoma. Among them, we selected one upregulated gene, the Mac-2 binding protein (Mac-2 BP), and verified the expression of the Mac-2 BP and its ligand, galectin-3, in a variety of epithelial ovarian tumours by immunohistochemistry. Positive expression of the Mac-2 BP was significantly higher in the mucinous ovarian tumours compared to the other epithelial tumours. Mac-2 BP expression was significantly increased in the borderline and malignant tumours compared to the benign tumours. Galectin-3 expression was more frequent in clear cell carcinomas, serous tumours and mucinous tumours than in endometrioid and transitional tumours. However, there were no differences in galectin-3 expression in comparisons among benign, borderline and malignant mucinous and serous tumours. CONCLUSION These data indicate that the Mac-2 BP may play a role in the development and progression of mucinous ovarian tumours.
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Affiliation(s)
- Ju-Han Lee
- Department of Pathology, Medical College, Korea University, Seoul, Korea
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46
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Cheng X, Jiang R, Li ZT, Tang J, Cai SM, Zhang ZY, Tian WJ, Zang RY. The role of secondary cytoreductive surgery for recurrent mucinous epithelial ovarian cancer (mEOC). Eur J Surg Oncol 2009; 35:1105-8. [PMID: 19443175 DOI: 10.1016/j.ejso.2009.03.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2008] [Revised: 03/21/2009] [Accepted: 03/24/2009] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Mucinous epithelial ovarian cancer (mEOC) may exhibit a distinct biological behavior in epithelial ovarian cancer (EOC). The role of secondary cytoreductive surgery was evaluated in patients with recurrent mEOC, and the prognosis was assessed. METHODS Twenty-one patients with stages IIc to IV mEOC who experienced disease recurrence and received secondary cytoreductive surgery at Fudan University Cancer Hospital between Jan. 1997 and Dec. 2005 were retrospectively reviewed. Survival curves were generated using the Kaplan-Meier method and the significant comparison of survival rate was estimated by the log-rank test. RESULTS The median progression-free interval (PFI) was 14 months (range, 5-46 months) after the first cytoreduction. Seven patients (33%) who received secondary cytoreductive surgery were optimally cytoreduced with residual disease less than or equal 1cm, and the other 14 patients (67%) underwent suboptimal surgical cytoreduction. The overall median survival time was 27 months (range, 8-64 months). The median survival time after recurrence was 10 months (range, 3-32 months). There was no significant statistical difference in median survival between patients with optimal and suboptimal secondary surgical cytoreduction, with an estimated survival of 10 months and 9.8 months, respectively (P>0.05). CONCLUSION Optimal primary cytoreductive surgery for advanced mEOC was very important. Once it recurs, the prognosis is very poor. Patients with recurrent mEOC should be carefully assessed before performing secondary cytoreductive surgery, as this may have limited impact on the overall survival rates.
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Affiliation(s)
- X Cheng
- Ovarian Cancer Program, Department of Gynecologic Oncology, Fudan University Cancer Hospital, 270 Dongan Road, Shanghai 200032, China
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Shimada M, Kigawa J, Ohishi Y, Yasuda M, Suzuki M, Hiura M, Nishimura R, Tabata T, Sugiyama T, Kaku T. Clinicopathological characteristics of mucinous adenocarcinoma of the ovary. Gynecol Oncol 2009; 113:331-4. [PMID: 19275957 DOI: 10.1016/j.ygyno.2009.02.010] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2008] [Revised: 01/29/2009] [Accepted: 02/04/2009] [Indexed: 02/08/2023]
Abstract
OBJECTIVE We conducted the present study to clarify the clinicopathological characteristics of mucinous adenocarcinoma. METHODS Two hundred twenty-five patients were diagnosed with mucinous adenocarcinoma at individual institutes and underwent primary treatment between 1998 and 2003. Of these patients, 189 patients who could undergo central pathological review were enrolled in this study. Of 189 patients undergoing central pathological review, 64 patients (33.9%) were diagnosed with mucinous invasive adenocarcinoma, 45 mucinous intraepithelial carcinoma, and 42 mucinous tumor of borderline malignancy. Twenty-five patients were diagnosed with other histological subtypes, including 8 endometrioid adenocarcinoma, 5 clear cell carcinoma, 3 serous adenocarcinoma, and 4 mixed type. There were 13 cases of metastatic mucinous adenocarcinoma, including 7 pseudomyxoma peritonei. Four hundred thirty-three patients with serous adenocarcinoma were used as controls. RESULTS Forty-five patients with mucinous invasive carcinoma were in FIGO I-II stages and 19 in III-IV stages. There was no difference in the outcome between mucinous invasive adenocarcinoma and serous adenocarcinoma in I-II stage patients and III-IV stage patients with optimal operation. In contrast, patients with mucinous invasive adenocarcinoma receiving suboptimal operation showed a significantly worse prognosis (survival rate: 27.8% vs. 61.5%). The response rate to chemotherapy for mucinous invasive adenocarcinoma was significantly lower than for serous adenocarcinoma (12.5% vs. 67.7%). CONCLUSIONS The diagnosis of mucinous invasive adenocarcinoma was difficult. Since patients with mucinous invasive adenocarcinoma had a lower response to chemotherapy, aggressive cytoreductive surgery was an effective treatment to improve the prognosis for advanced stage patients. A new chemotherapeutic regimen should be established for mucinous adenocarcinoma of the ovary.
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Affiliation(s)
- Muneaki Shimada
- Department of Obstetrics and Gynecology, Tottori University School of Medicine, Yonago, Tottori, Japan
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48
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Xu DM, Linghu H, Tsuda M, Tanaka S, Kazuo N. Adaptor protein Crk is implicated in mucus formation in mucinous epithelial ovarian cancer (mEOC) cells MCAS. Chin J Cancer Res 2008. [DOI: 10.1007/s11670-008-0121-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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