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Rodriguez GC, Yozwiak M, Nelson OL, Zhang HH, Kim AA, Watkin W, Barton JK, Alberts DS. The karyometric signature is altered in fallopian tubes with serous tubal intraepithelial carcinoma. Gynecol Oncol 2024; 186:110-116. [PMID: 38640774 PMCID: PMC11216887 DOI: 10.1016/j.ygyno.2024.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 04/01/2024] [Accepted: 04/08/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVE Recent evidence suggests that the fimbriated end of the fallopian tube harbors the precursor cells for many high-grade ovarian cancers, opening the door for development of better screening methods that directly assess the fallopian tube in women at risk for malignancy. Previously we have shown that the karyometric signature is abnormal in the fallopian tube epithelium in women at hereditary risk of ovarian cancer. In this study, we sought to determine whether the karyometric signature in serous tubal intraepithelial carcinoma (STIC) is significantly different from normal, and whether an abnormal karyometric signature can be detected in histologically normal tubal epithelial cells adjacent to STIC lesions. METHODS The karyometric signature was measured in epithelial cells from the proximal and fimbriated portion of the fallopian tube in fallopian tube specimens removed from women at: 1) average risk for ovarian cancer undergoing surgery for benign gynecologic indications (n = 37), 2) hereditary risk of ovarian cancer (germline BRCA alterations) undergoing risk-reducing surgery (n = 44), and 3) diagnosed with fimbrial STICs (n = 17). RESULTS The karyometric signature in tubes with fimbrial STICs differed from that of tubes with benign histology. The degree of karyometric alteration increased with increasing proximity to fimbrial STICs, ranging from moderate in the proximal portion of the tube, to greatest in both normal appearing fimbrial cells near STICs as well as in fimbrial STIC lesions. CONCLUSION These data demonstrate an abnormal karyometric signature in STICs that may extend beyond the STIC, potentially providing an opportunity for early detection of fallopian tube neoplasia.
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Affiliation(s)
- Gustavo C Rodriguez
- NorthShore University HealthSystem, Evanston, IL, United States; University of Chicago, Pritzker School of Medicine, Chicago, IL, United States.
| | - Michael Yozwiak
- University of Arizona, Department of Medicine, Tucson, AZ, United States
| | - Omar L Nelson
- NorthShore University HealthSystem, Evanston, IL, United States; University of Chicago, Pritzker School of Medicine, Chicago, IL, United States
| | - Hao Helen Zhang
- University of Arizona, Department of Mathematics, Tucson, AZ, United States; University of Arizona, Statistics and Data Science GIDP, Tucson, AZ, United States
| | - Ahyoung Amy Kim
- University of Arizona, Statistics and Data Science GIDP, Tucson, AZ, United States
| | - William Watkin
- NorthShore University HealthSystem, Evanston, IL, United States; University of Chicago, Pritzker School of Medicine, Chicago, IL, United States
| | - Jennifer K Barton
- University of Arizona, Department of Biomedical Engineering, Tucson, AZ, United States
| | - David S Alberts
- University of Arizona, Department of Medicine, Tucson, AZ, United States
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2
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Phung MT, Lee AW, McLean K, Anton-Culver H, Bandera EV, Carney ME, Chang-Claude J, Cramer DW, Doherty JA, Fortner RT, Goodman MT, Harris HR, Jensen A, Modugno F, Moysich KB, Pharoah PDP, Qin B, Terry KL, Titus LJ, Webb PM, Wu AH, Zeinomar N, Ziogas A, Berchuck A, Cho KR, Hanley GE, Meza R, Mukherjee B, Pike MC, Pearce CL, Trabert B. A framework for assessing interactions for risk stratification models: the example of ovarian cancer. J Natl Cancer Inst 2023; 115:1420-1426. [PMID: 37436712 PMCID: PMC10637032 DOI: 10.1093/jnci/djad137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/08/2023] [Accepted: 06/30/2023] [Indexed: 07/13/2023] Open
Abstract
Generally, risk stratification models for cancer use effect estimates from risk/protective factor analyses that have not assessed potential interactions between these exposures. We have developed a 4-criterion framework for assessing interactions that includes statistical, qualitative, biological, and practical approaches. We present the application of this framework in an ovarian cancer setting because this is an important step in developing more accurate risk stratification models. Using data from 9 case-control studies in the Ovarian Cancer Association Consortium, we conducted a comprehensive analysis of interactions among 15 unequivocal risk and protective factors for ovarian cancer (including 14 non-genetic factors and a 36-variant polygenic score) with age and menopausal status. Pairwise interactions between the risk/protective factors were also assessed. We found that menopausal status modifies the association among endometriosis, first-degree family history of ovarian cancer, breastfeeding, and depot-medroxyprogesterone acetate use and disease risk, highlighting the importance of understanding multiplicative interactions when developing risk prediction models.
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Affiliation(s)
- Minh Tung Phung
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Alice W Lee
- Department of Public Health, California State University, Fullerton, Fullerton, CA, USA
| | - Karen McLean
- Department of Gynecologic Oncology and Department of Pharmacology & Therapeutics, Elm & Carlton Streets, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Hoda Anton-Culver
- Department of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Elisa V Bandera
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Michael E Carney
- Department of Obstetrics and Gynecology, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Daniel W Cramer
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Obstetrics and Gynecology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Jennifer Anne Doherty
- Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Renee T Fortner
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Marc T Goodman
- Samuel Oschin Comprehensive Cancer Institute, Cancer Prevention and Genetics Program, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Community and Population Health Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Holly R Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, USA
| | - Allan Jensen
- Department of Lifestyle, Reproduction and Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Francesmary Modugno
- Women’s Cancer Research Center, Magee-Women’s Research Institute and Hillman Cancer Center, Pittsburgh, PA, USA
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburg, PA, USA
| | - Kirsten B Moysich
- Division of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Paul D P Pharoah
- Department of Computational Biomedicine, Cedars-Sinai Medical Centre, Los Angeles, CA, USA
| | - Bo Qin
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Kathryn L Terry
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Obstetrics and Gynecology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Linda J Titus
- Public Health, Muskie School of Public Service, University of Southern Maine, Portland, ME, USA
| | - Penelope M Webb
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Anna H Wu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Nur Zeinomar
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Argyrios Ziogas
- Department of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Andrew Berchuck
- Division of Gynecologic Oncology, Duke University School of Medicine, Durham, NC, USA
| | - Kathleen R Cho
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Gillian E Hanley
- Department of Obstetrics & Gynecology, University of British Columbia Faculty of Medicine, Vancouver, BC, Canada
| | - Rafael Meza
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Department of Integrative Oncology, BC Cancer Research Institute, Vancouver, BC, Canada
| | - Bhramar Mukherjee
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Malcolm C Pike
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Celeste Leigh Pearce
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Britton Trabert
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA
- Cancer Control and Populations Sciences Program, Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, USA
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Effects of Laparoscopic Hyperthermic Perfusion Therapy Combined with Adjuvant Treatment of Compound Yew Capsule on Ovarian Blood Flow Parameters and Immune Function in Patients with Ovarian Cancer. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:9603492. [PMID: 35873625 PMCID: PMC9300267 DOI: 10.1155/2022/9603492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 11/28/2022]
Abstract
Objective To determine the effects of laparoscopic hyperthermic perfusion therapy combined with adjuvant compound yew capsules on ovarian blood flow parameters and immune function in patients with ovarian cancer (OC). Methods A total of 90 OC patients enrolled in our hospital between January 2019 and January 2020 were randomly distributed into the control (Con group) and experimental group (Exp group) based on the sealed envelope method. The Con group was administered laparoscopic hyperthermic perfusion therapy. On this basis, the Exp group was subjected to compound yew capsules; the ovarian blood flow parameters and immune function indexes were compared between the two groups. Results The Exp group was reported to perform better than the Con group regarding ovarian blood flow parameters and immune indexes after treatment (p < 0.001). Conclusion Laparoscopic hyperthermic perfusion therapy combined with adjuvant compound yew capsules for patients with OC can substantially improve the clinical indexes and immune function. Furthermore, research and adequate promotion are needed to elicit the evidence beyond preclinical studies to understand the intricacies of its implementation.
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Xia YY, Gronwald J, Karlan B, Lubinski J, McCuaig JM, Brooks J, Moller P, Eisen A, Sun S, Senter L, Bordeleau L, Neuhausen SL, Singer CF, Tung N, Foulkes WD, Sun P, Narod SA, Kotsopoulos J. Contraceptive use and the risk of ovarian cancer among women with a BRCA1 or BRCA2 mutation. Gynecol Oncol 2022; 164:514-521. [DOI: 10.1016/j.ygyno.2022.01.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 01/04/2022] [Accepted: 01/08/2022] [Indexed: 01/05/2023]
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Nelson OL, Rosales R, Turbov JM, Thaete LG, Cline JM, Rodriguez GC. Progestin Significantly Inhibits Carcinogenesis in the Mogp-TAg Transgenic Mouse Model of Fallopian Tube Cancer. Cancer Prev Res (Phila) 2021; 15:75-86. [PMID: 34844992 DOI: 10.1158/1940-6207.capr-21-0324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/21/2021] [Accepted: 11/22/2021] [Indexed: 11/16/2022]
Abstract
Recent studies suggest that the fallopian tube epithelium (FTE) harbors the precursor for high grade ovarian cancer, creating opportunities for targeting the FTE for ovarian cancer prevention. Preclinical evidence supports progestins as ovarian cancer preventives, but the effect of progestins on the FTE is not well characterized. The murine oviduct-specific glycoprotein promotor-driven simian virus 40 large T-Antigen (mogp-TAg) transgenic mouse model develops neoplastic lesions in the fallopian tube (FT) in a manner similar to that described in human fallopian and ovarian cancer. In this study, we investigated the inhibitory effects of the progestin Depo-medroxyprogesterone acetate (DMPA) on FT carcinogenesis following treatment for 3 and 7 weeks in 5-week-old mogp-TAg mice. Overall, compared to vehicle-treated mice, the FT of DMPA-treated mice was significantly smaller (p<0.0005), accumulated fewer p53-positive cells, had normal distribution of ciliated cells, less nuclear pleomorphism and epithelial tufting, and had a significantly lower proliferative index (p=0.001). Accumulation of p53 signatures and serous tubal intraepithelial carcinomas (STICs) in the FT was significantly reduced in the DMPA (p<0.0005) treatment group. Moreover, the FT of the DMPA-treated mice developed significantly less adenocarcinoma compared to vehicle (p<0.005) at both treatment time points. DMPA treatment significantly induced cleaved caspase-3 (p<0.0005) in the FTE compared to vehicle suggesting that apoptosis is involved in DMPA-related clearance of abnormal cells from the FT. These data demonstrate that DMPA targets early events in FT carcinogenesis by clearing genetically damaged cells, leading to marked reduction in adenocarcinoma, supporting progestins as chemopreventives for FT and ovarian cancer.
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Affiliation(s)
- Omar L Nelson
- Obstetrics and Gynecology, Division of Gynecologic Oncology, NorthShore University HealthSystem
| | - Rebecca Rosales
- Division of Gynecologic Oncology, NorthShore University HealthSystem
| | | | - Larry G Thaete
- Division of Gynecologic Oncology, NorthShore University HealthSystem
| | - J Mark Cline
- Pathology, Section on Comparative Medicine, Wake Forest University School of Medicine
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6
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Phung MT, Lee AW, Wu AH, Berchuck A, Cho KR, Cramer DW, Doherty JA, Goodman MT, Hanley GE, Harris HR, McLean K, Modugno F, Moysich KB, Mukherjee B, Schildkraut JM, Terry KL, Titus LJ, Jordan SJ, Webb PM, Pike MC, Pearce CL. Depot-Medroxyprogesterone Acetate Use Is Associated with Decreased Risk of Ovarian Cancer: The Mounting Evidence of a Protective Role of Progestins. Cancer Epidemiol Biomarkers Prev 2021; 30:927-935. [PMID: 33619020 PMCID: PMC9281627 DOI: 10.1158/1055-9965.epi-20-1355] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/22/2020] [Accepted: 02/16/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Combined oral contraceptive use is associated with a decreased risk of invasive epithelial ovarian cancer (ovarian cancer). There is suggestive evidence of an inverse association between progestin-only contraceptive use and ovarian cancer risk, but previous studies have been underpowered. METHODS The current study used primary data from 7,977 women with ovarian cancer and 11,820 control women in seven case-control studies from the Ovarian Cancer Association Consortium to evaluate the association between use of depot-medroxyprogesterone acetate (DMPA), an injectable progestin-only contraceptive, and ovarian cancer risk. Logistic models were fit to determine the association between ever use of DMPA and ovarian cancer risk overall and by histotype. A systematic review of the association between DMPA use and ovarian cancer risk was conducted. RESULTS Ever use of DMPA was associated with a 35% decreased risk of ovarian cancer overall (OR, 0.65; 95% confidence interval, 0.50-0.85). There was a statistically significant trend of decreasing risk with increasing duration of use (P trend < 0.001). The systematic review yielded six studies, four of which showed an inverse association and two showed increased risk. CONCLUSIONS DMPA use appears to be associated with a decreased risk of ovarian cancer in a duration-dependent manner based on the preponderance of evidence. Further study of the mechanism through which DMPA use is associated with ovarian cancer is warranted. IMPACT The results of this study are of particular interest given the rise in popularity of progestin-releasing intrauterine devices that have a substantially lower progestin dose than that in DMPA, but may have a stronger local effect.
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Affiliation(s)
- Minh Tung Phung
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Alice W. Lee
- Department of Public Health, California State University, Fullerton, Fullerton, CA, USA
| | - Anna H. Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Andrew Berchuck
- Division of Gynecologic Oncology, Duke University School of Medicine, Durham, NC, USA
| | - Kathleen R. Cho
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Daniel W. Cramer
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Obstetrics and Gynecology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Jennifer Anne Doherty
- Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| | - Marc T. Goodman
- Samuel Oschin Comprehensive Cancer Institute, Cancer Prevention and Genetics Program, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Gillian E. Hanley
- University of British Columbia Faculty of Medicine, Department of Obstetrics & Gynecology, Vancouver, Canada
| | - Holly R. Harris
- Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Karen McLean
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Francesmary Modugno
- Womens Cancer Research Center, Magee-Women’s Research Institute and Hillman Cancer Center, Pittsburgh, PA, USA
- Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kirsten B. Moysich
- Division of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Bhramar Mukherjee
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Joellen M. Schildkraut
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Kathryn L. Terry
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Obstetrics and Gynecology, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Linda J. Titus
- Department of Epidemiology and Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, NH
| | | | - Susan J. Jordan
- University of Queensland, School of Public Health, Brisbane, Queensland, Australia
| | - Penelope M. Webb
- Department of Population Health, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | | | - Malcolm C. Pike
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Celeste Leigh Pearce
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
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