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Wróblewski O, Michalczyk K, Kozłowski M, Nowak K, Chudecka-Głaz A, Skwirczyńska E. A Longitudinal Study of the Influence of the COVID-19 Pandemic on Anxiety and Stress among Medical University Students. J Clin Med 2024; 13:890. [PMID: 38337584 PMCID: PMC10856275 DOI: 10.3390/jcm13030890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Background: The COVID-19 pandemic was declared an international health emergency by the World Health Organization. The dramatic, widespread transmission of the virus, high mortality, and lack of specific drugs caused the development of panic attacks and anxiety. Healthcare professionals, including medical students, were challenged to provide medical care to patients in need, often exposing themselves to the virus. (2) Methods: This study aimed to assess anxiety and stress levels in medical students, both at the beginning and after the end of the COVID-19 pandemic. The STAI and PSS-10 questionnaires were used. (3) Results: This study showed a decrease in anxiety levels among medical students after the end of the COVID-19 pandemic. In both 2020 and 2022, female students were found to experience higher stress levels than male students. Anxiety levels were similar among students of different medical-related faculties. (4) Conclusions: The COVID-19 pandemic caused stress and anxiety among medical students, which decreased throughout the duration of the pandemic.
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Affiliation(s)
| | - Kaja Michalczyk
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
| | - Mateusz Kozłowski
- Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University, 70-204 Szczecin, Poland; (M.K.); (K.N.)
| | - Katarzyna Nowak
- Department of Reconstructive Surgery and Gynecological Oncology, Pomeranian Medical University, 70-204 Szczecin, Poland; (M.K.); (K.N.)
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
| | - Edyta Skwirczyńska
- Department of History of Medicine and Medical Ethics, Pomeranian Medical University in Szczecin, 70-204 Szczecin, Poland;
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2
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Markowska A, Baranowski W, Pityński K, Chudecka-Głaz A, Markowska J, Sawicki W. Metastases and Recurrence Risk Factors in Endometrial Cancer-The Role of Selected Molecular Changes, Hormonal Factors, Diagnostic Methods and Surgery Procedures. Cancers (Basel) 2023; 16:179. [PMID: 38201606 PMCID: PMC10778296 DOI: 10.3390/cancers16010179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/06/2023] [Accepted: 12/16/2023] [Indexed: 01/12/2024] Open
Abstract
The presence of metastatic endometrial cancer (EC) is a key problem in treatment failure associated with reduced overall survival rates. The most common metastatic location is the pelvic lymph nodes, and the least common is the brain. The presence of metastasis depends on many factors, including the molecular profile of cancer (according to the TCGA-Genome Atlas), the activity of certain hormones (estrogen, prolactin), and pro-inflammatory adipocytokines. Additionally, an altered expression of microRNAs affecting the regulation of numerous genes is also related to the spread of cancer. This paper also discusses the value of imaging methods in detecting metastases; the primary role is attributed to the standard transvaginal USG with the tumor-free distance (uTFD) option. The influence of diagnostic and therapeutic methods on EC spread is also described. Hysteroscopy, according to the analysis discussed above, may increase the risk of metastases through a fluid medium, mainly performed in advanced stages of EC. According to another analysis, laparoscopic hysterectomy performed with particular attention to avoiding risky procedures (trocar flushing, tissue traumatization, preserving a margin of normal tissue) was not found to increase the risk of EC dissemination.
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Affiliation(s)
- Anna Markowska
- Department of Perinatology and Women’s Diseases, Poznan University of Medical Sciences, 60-535 Poznan, Poland;
| | - Włodzimierz Baranowski
- Department of Gynecological Oncology, Military Institute of Medicine, 04-141 Warsaw, Poland
| | - Kazimierz Pityński
- Department of Gynecology and Oncology, Jagiellonian University Medical College, 31-501 Krakow, Poland;
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, 70-204 Szczecin, Poland;
| | - Janina Markowska
- Gynecological Oncology Center Poznań, Poznanska 58A, 60-850 Poznan, Poland;
| | - Włodzimierz Sawicki
- Department of Obstetrics, Gynecology and Gynecological Oncology, Medical University of Warsaw, 02-091 Warsaw, Poland;
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Wieder-Huszla S, Chudecka-Głaz A, Gutowska I, Karakiewicz B, Jurczak A. Effect of the treatment stage on the serum levels of selected cytokines and antioxidant enzymes in patients with tumors of the reproductive organs. Eur Rev Med Pharmacol Sci 2023; 27:3117-3133. [PMID: 37070915 DOI: 10.26355/eurrev_202304_31946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
OBJECTIVE Chronic inflammation along with concomitant oxidative stress contributes to an increased risk of cancer development. The aim of this study was to analyze selected cytokines and antioxidant enzymes in patients with ovarian and endometrial cancers, taking into account the stage of oncological treatment. PATIENTS AND METHODS The study sample included 52 female patients with advanced endometrial cancer (n = 26.50%) and ovarian cancer (n = 26.50%), undergoing chemotherapy. Long-term observation at four time points was used in the subjects. Each of the women was blood sampled several times (before surgery, and then before the first, third, and sixth cycle of chemotherapy) in order to determine serum levels of pro- and anti-inflammatory cytokines and antioxidant enzymes. RESULTS The levels of catalase (CAT), glutathione reductase (GR), interleukin (IL)-10, IL-1α, IL-4 differed significantly depending on the stage of therapy and the type of cancer. The serum levels of IL-4 and IL-10 in patients with ovarian cancer were statistically significantly higher than those observed in patients with endometrial cancer. The activity of the tested antioxidant enzymes varied depending on the chemotherapy cycle. Their highest activity in most cases was observed before the third cycle of chemotherapy, and it decreased before the sixth cycle, irrespective of the type of cancer. CONCLUSIONS In the studied group of patients with ovarian and endometrial cancer, the applied chemotherapy significantly changed the concentration and activity of some interleukins and antioxidant enzymes. The type of tumor determined the levels of IL-4 and IL-10 before the treatment. Evaluation of inflammatory parameters and oxidative stress in women with cancer of the reproductive organ may help to understand physiological changes resulting from the applied therapy.
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Affiliation(s)
- S Wieder-Huszla
- Department of Clinical Nursing, Pomeranian Medical University, Szczecin, Poland.
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Skwirczyńska E, Chudecka-Głaz A, Wróblewski O, Tejchman K, Skonieczna-Żydecka K, Piotrowiak M, Michalczyk K, Karakiewicz B. Age Matters: The Moderating Effect of Age on Styles and Strategies of Coping with Stress and Self-Esteem in Patients with Neoplastic Prostate Hyperplasia. Cancers (Basel) 2023; 15:cancers15051450. [PMID: 36900243 PMCID: PMC10000508 DOI: 10.3390/cancers15051450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/15/2023] [Accepted: 02/21/2023] [Indexed: 03/02/2023] Open
Abstract
The aim of this study was to analyze coping mechanisms and their psychological aspects during the treatment of neoplastic prostate hyperplasia. We have analyzed strategies and styles of coping with stress and self-esteem of patients diagnosed with neoplastic prostate hyperplasia. A total of 126 patients were included in the study. Standardized psychological questionnaires were used to determine the type of coping strategy by using the Stress Coping Inventory MINI-COPE, while a coping style questionnaire was used to assess the type of coping style by using the Convergence Insufficiency Symptom Survey (CISS). The SES Self-Assessment Scale was used to measure the level of self-esteem. Patients using adaptive strategies of coping with stress in the form of active coping, seeking support and planning had higher self-esteem. However, the use of maladaptive coping strategies in the form of self-blame was found to cause a significant decrease in patients' self-esteem. The study has also shown the choice of a task-based coping style to positively influence one's self-esteem. An analysis related to patients' age and coping methods revealed younger patients, up to 65 years of age, using adaptive strategies of coping with stress to have a higher level of self-esteem than older patients using similar strategies. The results of this study show that older patients, despite the use of adaptation strategies, have lower self-esteem. This group of patients should receive special care both from family and medical staff. The obtained results support the implementation of holistic care for patients, using psychological interventions to improve patients' quality of life. Early psychological consultation and mobilization of patients' personal resources may allow patients to change stress coping methods towards more adaptive forms.
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Affiliation(s)
- Edyta Skwirczyńska
- Department of the History of Medicine and Medical Ethics, Pomeranian Medical University, Aleja Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
- Correspondence: ; Tel.: +48-508-359-596
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Oskar Wróblewski
- Subdepartment of Social Medicine and Public Health, Department of Social Medicine, Pomeranian Medical University, 71-210 Szczecin, Poland
| | - Karol Tejchman
- Department of General Surgery and Transplantology, Pomeranian Medical University, 70-111 Szczecin, Poland
| | | | - Michał Piotrowiak
- Department of General Surgery and Transplantology, Pomeranian Medical University, 70-111 Szczecin, Poland
| | - Kaja Michalczyk
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Beata Karakiewicz
- Subdepartment of Social Medicine and Public Health, Department of Social Medicine, Pomeranian Medical University, 71-210 Szczecin, Poland
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Jagodzińska A, Chudecka-Głaz A, Michalczyk K, Pius-Sadowska E, Wieder-Huszla S, Jurczak A, Machaliński B. The Diagnostic Role of FGF 21 in Endometrial Cancer and Other Pathologies of the Uterine Corpus. Diagnostics (Basel) 2023; 13:diagnostics13030399. [PMID: 36766504 PMCID: PMC9914808 DOI: 10.3390/diagnostics13030399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/08/2023] [Accepted: 01/14/2023] [Indexed: 01/24/2023] Open
Abstract
Endometrial cancer is becoming an increasing problem. Taking into account its pathomechanisms, we aimed to investigate whether FGF 21, an important metabolism regulator, could be used as a biomarker for endometrial cancer. The study included 233 patients who were classified into five subgroups depending on the result of the histological examination: endometrial carcinomas, sarcomas, endometrial polyps, fibroids, and normal endometrium. Statistically significantly higher FGF 21 levels were found in patients diagnosed with malignant lesions (p < 0.001). FGF 21 concentration correlated with the degree of cellular differentiation (p = 0.020) and the presence of lymph node metastases (p = 0.009). The diagnostic performance characteristics of FGF 21 as an EC diagnostic marker demonstrated an AUC of 0.677. Of all of the assessed biomarkers, FGF 21 had the highest specificity (90%), yet limited sensitivity (41%). Additionally, HE4 and CA 125 were confirmed to have roles as EC biomarkers, with a higher accuracy for HE4 (79% vs. 72%).
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Affiliation(s)
- Anna Jagodzińska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Kaja Michalczyk
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, 70-204 Szczecin, Poland
- Correspondence:
| | - Ewa Pius-Sadowska
- Department of General Pathology, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Sylwia Wieder-Huszla
- Department of Clinical Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland
| | - Anna Jurczak
- Department of Clinical Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland
| | - Bogusław Machaliński
- Department of General Pathology, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
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Michalczyk K, Misiek M, Chudecka-Głaz A. Can Adjuvant HPV Vaccination Be Helpful in the Prevention of Persistent/Recurrent Cervical Dysplasia after Surgical Treatment?—A Literature Review. Cancers (Basel) 2022; 14:cancers14184352. [PMID: 36139514 PMCID: PMC9496656 DOI: 10.3390/cancers14184352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/02/2022] [Accepted: 09/05/2022] [Indexed: 12/24/2022] Open
Abstract
Simple Summary Primary prophylactic, early detection and the treatment of precancerous lesions are the main goals of cervical cancer screening. Despite effective surgical treatment methods, using loop electrosurgical excision procedures and conization, the overall risk of the recurrence of HSIL lesions remains at approximately 6.6%. There is increasing evidence of the potential role of HPV vaccines in the adjuvant setting and their impact on the reduction of disease recurrence. This review aims to analyze the up-to-date research concerning the use and efficacy of secondary human papilloma virus (HPV) vaccination as an adjuvant method to surgical treatment in patients diagnosed with cervical HSILs. Abstract Cervical cancer formation is preceded by precursor lesions, including low-grade squamous intraepithelial lesions (LSILs) and high-grade squamous intraepithelial lesions (HSILs), which are usually diagnosed in women of reproductive age. Despite the recent advanced diagnostic and treatment methods, including colposcopy, the loop electrosurgical excision procedure (LEEP), and surgical conization, the recurrence or residual disease affects as many as 6.6% of patients. The lesions are often associated with human papilloma virus (HPV) infection. As HPV persistence is the leading and only modifiable factor affecting the risk of progression of CIN lesions into high-grade cervical dysplasia and cancer, it has been proposed to conduct adjuvant vaccination in patients treated for high-grade cervical dysplasia. To date, no vaccine has been approved for therapeutic use in patients diagnosed with HSILs; however, attempts have been made to determine the use of HPV prophylactic vaccination to reduce recurrent HSILs and prevent cervical cancer. The aim of this review was to analyze the up-to-date literature concerning the possible use of secondary human papilloma virus (HPV) vaccination as an adjuvant method to surgical treatment in patients diagnosed with cervical HSILs. Adjuvant HPV vaccination after surgical treatment may reduce the risk of recurrent cervical dysplasia.
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Affiliation(s)
- Kaja Michalczyk
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, 70-204 Szczecin, Poland
- Correspondence:
| | - Marcin Misiek
- Holy Cross Cancer Center, Clinical Gynecology, 25-743 Kielce, Poland
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, 70-204 Szczecin, Poland
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Wieder-Huszla S, Owsianowska J, Chudecka-Głaz A, Branecka-Woźniak D, Jurczak A. The Significance of Adaptation and Coping with Disease among Patients with Diagnosed Gynaecological Cancer in the Context of Disease Acceptance. Int J Environ Res Public Health 2022; 19:ijerph19127218. [PMID: 35742468 PMCID: PMC9223192 DOI: 10.3390/ijerph19127218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/09/2022] [Accepted: 06/11/2022] [Indexed: 12/10/2022]
Abstract
Uterine/endometrial and ovarian tumours are among the most common gynaecological cancers. Adaptation to cancer encompasses a variety of complex behavioural, cognitive, and emotional processes. The purpose of mental adaptation is to alleviate emotional discomfort and regain mental stability. The aim of the study was to assess the influence of adaptation and coping with gynaecological cancer on the level of disease acceptance among the studied women. The study included 81 patients diagnosed with gynaecological cancer. Mental adaptation to cancer was measured using the Min-Mac scale, disease acceptance was measured using the AIS and the level of adaptation was measured using the CAPS. The average AIS score was 26.65 ± 8.85 points. Adaptation and coping methods did not vary significantly depending on the diagnosed type of cancer. The constructive style of fighting the disease prevailed (45.11 ± 6.01). The AIS scores correlated significantly and positively with the intensity of the constructive style of mental adaptation, and negatively with the intensity of the destructive style. The studied group of patients with gynaecological cancer displayed a moderate level of disease acceptance, the constructive style of adaptation was the most prevalent, and the location of the cancer did not have an effect on coping mechanisms.
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Affiliation(s)
- Sylwia Wieder-Huszla
- Department of Clinical Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland; (J.O.); (A.J.)
- Correspondence: ; Tel.: +48-914-800-910
| | - Joanna Owsianowska
- Department of Clinical Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland; (J.O.); (A.J.)
| | - Anita Chudecka-Głaz
- Department of Gynaecological Surgery and Gynaecological Oncology of Adults and Adolescents, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland;
| | - Dorota Branecka-Woźniak
- Department of Gynaecology and Reproductive Health, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland;
| | - Anna Jurczak
- Department of Clinical Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland; (J.O.); (A.J.)
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Stanisławiak-Rudowicz J, Chudecka-Głaz A, Jazel M, Mądry R. Desensitization in patients hypersensitive to platinum compounds in gynecologic oncology. Oncol Clin Pract 2021. [DOI: 10.5603/ocp.2021.0037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Cymbaluk-Płoska A, Gargulińska P, Chudecka-Głaz A, Kwiatkowski S, Pius-Sadowska E, Machaliński B. The Suitability of FGF21 and FGF23 as New Biomarkers in Endometrial Cancer Patients. Diagnostics (Basel) 2020; 10:diagnostics10060414. [PMID: 32570721 PMCID: PMC7344631 DOI: 10.3390/diagnostics10060414] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/29/2020] [Accepted: 06/14/2020] [Indexed: 12/14/2022] Open
Abstract
Endometrial cancer is one of the most common cancers of the reproductive organ in women. The incidence of it increases from year to year. In our study we assessed role of FGF21 and FGF23 in the diagnostics of patients with endometrial cancer. The study involved 182 patients, who were undergoing abrasion due to perimenopausal bleeding. FGF21, FGF23, and leptin concentration were quantified in serum by multiplex fluorescent bead-based immunoassays (Luminex Corporation). The median of FGF21 protein (181.8 pg/mL) as well as leptin (16.9 ng/mL) in patients with endometrial cancer was statistically significant higher compared to median of those proteins among patients from control group (152.1 pg/mL and 14.1 ng/mL, respectively). However, no significant differences were found in these groups at median FGF23 concentrations. For FGF21 and leptin, the AUC values were 0.81/0.79, while FGF23, the AUC values was 0.66 for all study patients. Leptin and FGF21 concentrations were statistically significantly higher in patients with poorly differentiated G3 tumors compared to patients with moderately differentiated G2 tumors and with moderately differentiated G2 with highly differentiated G1 respectively: p = 0.02/p = 0.03 and p = 0.02/p = 0.005. FGF21 appears to be useful as a diagnostic as well as prognostic factor in patients with endometrioid endometrial carcinoma.
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Affiliation(s)
- Aneta Cymbaluk-Płoska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (P.G.); (A.C.-G.)
- Correspondence:
| | - Paula Gargulińska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (P.G.); (A.C.-G.)
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (P.G.); (A.C.-G.)
| | - Sebastian Kwiatkowski
- Department of Obstetrics and Gynecology, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland;
| | - Ewa Pius-Sadowska
- General Pathology Department, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (E.P.-S.); (B.M.)
| | - Bogusław Machaliński
- General Pathology Department, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland; (E.P.-S.); (B.M.)
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Cymbaluk-Płoska A, Sobolewski P, Chudecka-Głaz A, Wiśniewska E, Łapczuk J, Frankowski M, Droździk M, El Fray M. Double-Emulsion Copolyester Microcapsules for Sustained Intraperitoneal Release of Carboplatin. J Funct Biomater 2019; 10:jfb10040055. [PMID: 31817672 PMCID: PMC6963559 DOI: 10.3390/jfb10040055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/02/2019] [Accepted: 12/04/2019] [Indexed: 12/24/2022] Open
Abstract
Despite on-going medical advances, ovarian cancer survival rates have stagnated. In order to improve IP delivery of platinum-based antineoplastics, we aimed to develop a sustained drug delivery system for carboplatin (CPt). Toward this aim, we pursued a double emulsion process for obtaining CPt-loaded microcapsules composed of poly(ethylene terephthalate-ethylene dilinoleate) (PET-DLA) copolymer. We were able to obtain PET-DLA microspheres in the targeted size range of 10–25 µm (median: 18.5 µm), to reduce intraperitoneal clearance by phagocytosis and lymphoid transit. Empty microspheres showed the lack of toxicity in vitro. The double emulsion process yielded 2.5% w/w CPt loading and obtained microcapsules exhibited sustained (>20 day) zero-order release. The encapsulated CPt was confirmed to be bioavailable, as the microcapsules demonstrated efficacy against human ovarian adenocarcinoma (SK-OV-3) cells in vitro. Following intraperitoneal injection in mice, we did not observe adhesions, only mild, clinically-insignificant, local inflammatory response. Tissue platinum levels, monitored over 14 days using atomic absorption spectroscopy, revealed low burst and reduced systemic uptake (plasma, kidney), as compared to neat carboplatin injection. Overall, the results demonstrate the potential of the developed microencapsulation system for long-term intraperitoneal sustained release of carboplatin for the treatment of ovarian cancer.
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Affiliation(s)
- Aneta Cymbaluk-Płoska
- Department and Clinic of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, ul. Powstanców Wlkp. 72, 70-111 Szczecin, Poland; (A.C.-P.); (A.C.-G.)
| | - Peter Sobolewski
- Department of Polymer and Biomaterials Science, Faculty of Chemical Technology and Engineering, West Pomeranian University of Technology, Szczecin, Al. Piastów 45, 70-311 Szczecin, Poland; (P.S.); (E.W.)
| | - Anita Chudecka-Głaz
- Department and Clinic of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, ul. Powstanców Wlkp. 72, 70-111 Szczecin, Poland; (A.C.-P.); (A.C.-G.)
| | - Ewa Wiśniewska
- Department of Polymer and Biomaterials Science, Faculty of Chemical Technology and Engineering, West Pomeranian University of Technology, Szczecin, Al. Piastów 45, 70-311 Szczecin, Poland; (P.S.); (E.W.)
| | - Joanna Łapczuk
- Department of Experimental and Clinical Pharmacology, Pomeranian Medical University, ul. Powstanców Wlkp. 72, 70-111 Szczecin, Poland; (J.Ł.); (M.D.)
| | - Marcin Frankowski
- Faculty of Chemistry, Adam Mickiewicz University in Poznań, ul. Uniwersytetu Poznańskiego 8, 61-614 Poznań, Poland;
| | - Marek Droździk
- Department of Experimental and Clinical Pharmacology, Pomeranian Medical University, ul. Powstanców Wlkp. 72, 70-111 Szczecin, Poland; (J.Ł.); (M.D.)
| | - Miroslawa El Fray
- Department of Polymer and Biomaterials Science, Faculty of Chemical Technology and Engineering, West Pomeranian University of Technology, Szczecin, Al. Piastów 45, 70-311 Szczecin, Poland; (P.S.); (E.W.)
- Correspondence: ; Tel.: +48-91-449-4828; Fax: +48-91-449-4098
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Szarszewska M, Markowska A, Jach R, Marszałek A, Filas V, Bednarek W, Olejek A, Tomczak P, Sajdak S, Nowak-Markwitz E, Jaszczyńska-Nowinka K, Stanisławiak-Rudowicz J, Gryboś A, Chudecka-Głaz A, Gryboś M, Adamska K, Ramlau R, Markowska J, Knapp P. Significance of BRCA1 expression in breast and ovarian cancer patients with brain metastasis - A multicentre study. Adv Med Sci 2019; 64:235-240. [PMID: 30822630 DOI: 10.1016/j.advms.2018.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 09/02/2018] [Accepted: 12/18/2018] [Indexed: 01/09/2023]
Abstract
PURPOSE Cerebral metastases develop in 10-30% of patients with breast cancer (BC) and in around 3.3 to 4% of patients with ovarian cancer (OC). The aim of the multicenter study is to investigate the correlation between the expression of estrogen alpha receptors (ERα), progesterone receptors (PR), human epidermal growth factor receptor 2 (HER2), stromal cell-derived factor 1 (SDF1) and its receptor C-X-C chemokine receptor type 4 (CXCR4), breast cancer metastasis suppressor 1 (BRMS1), astrocyte elevated gene 1 (AEG1), depending on the status of BRCA1 protein, in patients suffering from OC and BC with brain metastases. PATIENTS AND METHODS The analysis included 51 patients: 29 with BC and 22 with OC, in whom brain metastases were disclosed. RESULTS In most patients (65.5% of BC patients and 68.2% of patients with OC tumors) BRCA1 protein loss was found. No correlation was disclosed between the levels of ERα, PR receptors, HER2, SDF1, CXCR4, AEG1, BRMS1 and BRCA1 status, patient age, stage of disease advancement, grade of histological maturity of the cells, presence of metastases to lymph nodes. A statistically significant correlation was disclosed between the negative expression of PR receptors and a high expression of CXCR4 in patients with BC. High values of the AEG1 protein (linked to metastases) were detected alongside a high expression of BRMS1 (a suppressor of metastases). CONCLUSIONS Patients with BC and OC and brain metastases have a frequent loss of BRCA1 expression. The role of ERα, PR, HER2, SDF1, CXCR4, AEG1, BRMS1 in metastatic process needs further studies.
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Cymbaluk-Płoska A, Chudecka-Głaz A, Pius-Sadowska E, Machaliński B, Sompolska-Rzechuła A, Kwiatkowski S, Menkiszak J. The role of lipocalin-2 serum levels in the diagnostics of endometrial cancer. Cancer Biomark 2019; 24:315-324. [PMID: 30829613 PMCID: PMC6484256 DOI: 10.3233/cbm-181942] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND: Endometrial cancer is one of the most common tumor of the woman genital organs. OBJECTIVE: The goal of this study was to determine the lipocalin-2 levels in patients with endometrial cancer compared to those with normal endometrium or mild endometrial pathologies. METHODS: Study included 123 patients with BMI > 21 kg/m2 who were admitted due to abnormal bleeding, in which 52 patients with endometrial cancer. The NGAL, CA125, HE4 serum levels were determined for all patients. RESULTS: Significantly lower median NGAL serum levels were found in a group of patients with normal endometrium compared to the endometrial cancer group, p= 0.006. NGAL protein area under ROC curves value as a diagnostic test, differentiating between endometrial cancer and other benign changes endometrium is AUC – 0.81 (p< 0.00001). The NGAL protein had a high sensitivity in all patients included in the analysis: 84% vs. 82% in pre-menopausal patients, and 81% in postmenopausal women with a specificity of 78%, 80% and 87%, respectively. The independent variable for FIGO and model logistic regression proves that NGAL is statistically significant (p= 0.000602), the odds ratio is 3.66. The model for grading shows, that NGAL increase by one ng/ml increases risk chances by 2.32 times in diagnosis with less cancer differentiation. CONCLUSIONS: Our preliminary studies demonstrate that lipocalin-2 may be of value in the diagnostics of uterine body cancers.
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Affiliation(s)
- Aneta Cymbaluk-Płoska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Ewa Pius-Sadowska
- General Pathology Department, Pomeranian Medical University, Szczecin, Poland
| | | | | | - Sebastian Kwiatkowski
- Department of Obstetrics and Gynecology, Pomeranian Medical University, Szczecin, Poland
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
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Menkiszak J, Chudecka-Głaz A, Cymbaluk-Płoska A, Celewicz A, Kojs Z, Szajda M, Świniarska M, Bedner R, Jurczak A, Celewicz M, Cieszyńska M, Lubiński J, Gronwald J. Selected features of breast and peritoneal cancers diagnosed in BRCA1 carriers after risk-reducing salpingo-oophorectomy. Hered Cancer Clin Pract 2019; 17:10. [PMID: 30918533 PMCID: PMC6419350 DOI: 10.1186/s13053-019-0109-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 03/05/2019] [Indexed: 11/10/2022] Open
Abstract
Background Since more than two decades Risk-reducing salpingo-oophorectomy (RRSO) is recommended and widely accepted by BRCA1/2 carriers as a method reducing ovarian cancer risk and improving survival rate. After RRSO, there remains a risk of breast cancer and peritoneal cancer. The characteristics of these neoplasms are not well known. In this study, we determined the selected parameters such as age at cancer diagnosis, time from RRSO to the diagnosis of cancer, and significance of BRCA1 mutation type in patients diagnosed with breast or peritoneal cancer during postoperative follow-up. Methods The material comprised of 195 BRCA1 carriers who performed RRSO between years 1999-2012. In this period, 16 patients developed cancer (6-primary breast cancer, 3-contralateral breast cancer, 5-relapse of breast cancer, 2-peritoneal cancer). They were subject of the further analysis. Results During the follow-up period mean age of patients after RRSO at the time of cancer diagnosis was 53.19. The mean age of patients diagnosed with primary breast cancer was 50, contralateral breast cancer - 58.67, recurrence of breast cancer - 51 and peritoneal cancer 60. The mean time periods from RRSO to the diagnosis of primary, contralateral, recurrence breast cancer were 53, 58.67 and 25,4 months respectively and of peritoneal cancer 46 months. BRCA1 c.5266dupC mutation carriers demonstrated significantly shorter time of cancer development compared to patients carrying c.181T > G and c.4035delA mutations. Peritoneal cancer was only observed in two c.181T > G BRCA1 mutation carriers. Conclusions The mean age of cancer diagnosis and the mean time periods from RRSO to the diagnosis of cancer are similar to those observed by other researchers. The carriers of c.181T > G and c.5266dupC BRCA1 mutation should be the subject further studies in context of breast and peritoneal cancer risk or time of cancer development after RRSO, respectively.
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Affiliation(s)
- Janusz Menkiszak
- 1Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Anita Chudecka-Głaz
- 1Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Aneta Cymbaluk-Płoska
- 1Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Aleksander Celewicz
- 1Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Zbigniew Kojs
- 2Department of Gynecologic Oncology, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Branch, Cracow, Poland
| | - Mariusz Szajda
- 3International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Maria Świniarska
- Department of the Clinical Oncology the West Pomeranian Centre of the Oncology in Szczecin, Szczecin, Poland
| | - Ryszard Bedner
- 1Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Anna Jurczak
- 5Department of Clinical Nursing, Pomeranian Medical University, Szczecin, Poland
| | - Marta Celewicz
- 6Department of Obstetrics and Gynecology, Pomeranian Medical University, Szczecin, Poland
| | - Monika Cieszyńska
- 3International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Jan Lubiński
- 3International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Jacek Gronwald
- 3International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
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Cymbaluk-Płoska A, Chudecka-Głaz A, Sompolska-Rzechuła A, Rasinska K, Dubiel P, Menkiszak J. Risk Model in Women with Ovarian Cancer Without Mutations. Open Med (Wars) 2018; 13:565-574. [PMID: 30519634 PMCID: PMC6272051 DOI: 10.1515/med-2018-0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 08/09/2018] [Indexed: 11/18/2022] Open
Abstract
Ovarian cancer is characterised by the greatest mortality among all tumors of the reproductive tract. This study included 246 patients which consisted of 136 women with ovarian cancer without genetic mutation and 110 women with benign ovarian cysts. We created two mathematical logic models containing positive and negative risk factors of ovarian cancer such as: age at last menstruation cycle, patient age, OC, HRT, smoking, education status, and alcohol consumption. The calculated cut-off point for the first model was 0.5117. Classification determined on the basis of that cut-off point yielded 87.19% of correctly classified cases, of which 91.38% are "case" and 81.61% - "noncase". For the second model the designated cut-off point was set at 0.5149 and the percentage of correctly classified patients was 88.12%, with 92.24% correctly rated as cancer patients and 82.56% of the cases rightly recognised as having no ovarian cancer. Logit is a simple mathematical model that can be a useful tool for identification of patients with increased risk of ovarian cancer.
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Affiliation(s)
- Aneta Cymbaluk-Płoska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | | | - Kamila Rasinska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Paulina Dubiel
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
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Kwiatkowski S, Bednarek-Jędrzejek M, Ksel J, Tousty P, Kwiatkowska E, Cymbaluk A, Rzepka R, Chudecka-Głaz A, Dołęgowska B, Torbè A. sFlt-1/PlGF and Doppler ultrasound parameters in SGA pregnancies with confirmed neonatal birth weight below 10th percentile. Pregnancy Hypertens 2018; 14:79-85. [PMID: 30527123 DOI: 10.1016/j.preghy.2018.08.448] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 08/02/2018] [Accepted: 08/15/2018] [Indexed: 11/30/2022]
Abstract
We explored whether there was a relationship between the sFlt-1/PlGF ratio in early-late and late-onset SGA patients and whether it is associated with neonatal birth weight. MATERIAL/METHODS 110 patients who were diagnosed with a fetal weight below the 10th percentile for gestational age and who at the same time delivered neonates with a birth weight below the 10th percentile for gestational age. For each of the patients sFlt-1, PlGF and the sFlt-1/PlGF ratio were studied and uterine artery (UtA) and umbilical artery (UA) Doppler were performed. RESULTS sFlt-1/PlGF ratios and neonatal birth weight which showed significant negative correlation across the entire population studied (R = -0.46, p < 0.001). In late-onset SGA patients this negative correlation was observed, as well (R = -0.54, p < 0.001) In the group of patients with pregnancies older than 34 weeks and an sFlt-1/PlGF ratio ≥38, we observed a significantly lower neonatal birth weight when compared to the same gestational age group with an sFlt-1/PlGF ratio <38 (2045 g vs 2405 g, p < 0.001). CONCLUSION Late-onset SGA syndromes are characterized by lower sFlt-1/PlGF ratios, which indicates a lower degree of placental function impairment. The sFlt-1/PlGF ratio can be a predictor of more significant growth disorders and a lower neonatal birth weight. The sFlt-1/PlGF ratio can be helpful in distinguishing between disordered angiogenesis-dependent and other causes of late-onset SGA cases.
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Affiliation(s)
- Sebastian Kwiatkowski
- Department of Obstetrics and Gynecology, Pomeranian Medical University, Szczecin, Poland.
| | | | - Joanna Ksel
- Department of Obstetrics and Gynecology, Pomeranian Medical University, Szczecin, Poland
| | - Piotr Tousty
- Department of Obstetrics and Gynecology, Pomeranian Medical University, Szczecin, Poland
| | - Ewa Kwiatkowska
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Aneta Cymbaluk
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Rafał Rzepka
- Department of Obstetrics and Gynecology, Pomeranian Medical University, Szczecin, Poland
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Barbara Dołęgowska
- Department of Microbiology, Immunology and Laboratory Medicine, Pomeranian Medical University, Szczecin, Poland
| | - Andrzej Torbè
- Department of Obstetrics and Gynecology, Pomeranian Medical University, Szczecin, Poland
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Cymbaluk-Płoska A, Chudecka-Głaz A, Pius-Sadowska E, Machaliński B, Menkiszak J. Thrombospondin-I concentrations behavior in plasma of patients with ovarian cancer. Cancer Biomark 2018; 20:31-39. [PMID: 28655131 DOI: 10.3233/cbm-161546] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE To determine whether thrombospondin-1 might be used as a prognostic factor in ovarian cancer patients. METHOD Ninety-six female subjects hospitalized in years 2011-2014 was included in the study. Transvaginal ultrasound examination was performed in all patients. In 39 cases of suspected ovarian cancer, CT scans were also performed. Each patient had been subjected to collection of a 5-mL blood sample before the laparoscopic procedure. Thrombospondin-1 concentrations were quantified in serum by multiplex fluorescent bead-based immunoassays (Luminex) at the Laboratory of the Department of General Pathology. RESULTS Statistical analysis performed using the Kaplan-Meier survival curves and log-rank test revealed no statistically significant correlations between the median, 75th percentile and 95th percentile thrombospondin-1 levels with progression-free survival of patients (p= 0.47). In the univariate OS model, median thrombospondin-1 level was a significant variable. Correlation was demonstrated between baseline thrombospondin-1 levels and overall survival of patients (p= 0.04, HR = 0.99). The higher the baseline TSP1 level, the longer the overall survival of patients. CONCLUSION In our study, we were the first to demonstrate correlation between the levels of thrombospondin-1 and overall survival of patients. Therefore, it appears that thrombospondin-1 may be used as a prognostic factor in ovarian cancer patients.
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Affiliation(s)
- Aneta Cymbaluk-Płoska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Ewa Pius-Sadowska
- General Pathology Department, Pomeranian Medical University, Szczecin, Poland
| | | | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
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Chudecka-Głaz A, Cymbaluk-Płoska A, Wężowska M, Menkiszak J. Could HE4 level measurements during first-line chemotherapy predict response to treatment among ovarian cancer patients? PLoS One 2018; 13:e0194270. [PMID: 29584739 PMCID: PMC5870956 DOI: 10.1371/journal.pone.0194270] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 02/28/2018] [Indexed: 12/31/2022] Open
Abstract
Background This study assessed the prognostic value of HE4 marker measurements at various stages of first-line chemotherapy for ovarian cancer. Methods The study consisted of 90 ovarian cancer patients, including 48 women undergoing primary surgical treatment and 42 patients qualified for neoadjuvant chemotherapy. Each patient underwent HE4 and CA 125 level measurements at the time of diagnosis and subsequently as follows: after surgical treatment, after the third course of adjuvant chemotherapy, before interval cytoreductive surgery and after chemotherapy. The HE4 value was assessed based on the PSF, OS, DFS, surgical outcome, two-year survival and platinum sensitivity. Results Preoperative HE4 levels were a predictor of platinum sensitivity (AUC– 0.644; p = 0.035) and DFS (AUC = 0.637; p = 0.0492). A univariate logistic regression analysis showed that serum HE4 significantly correlated with PFS (baseline results over median HR = 2.96, p = 0.0009; baseline over 75 percentile HR = 2.44, p = 0.0062; normalization after treatment HR = 0.46, p = 0.0125; 50% reduction before IDS HR = 0.64, p = 0.0017). In the multivariate analysis, normalization after treatment and 50% reduction before IDS significantly influenced the PFS (HR = 0.29, p = 0.00008; HR = 0.23, p = 0.0024). The HE4 levels also correlated with the OS as follows: values below the median (HR = 1.88, p = 0.0087), normalization after chemotherapy (HR = 0.08, p = 0.0003), and 50% reduction before IDS (HR = 0.39, p = 0.0496). Conclusions The significant effect of the normalization of the HE4 marker after therapy and 50% reduction of HE4 levels before interval cytoreductive surgery on PFS and OS confirmed that HE4 might be an independent prognostic factor of treatment response. HE4 measurements performed during first-line treatment of ovarian cancer may have prognostic significance.
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Affiliation(s)
- Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
- * E-mail:
| | - Aneta Cymbaluk-Płoska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Małgorzata Wężowska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
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18
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Cymbaluk-Płoska A, Chudecka-Głaz A, Jagodzińska A, Pius-Sadowska E, Sompolska-Rzechuła A, Machaliński B, Menkiszak J. Evaluation of biologically active substances promoting the development of or protecting against endometrial cancer. Onco Targets Ther 2018; 11:1363-1372. [PMID: 29559794 PMCID: PMC5856062 DOI: 10.2147/ott.s155942] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Introduction Adipose tissue is considered an endocrine organ and produces a number of biologically active substances. Aims To consider the role that four adipokines – leptin, omentin-1, vaspin, and galectin-3 – play in the diagnosis of endometrium cancer and to investigate the association between serum concentrations of adipose tissue metabolism products and the diagnostics and prognosis in endometrial cancer. Patients and methods The study included 168 patients with body mass index (BMI) >20 kg/m2 admitted due to post-menopausal bleeding. Results A receiver operating characteristic curves test was performed to determine the diagnostic values of the proteins tested. For leptin and galectin-3 the area under the curve (AUC) values were 0.79/0.68, while for vaspin and omentin-1 the AUC values were 0.82/0.86 for all study patients. The final model identified the following independent risk factors: glucose concentration, BMI, waist circumference, leptin, and vaspin concentrations. Diagnostic values of leptin and galectin-3 with regard to differentiation between high (Fédération Internationale de Gynécologie Obstétrique [FIGO] III and IV) and low (FIGO I and II) stages of clinical tumor advancement and prediction of tumor grading (G1 vs G3) based on the AUC curve were 0.82/0.70 and 0.80/0.74. The AUC values for vaspin and omentin-1 with respect to differentiation between histopathological advancement and grading were 0.86/0.81 and 0.83/0.77, respectively. Significantly lower values of mean omentin-1 and vaspin concentrations were also demonstrated in cases of lymphatic vessel invasion, lymph node metastases, or deep endometrial infiltration (p=0.002, p=0.01, p=0.003, respectively). Conclusion It appears that elevated concentrations of leptin, vaspin, and omentin-1 may indicate the presence of endometrial cancer. Furthermore, leptin serum level and vaspin appear to be useful tools in the assessment of clinical staging of endometrial cancer.
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Affiliation(s)
- Aneta Cymbaluk-Płoska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Anna Jagodzińska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Ewa Pius-Sadowska
- General Pathology Department, Pomeranian Medical University, Szczecin, Poland
| | | | | | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
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Block MS, Vierkant RA, Rambau PF, Winham SJ, Wagner P, Traficante N, Tołoczko A, Tiezzi DG, Taran FA, Sinn P, Sieh W, Sharma R, Rothstein JH, Ramón Y Cajal T, Paz-Ares L, Oszurek O, Orsulic S, Ness RB, Nelson G, Modugno F, Menkiszak J, McGuire V, McCauley BM, Mack M, Lubiński J, Longacre TA, Li Z, Lester J, Kennedy CJ, Kalli KR, Jung AY, Johnatty SE, Jimenez-Linan M, Jensen A, Intermaggio MP, Hung J, Herpel E, Hernandez BY, Hartkopf AD, Harnett PR, Ghatage P, García-Bueno JM, Gao B, Fereday S, Eilber U, Edwards RP, de Sousa CB, de Andrade JM, Chudecka-Głaz A, Chenevix-Trench G, Cazorla A, Brucker SY, Alsop J, Whittemore AS, Steed H, Staebler A, Moysich KB, Menon U, Koziak JM, Kommoss S, Kjaer SK, Kelemen LE, Karlan BY, Huntsman DG, Høgdall E, Gronwald J, Goodman MT, Gilks B, García MJ, Fasching PA, de Fazio A, Deen S, Chang-Claude J, Candido Dos Reis FJ, Campbell IG, Brenton JD, Bowtell DD, Benítez J, Pharoah PDP, Köbel M, Ramus SJ, Goode EL. MyD88 and TLR4 Expression in Epithelial Ovarian Cancer. Mayo Clin Proc 2018; 93:307-320. [PMID: 29502561 PMCID: PMC5870793 DOI: 10.1016/j.mayocp.2017.10.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 09/14/2017] [Accepted: 10/16/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To evaluate myeloid differentiation primary response gene 88 (MyD88) and Toll-like receptor 4 (TLR4) expression in relation to clinical features of epithelial ovarian cancer, histologic subtypes, and overall survival. PATIENTS AND METHODS We conducted centralized immunohistochemical staining, semi-quantitative scoring, and survival analysis in 5263 patients participating in the Ovarian Tumor Tissue Analysis consortium. Patients were diagnosed between January 1, 1978, and December 31, 2014, including 2865 high-grade serous ovarian carcinomas (HGSOCs), with more than 12,000 person-years of follow-up time. Tissue microarrays were stained for MyD88 and TLR4, and staining intensity was classified using a 2-tiered system for each marker (weak vs strong). RESULTS Expression of MyD88 and TLR4 was similar in all histotypes except clear cell ovarian cancer, which showed reduced expression compared with other histotypes (P<.001 for both). In HGSOC, strong MyD88 expression was modestly associated with shortened overall survival (hazard ratio [HR], 1.13; 95% CI, 1.01-1.26; P=.04) but was also associated with advanced stage (P<.001). The expression of TLR4 was not associated with survival. In low-grade serous ovarian cancer (LGSOC), strong expression of both MyD88 and TLR4 was associated with favorable survival (HR [95% CI], 0.49 [0.29-0.84] and 0.44 [0.21-0.89], respectively; P=.009 and P=.02, respectively). CONCLUSION Results are consistent with an association between strong MyD88 staining and advanced stage and poorer survival in HGSOC and demonstrate correlation between strong MyD88 and TLR4 staining and improved survival in LGSOC, highlighting the biological differences between the 2 serous histotypes.
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Affiliation(s)
| | | | - Peter F Rambau
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada; Pathology Department, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Stacey J Winham
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Philipp Wagner
- Tübingen University Hospital, Department of Women's Health, Tübingen, Germany
| | - Nadia Traficante
- Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville, Victoria, Australia
| | - Aleksandra Tołoczko
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Daniel G Tiezzi
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Florin Andrei Taran
- Tübingen University Hospital, Department of Women's Health, Tübingen, Germany
| | - Peter Sinn
- Department of Pathology, Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Weiva Sieh
- Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Raghwa Sharma
- Pathology West ICPMR Westmead, Westmead Hospital, the University of Sydney, Sydney, Australia; University of Western Sydney at Westmead Hospital, Westmead, New South Wales, Australia
| | - Joseph H Rothstein
- Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | - Luis Paz-Ares
- H12O-CNIO Lung Cancer Clinical Research Unit, Madrid, Spain; Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Oleg Oszurek
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Sandra Orsulic
- Women's Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | | | - Gregg Nelson
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Francesmary Modugno
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA; Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA; Womens Cancer Research Program, Magee-Womens Research Institute and University of Pittsburgh Cancer Institute, Pittsburgh, PA
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Valerie McGuire
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA
| | - Bryan M McCauley
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Marie Mack
- Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Jan Lubiński
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | | | - Zheng Li
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN; Department of Gynecologic Oncology, the Third Affiliated Hospital of Kunming Medical University (Yunnan Tumor Hospital), Kunming, China
| | - Jenny Lester
- Women's Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Catherine J Kennedy
- Centre for Cancer Research, the Westmead Institute for Medical Research, the University of Sydney, Sydney, New South Wales, Australia; Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | | | - Audrey Y Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sharon E Johnatty
- Department of Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | - Allan Jensen
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Maria P Intermaggio
- School of Women's and Children's Health, University of New South Wales, Sydney, Australia
| | - Jillian Hung
- Centre for Cancer Research, the Westmead Institute for Medical Research, the University of Sydney, Sydney, New South Wales, Australia; Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Esther Herpel
- Tissue Bank of the National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany; Institute of Pathology, University of Heidelberg, Heidelberg, Germany
| | | | - Andreas D Hartkopf
- Tübingen University Hospital, Department of Women's Health, Tübingen, Germany
| | - Paul R Harnett
- Centre for Cancer Research, the Westmead Institute for Medical Research, the University of Sydney, Sydney, New South Wales, Australia; Crown Princess Mary Cancer Centre, Westmead Hospital, the University of Sydney, Sydney, Australia
| | - Prafull Ghatage
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Bo Gao
- Centre for Cancer Research, the Westmead Institute for Medical Research, the University of Sydney, Sydney, New South Wales, Australia; Crown Princess Mary Cancer Centre, Westmead Hospital, the University of Sydney, Sydney, Australia
| | - Sian Fereday
- Department of Cancer Genomics and Genetics, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - Ursula Eilber
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Robert P Edwards
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Christiani B de Sousa
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Jurandyr M de Andrade
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | | | - Alicia Cazorla
- Pathology Department, Fundación Jiménez Díaz, Madrid, Spain
| | - Sara Y Brucker
- Tübingen University Hospital, Department of Women's Health, Tübingen, Germany
| | - Jennifer Alsop
- Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Alice S Whittemore
- Department of Health Research and Policy and Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA
| | - Helen Steed
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Royal Alexandra Hospital, Edmonton, Alberta, Canada
| | - Annette Staebler
- Tübingen University Hospital, Institute of Pathology, Tübingen, Germany
| | - Kirsten B Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY
| | - Usha Menon
- Gynaecological Cancer Research Centre, Department of Women's Cancer, Institute for Women's Health, University College London, London, UK
| | | | - Stefan Kommoss
- Tübingen University Hospital, Department of Women's Health, Tübingen, Germany
| | - Susanne K Kjaer
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Linda E Kelemen
- Department of Public Health Sciences, Medical University of South Carolina and Hollings Cancer Center, Charleston, SC
| | - Beth Y Karlan
- Women's Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - David G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Translational and Applied Genomics, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Estrid Høgdall
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark; Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Jacek Gronwald
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Marc T Goodman
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Blake Gilks
- Genetic Pathology Evaluation Centre, Vancouver General Hospital and University of British Columbia, Vancouver, British Columbia, Canada
| | - María José García
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain; Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Peter A Fasching
- David Geffen School of Medicine, Department of Medicine, Division of Hematology and Oncology, University of California at Los Angeles; University Breast Center Franconia, Department of Gynecology and Obstetrics, University Hospital Erlangen, Erlangen, Germany
| | - Anna de Fazio
- Centre for Cancer Research, the Westmead Institute for Medical Research, the University of Sydney, Sydney, New South Wales, Australia; Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Suha Deen
- Department of Histopathology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany; University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Francisco J Candido Dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Ian G Campbell
- Cancer Genetics Laboratory, Research Division, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia; Department of Pathology, University of Melbourne, Melbourne, Victoria, Australia
| | - James D Brenton
- Department of Oncology, University of Cambridge, Hutchison/MRC Research Centre, Cambridge, UK; Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Cambridge, UK; Cambridge Experimental Cancer Medicine Centre, Cambridge, UK
| | - David D Bowtell
- Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville, Victoria, Australia; Cancer Genomics Program, Research Department, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia; Garvan Institute, Sydney, New South Wales, Australia
| | - Javier Benítez
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain; Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Paul D P Pharoah
- Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK; Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Susan J Ramus
- School of Women's and Children's Health, University of New South Wales, Sydney, Australia; Garvan Institute, Sydney, New South Wales, Australia
| | - Ellen L Goode
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
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20
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Cymbaluk-Płoska A, Chudecka-Głaz A, Pius-Sadowska E, Machaliński B, Menkiszak J, Sompolska-Rzechuła A. Suitability assessment of baseline concentration of MMP3, TIMP3, HE4 and CA125 in the serum of patients with ovarian cancer. J Ovarian Res 2018; 11:1. [PMID: 29304854 PMCID: PMC5755423 DOI: 10.1186/s13048-017-0373-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 12/21/2017] [Indexed: 01/01/2023] Open
Abstract
Background MMP and TIMP play an important role in the degradation of extracellular matrix components which are essential for tumor growth, invasion and metastasis. Aim of this research was to assess MMP3 and TIMP3 as prognostic factors among patients with ovarian cancer. Results It was found that high levels of output MMP3 correlated with shortened overall survival time of patients by 9.7 months. In addition, it has been shown that high concentrations of output MMP3 were significantly associated with a shorter disease free time in median concentrations implemented p = 0.0059. Statistically significant dependence has been shown between an average concentration of TIMP3 protein to the overall survival of patients. The higher output concentration of TIMP3, the longer patients’ survival by 8.9 month. In addition, it was found that high TIMP3 concentrations output were associated with a significantly longer disease free duration at a median concentrations p = 0.007. Conclusion Preliminary research shows that output levels of MMP3 and TIMP3 proteins correlate with overall survival of patients. In some cases also time free of illness.
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Affiliation(s)
- Aneta Cymbaluk-Płoska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland.
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
| | - Ewa Pius-Sadowska
- General Pathology Department, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
| | - Bogusław Machaliński
- General Pathology Department, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
| | - Agnieszka Sompolska-Rzechuła
- Department of Mathematics Applications in Economy, West Pomeranian University of Technology, al. Piastów 17, 70-310, Szczecin, Poland
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21
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Goode EL, Block MS, Kalli KR, Vierkant RA, Chen W, Fogarty ZC, Gentry-Maharaj A, Tołoczko A, Hein A, Bouligny AL, Jensen A, Osorio A, Hartkopf A, Ryan A, Chudecka-Głaz A, Magliocco AM, Hartmann A, Jung AY, Gao B, Hernandez BY, Fridley BL, McCauley BM, Kennedy CJ, Wang C, Karpinskyj C, de Sousa CB, Tiezzi DG, Wachter DL, Herpel E, Taran FA, Modugno F, Nelson G, Lubiński J, Menkiszak J, Alsop J, Lester J, García-Donas J, Nation J, Hung J, Palacios J, Rothstein JH, Kelley JL, de Andrade JM, Robles-Díaz L, Intermaggio MP, Widschwendter M, Beckmann MW, Ruebner M, Jimenez-Linan M, Singh N, Oszurek O, Harnett PR, Rambau PF, Sinn P, Wagner P, Ghatage P, Sharma R, Edwards RP, Ness RB, Orsulic S, Brucker SY, Johnatty SE, Longacre TA, Ursula E, McGuire V, Sieh W, Natanzon Y, Li Z, Whittemore AS, Anna D, Staebler A, Karlan BY, Gilks B, Bowtell DD, Høgdall E, Candido dos Reis FJ, Steed H, Campbell IG, Gronwald J, Benítez J, Koziak JM, Chang-Claude J, Moysich KB, Kelemen LE, Cook LS, Goodman MT, García MJ, Fasching PA, Kommoss S, Deen S, Kjaer SK, Menon U, Brenton JD, Pharoah PDP, Chenevix-Trench G, Huntsman DG, Winham SJ, Köbel M, Ramus SJ. Dose-Response Association of CD8+ Tumor-Infiltrating Lymphocytes and Survival Time in High-Grade Serous Ovarian Cancer. JAMA Oncol 2017; 3:e173290. [PMID: 29049607 PMCID: PMC5744673 DOI: 10.1001/jamaoncol.2017.3290] [Citation(s) in RCA: 219] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Importance Cytotoxic CD8+ tumor-infiltrating lymphocytes (TILs) participate in immune control of epithelial ovarian cancer; however, little is known about prognostic patterns of CD8+ TILs by histotype and in relation to other clinical factors. Objective To define the prognostic role of CD8+ TILs in epithelial ovarian cancer. Design, Setting, and Participants This was a multicenter observational, prospective survival cohort study of the Ovarian Tumor Tissue Analysis Consortium. More than 5500 patients, including 3196 with high-grade serous ovarian carcinomas (HGSOCs), were followed prospectively for over 24 650 person-years. Exposures Following immunohistochemical analysis, CD8+ TILs were identified within the epithelial components of tumor islets. Patients were grouped based on the estimated number of CD8+ TILs per high-powered field: negative (none), low (1-2), moderate (3-19), and high (≥20). CD8+ TILs in a subset of patients were also assessed in a quantitative, uncategorized manner, and the functional form of associations with survival was assessed using penalized B-splines. Main Outcomes and Measures Overall survival time. Results The final sample included 5577 women; mean age at diagnosis was 58.4 years (median, 58.2 years). Among the 5 major invasive histotypes, HGSOCs showed the most infiltration. CD8+ TILs in HGSOCs were significantly associated with longer overall survival; median survival was 2.8 years for patients with no CD8+ TILs and 3.0 years, 3.8 years, and 5.1 years for patients with low, moderate, or high levels of CD8+ TILs, respectively (P value for trend = 4.2 × 10−16). A survival benefit was also observed among women with endometrioid and mucinous carcinomas, but not for those with the other histotypes. Among HGSOCs, CD8+ TILs were favorable regardless of extent of residual disease following cytoreduction, known standard treatment, and germline BRCA1 pathogenic mutation, but were not prognostic for BRCA2 mutation carriers. Evaluation of uncategorized CD8+ TIL counts showed a near-log-linear functional form. Conclusions and Relevance This study demonstrates the histotype-specific nature of immune infiltration and provides definitive evidence for a dose-response relationship between CD8+ TILs and HGSOC survival. That the extent of infiltration is prognostic, not merely its presence or absence, suggests that understanding factors that drive infiltration will be the key to unraveling outcome heterogeneity in this cancer.
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Affiliation(s)
- Ellen L Goode
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Matthew S Block
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | | | - Robert A Vierkant
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Wenqian Chen
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Zachary C Fogarty
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Aleksandra Gentry-Maharaj
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Aleksandra Tołoczko
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Alexander Hein
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany
| | - Aliecia L Bouligny
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Department of Health Sciences, Spelman College, Atlanta, GA, USA
| | - Allan Jensen
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Ana Osorio
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Andreas Hartkopf
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Andy Ryan
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | | | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University
| | - Audrey Y Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Bo Gao
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- The Crown Princess Mary Cancer Centre, Westmead Hospital, The University of Sydney, Australia
| | | | - Brooke L Fridley
- Department of Biostatistics and Bioinformatics, Division of Population Sciences, Moffitt Cancer Center, Tampa, FL, USA
| | - Bryan M McCauley
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Catherine J Kennedy
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Chen Wang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Chloe Karpinskyj
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Christiani B de Sousa
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Daniel G Tiezzi
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - David L Wachter
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University
| | - Esther Herpel
- Tissue Bank of the National Center for Tumor Diseases (NCT) Heidelberg, Germany and Institute of Pathology, University of Heidelberg, Heidelberg, Germany
| | - Florin Andrei Taran
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Francesmary Modugno
- 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, Pittsburgh, PA, USA
- Womens Cancer Research Program, Magee-Womens Research Institute and University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - Gregg Nelson
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jan Lubiński
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Jennifer Alsop
- Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Jenny Lester
- Women’s Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jesús García-Donas
- Medical Oncology Service, HM Hospitales – Centro Integral Oncológico HM Clara Campal, Madrid, Spain
| | - Jill Nation
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jillian Hung
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - José Palacios
- Pathology Department, Hospital Universitario Ramón y Cajal. IRYCIS. Universidad de Alcalá, Madrid, Spain. CIBERONC
| | - Joseph H Rothstein
- Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joseph L Kelley
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jurandyr M de Andrade
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Luis Robles-Díaz
- Familial Cancer Unit and Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Maria P Intermaggio
- School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia
| | - Martin Widschwendter
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany
| | | | - Naveena Singh
- Department of Pathology, Barts Health National Health Service Trust, London, UK
| | - Oleg Oszurek
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Paul R Harnett
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- The Crown Princess Mary Cancer Centre, Westmead Hospital, The University of Sydney, Australia
| | - Peter F Rambau
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
- Pathology Department, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Peter Sinn
- Department of Pathology, Institute of Pathology, Heidelberg University Hospital, Germany
| | - Philipp Wagner
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Prafull Ghatage
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Raghwa Sharma
- Pathology West ICPMR Westmead, Westmead Hospital, The University of Sydney, Sydney, Australia
- University of Western Sydney at Westmead Hospital, Westmead, New South Wales, Australia
| | - Robert P Edwards
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Roberta B Ness
- The University of Texas School of Public Health, Houston, TX, USA
| | - Sandra Orsulic
- Women’s Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Sara Y Brucker
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Sharon E Johnatty
- Department of Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Teri A Longacre
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Eilber Ursula
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Valerie McGuire
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA
| | - Weiva Sieh
- Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yanina Natanzon
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Zheng Li
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Department of Gynecologic Oncology, The Third Affiliated Hospital of Kunming Medical University (Yunnan Tumor Hospital), Kunming, China
| | - Alice S Whittemore
- Department of Health Research and Policy, Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - deFazio Anna
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia
- Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Annette Staebler
- Tübingen University Hospital, Institute of Pathology, Tübingen, Germany
| | - Beth Y Karlan
- Women’s Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Blake Gilks
- Genetic Pathology Evaluation Centre, Vancouver General Hospital and University of British Columbia, Vancouver, British Columbia,Canada
| | - David D Bowtell
- Cancer Genomics Program, Research Department, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
- Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville, Victoria, Australia
- The Garvan Institute, Sydney, New South Wales, Australia
| | - Estrid Høgdall
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Francisco J Candido dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Helen Steed
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Royal Alexandra Hospital, Edmonton, Alberta, Canada
| | - Ian G Campbell
- Cancer Genetics Laboratory, Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia
- Department of Pathology, University of Melbourne, Melbourne, Victoria, Australia
| | - Jacek Gronwald
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Javier Benítez
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kirsten B Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Linda E Kelemen
- Department of Public Health Sciences, Medical University of South Carolina and Hollings Cancer Center, Charleston, SC, USA
| | - Linda S Cook
- Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM, USA
| | - Marc T Goodman
- Samuel Oschin Comprehensive Cancer Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - María José García
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, CA, USA
| | - Stefan Kommoss
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Suha Deen
- Department of Histopathology, Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Susanne K Kjaer
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Usha Menon
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - James D Brenton
- Department of Oncology, University of Cambridge, Hutchison/MRC Research Centre, Cambridge, UK
- Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, UK
- Cambridge Experimental Cancer Medicine Centre, Cambridge, UK
| | - Paul DP Pharoah
- Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
- Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, UK
| | | | - David G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Translational and Applied Genomics, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Stacey J Winham
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Susan J Ramus
- School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia
- The Garvan Institute, Sydney, New South Wales, Australia
| |
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22
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Goode EL, Block MS, Kalli KR, Vierkant RA, Chen W, Fogarty ZC, Gentry-Maharaj A, Tołoczko A, Hein A, Bouligny AL, Jensen A, Osorio A, Hartkopf A, Ryan A, Chudecka-Głaz A, Magliocco AM, Hartmann A, Jung AY, Gao B, Hernandez BY, Fridley BL, McCauley BM, Kennedy CJ, Wang C, Karpinskyj C, de Sousa CB, Tiezzi DG, Wachter DL, Herpel E, Taran FA, Modugno F, Nelson G, Lubiński J, Menkiszak J, Alsop J, Lester J, García-Donas J, Nation J, Hung J, Palacios J, Rothstein JH, Kelley JL, de Andrade JM, Robles-Díaz L, Intermaggio MP, Widschwendter M, Beckmann MW, Ruebner M, Jimenez-Linan M, Singh N, Oszurek O, Harnett PR, Rambau PF, Sinn P, Wagner P, Ghatage P, Sharma R, Edwards RP, Ness RB, Orsulic S, Brucker SY, Johnatty SE, Longacre TA, Ursula E, McGuire V, Sieh W, Natanzon Y, Li Z, Whittemore AS, Anna D, Staebler A, Karlan BY, Gilks B, Bowtell DD, Høgdall E, Candido dos Reis FJ, Steed H, Campbell IG, Gronwald J, Benítez J, Koziak JM, Chang-Claude J, Moysich KB, Kelemen LE, Cook LS, Goodman MT, García MJ, Fasching PA, Kommoss S, Deen S, Kjaer SK, Menon U, Brenton JD, Pharoah PDP, Chenevix-Trench G, Huntsman DG, Winham SJ, Köbel M, Ramus SJ. Dose-Response Association of CD8+ Tumor-Infiltrating Lymphocytes and Survival Time in High-Grade Serous Ovarian Cancer. JAMA Oncol 2017. [PMID: 29049607 DOI: 10.1001/jamaoncol.2017.3290] [] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Cytotoxic CD8+ tumor-infiltrating lymphocytes (TILs) participate in immune control of epithelial ovarian cancer; however, little is known about prognostic patterns of CD8+ TILs by histotype and in relation to other clinical factors. Objective To define the prognostic role of CD8+ TILs in epithelial ovarian cancer. Design, Setting, and Participants This was a multicenter observational, prospective survival cohort study of the Ovarian Tumor Tissue Analysis Consortium. More than 5500 patients, including 3196 with high-grade serous ovarian carcinomas (HGSOCs), were followed prospectively for over 24 650 person-years. Exposures Following immunohistochemical analysis, CD8+ TILs were identified within the epithelial components of tumor islets. Patients were grouped based on the estimated number of CD8+ TILs per high-powered field: negative (none), low (1-2), moderate (3-19), and high (≥20). CD8+ TILs in a subset of patients were also assessed in a quantitative, uncategorized manner, and the functional form of associations with survival was assessed using penalized B-splines. Main Outcomes and Measures Overall survival time. Results The final sample included 5577 women; mean age at diagnosis was 58.4 years (median, 58.2 years). Among the 5 major invasive histotypes, HGSOCs showed the most infiltration. CD8+ TILs in HGSOCs were significantly associated with longer overall survival; median survival was 2.8 years for patients with no CD8+ TILs and 3.0 years, 3.8 years, and 5.1 years for patients with low, moderate, or high levels of CD8+ TILs, respectively (P value for trend = 4.2 × 10−16). A survival benefit was also observed among women with endometrioid and mucinous carcinomas, but not for those with the other histotypes. Among HGSOCs, CD8+ TILs were favorable regardless of extent of residual disease following cytoreduction, known standard treatment, and germline BRCA1 pathogenic mutation, but were not prognostic for BRCA2 mutation carriers. Evaluation of uncategorized CD8+ TIL counts showed a near-log-linear functional form. Conclusions and Relevance This study demonstrates the histotype-specific nature of immune infiltration and provides definitive evidence for a dose-response relationship between CD8+ TILs and HGSOC survival. That the extent of infiltration is prognostic, not merely its presence or absence, suggests that understanding factors that drive infiltration will be the key to unraveling outcome heterogeneity in this cancer.
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Affiliation(s)
| | - Ellen L Goode
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Matthew S Block
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | | | - Robert A Vierkant
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Wenqian Chen
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Zachary C Fogarty
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Aleksandra Gentry-Maharaj
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Aleksandra Tołoczko
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Alexander Hein
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany
| | - Aliecia L Bouligny
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA,Department of Health Sciences, Spelman College, Atlanta, GA, USA
| | - Allan Jensen
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Ana Osorio
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain,Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Andreas Hartkopf
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Andy Ryan
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | | | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University
| | - Audrey Y Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Bo Gao
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia,The Crown Princess Mary Cancer Centre, Westmead Hospital, The University of Sydney, Australia
| | | | - Brooke L Fridley
- Department of Biostatistics and Bioinformatics, Division of Population Sciences, Moffitt Cancer Center, Tampa, FL, USA
| | - Bryan M McCauley
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Catherine J Kennedy
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia,Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Chen Wang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Chloe Karpinskyj
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Christiani B de Sousa
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Daniel G Tiezzi
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - David L Wachter
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University
| | - Esther Herpel
- Tissue Bank of the National Center for Tumor Diseases (NCT) Heidelberg, Germany and Institute of Pathology, University of Heidelberg, Heidelberg, Germany
| | - Florin Andrei Taran
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Francesmary Modugno
- 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, Pittsburgh, PA, USA,Womens Cancer Research Program, Magee-Womens Research Institute and University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - Gregg Nelson
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jan Lubiński
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Jennifer Alsop
- Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Jenny Lester
- Women’s Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jesús García-Donas
- Medical Oncology Service, HM Hospitales – Centro Integral Oncológico HM Clara Campal, Madrid, Spain
| | - Jill Nation
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jillian Hung
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia,Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - José Palacios
- Pathology Department, Hospital Universitario Ramón y Cajal. IRYCIS. Universidad de Alcalá, Madrid, Spain. CIBERONC
| | - Joseph H Rothstein
- Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joseph L Kelley
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jurandyr M de Andrade
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Luis Robles-Díaz
- Familial Cancer Unit and Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Maria P Intermaggio
- School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia
| | - Martin Widschwendter
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany
| | | | - Naveena Singh
- Department of Pathology, Barts Health National Health Service Trust, London, UK
| | - Oleg Oszurek
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Paul R Harnett
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia,The Crown Princess Mary Cancer Centre, Westmead Hospital, The University of Sydney, Australia
| | - Peter F Rambau
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada,Pathology Department, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Peter Sinn
- Department of Pathology, Institute of Pathology, Heidelberg University Hospital, Germany
| | - Philipp Wagner
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Prafull Ghatage
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Raghwa Sharma
- Pathology West ICPMR Westmead, Westmead Hospital, The University of Sydney, Sydney, Australia,University of Western Sydney at Westmead Hospital, Westmead, New South Wales, Australia
| | - Robert P Edwards
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Roberta B Ness
- The University of Texas School of Public Health, Houston, TX, USA
| | - Sandra Orsulic
- Women’s Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Sara Y Brucker
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Sharon E Johnatty
- Department of Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Teri A Longacre
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Eilber Ursula
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Valerie McGuire
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA
| | - Weiva Sieh
- Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yanina Natanzon
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Zheng Li
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA,Department of Gynecologic Oncology, The Third Affiliated Hospital of Kunming Medical University (Yunnan Tumor Hospital), Kunming, China
| | - Alice S Whittemore
- Department of Health Research and Policy, Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - deFazio Anna
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia,Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Annette Staebler
- Tübingen University Hospital, Institute of Pathology, Tübingen, Germany
| | - Beth Y Karlan
- Women’s Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Blake Gilks
- Genetic Pathology Evaluation Centre, Vancouver General Hospital and University of British Columbia, Vancouver, British Columbia,Canada
| | - David D Bowtell
- Cancer Genomics Program, Research Department, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia,Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville, Victoria, Australia,The Garvan Institute, Sydney, New South Wales, Australia
| | - Estrid Høgdall
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark,Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Francisco J Candido dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Helen Steed
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Royal Alexandra Hospital, Edmonton, Alberta, Canada
| | - Ian G Campbell
- Cancer Genetics Laboratory, Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia,Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia,Department of Pathology, University of Melbourne, Melbourne, Victoria, Australia
| | - Jacek Gronwald
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Javier Benítez
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain,Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany,University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kirsten B Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Linda E Kelemen
- Department of Public Health Sciences, Medical University of South Carolina and Hollings Cancer Center, Charleston, SC, USA
| | - Linda S Cook
- Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM, USA
| | - Marc T Goodman
- Samuel Oschin Comprehensive Cancer Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - María José García
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain,Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany,David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, CA, USA
| | - Stefan Kommoss
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Suha Deen
- Department of Histopathology, Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Susanne K Kjaer
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark,Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Usha Menon
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - James D Brenton
- Department of Oncology, University of Cambridge, Hutchison/MRC Research Centre, Cambridge, UK,Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, UK,Cambridge Experimental Cancer Medicine Centre, Cambridge, UK
| | - Paul DP Pharoah
- Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK,Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, UK
| | | | - David G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada,Centre for Translational and Applied Genomics, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Stacey J Winham
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Susan J Ramus
- School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia,The Garvan Institute, Sydney, New South Wales, Australia
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23
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Goode EL, Block MS, Kalli KR, Vierkant RA, Chen W, Fogarty ZC, Gentry-Maharaj A, Tołoczko A, Hein A, Bouligny AL, Jensen A, Osorio A, Hartkopf A, Ryan A, Chudecka-Głaz A, Magliocco AM, Hartmann A, Jung AY, Gao B, Hernandez BY, Fridley BL, McCauley BM, Kennedy CJ, Wang C, Karpinskyj C, de Sousa CB, Tiezzi DG, Wachter DL, Herpel E, Taran FA, Modugno F, Nelson G, Lubiński J, Menkiszak J, Alsop J, Lester J, García-Donas J, Nation J, Hung J, Palacios J, Rothstein JH, Kelley JL, de Andrade JM, Robles-Díaz L, Intermaggio MP, Widschwendter M, Beckmann MW, Ruebner M, Jimenez-Linan M, Singh N, Oszurek O, Harnett PR, Rambau PF, Sinn P, Wagner P, Ghatage P, Sharma R, Edwards RP, Ness RB, Orsulic S, Brucker SY, Johnatty SE, Longacre TA, Ursula E, McGuire V, Sieh W, Natanzon Y, Li Z, Whittemore AS, Anna D, Staebler A, Karlan BY, Gilks B, Bowtell DD, Høgdall E, Candido dos Reis FJ, Steed H, Campbell IG, Gronwald J, Benítez J, Koziak JM, Chang-Claude J, Moysich KB, Kelemen LE, Cook LS, Goodman MT, García MJ, Fasching PA, Kommoss S, Deen S, Kjaer SK, Menon U, Brenton JD, Pharoah PDP, Chenevix-Trench G, Huntsman DG, Winham SJ, Köbel M, Ramus SJ. Dose-Response Association of CD8+ Tumor-Infiltrating Lymphocytes and Survival Time in High-Grade Serous Ovarian Cancer. JAMA Oncol 2017. [PMID: 29049607 DOI: 10.1001/jamaoncol.2017.3290]+[] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Cytotoxic CD8+ tumor-infiltrating lymphocytes (TILs) participate in immune control of epithelial ovarian cancer; however, little is known about prognostic patterns of CD8+ TILs by histotype and in relation to other clinical factors. Objective To define the prognostic role of CD8+ TILs in epithelial ovarian cancer. Design, Setting, and Participants This was a multicenter observational, prospective survival cohort study of the Ovarian Tumor Tissue Analysis Consortium. More than 5500 patients, including 3196 with high-grade serous ovarian carcinomas (HGSOCs), were followed prospectively for over 24 650 person-years. Exposures Following immunohistochemical analysis, CD8+ TILs were identified within the epithelial components of tumor islets. Patients were grouped based on the estimated number of CD8+ TILs per high-powered field: negative (none), low (1-2), moderate (3-19), and high (≥20). CD8+ TILs in a subset of patients were also assessed in a quantitative, uncategorized manner, and the functional form of associations with survival was assessed using penalized B-splines. Main Outcomes and Measures Overall survival time. Results The final sample included 5577 women; mean age at diagnosis was 58.4 years (median, 58.2 years). Among the 5 major invasive histotypes, HGSOCs showed the most infiltration. CD8+ TILs in HGSOCs were significantly associated with longer overall survival; median survival was 2.8 years for patients with no CD8+ TILs and 3.0 years, 3.8 years, and 5.1 years for patients with low, moderate, or high levels of CD8+ TILs, respectively (P value for trend = 4.2 × 10−16). A survival benefit was also observed among women with endometrioid and mucinous carcinomas, but not for those with the other histotypes. Among HGSOCs, CD8+ TILs were favorable regardless of extent of residual disease following cytoreduction, known standard treatment, and germline BRCA1 pathogenic mutation, but were not prognostic for BRCA2 mutation carriers. Evaluation of uncategorized CD8+ TIL counts showed a near-log-linear functional form. Conclusions and Relevance This study demonstrates the histotype-specific nature of immune infiltration and provides definitive evidence for a dose-response relationship between CD8+ TILs and HGSOC survival. That the extent of infiltration is prognostic, not merely its presence or absence, suggests that understanding factors that drive infiltration will be the key to unraveling outcome heterogeneity in this cancer.
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Affiliation(s)
| | - Ellen L Goode
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Matthew S Block
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | | | - Robert A Vierkant
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Wenqian Chen
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Zachary C Fogarty
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Aleksandra Gentry-Maharaj
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Aleksandra Tołoczko
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Alexander Hein
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany
| | - Aliecia L Bouligny
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA,Department of Health Sciences, Spelman College, Atlanta, GA, USA
| | - Allan Jensen
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Ana Osorio
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain,Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Andreas Hartkopf
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Andy Ryan
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | | | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University
| | - Audrey Y Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Bo Gao
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia,The Crown Princess Mary Cancer Centre, Westmead Hospital, The University of Sydney, Australia
| | | | - Brooke L Fridley
- Department of Biostatistics and Bioinformatics, Division of Population Sciences, Moffitt Cancer Center, Tampa, FL, USA
| | - Bryan M McCauley
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Catherine J Kennedy
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia,Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Chen Wang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Chloe Karpinskyj
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Christiani B de Sousa
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Daniel G Tiezzi
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - David L Wachter
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University
| | - Esther Herpel
- Tissue Bank of the National Center for Tumor Diseases (NCT) Heidelberg, Germany and Institute of Pathology, University of Heidelberg, Heidelberg, Germany
| | - Florin Andrei Taran
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Francesmary Modugno
- 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, Pittsburgh, PA, USA,Womens Cancer Research Program, Magee-Womens Research Institute and University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA
| | - Gregg Nelson
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jan Lubiński
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Jennifer Alsop
- Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK
| | - Jenny Lester
- Women’s Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Jesús García-Donas
- Medical Oncology Service, HM Hospitales – Centro Integral Oncológico HM Clara Campal, Madrid, Spain
| | - Jill Nation
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Jillian Hung
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia,Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - José Palacios
- Pathology Department, Hospital Universitario Ramón y Cajal. IRYCIS. Universidad de Alcalá, Madrid, Spain. CIBERONC
| | - Joseph H Rothstein
- Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joseph L Kelley
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jurandyr M de Andrade
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Luis Robles-Díaz
- Familial Cancer Unit and Medical Oncology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Maria P Intermaggio
- School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia
| | - Martin Widschwendter
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany
| | | | - Naveena Singh
- Department of Pathology, Barts Health National Health Service Trust, London, UK
| | - Oleg Oszurek
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Paul R Harnett
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia,The Crown Princess Mary Cancer Centre, Westmead Hospital, The University of Sydney, Australia
| | - Peter F Rambau
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada,Pathology Department, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Peter Sinn
- Department of Pathology, Institute of Pathology, Heidelberg University Hospital, Germany
| | - Philipp Wagner
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Prafull Ghatage
- Department of Oncology, Division of Gynecologic Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Raghwa Sharma
- Pathology West ICPMR Westmead, Westmead Hospital, The University of Sydney, Sydney, Australia,University of Western Sydney at Westmead Hospital, Westmead, New South Wales, Australia
| | - Robert P Edwards
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Roberta B Ness
- The University of Texas School of Public Health, Houston, TX, USA
| | - Sandra Orsulic
- Women’s Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Sara Y Brucker
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Sharon E Johnatty
- Department of Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Teri A Longacre
- Department of Pathology, Stanford University, Stanford, CA, USA
| | - Eilber Ursula
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Valerie McGuire
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA
| | - Weiva Sieh
- Department of Population Health Science and Policy, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yanina Natanzon
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Zheng Li
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA,Department of Gynecologic Oncology, The Third Affiliated Hospital of Kunming Medical University (Yunnan Tumor Hospital), Kunming, China
| | - Alice S Whittemore
- Department of Health Research and Policy, Department of Biomedical Data Science, Stanford University School of Medicine, Stanford, CA, USA
| | - deFazio Anna
- Centre for Cancer Research, The Westmead Institute for Medical Research, The University of Sydney, Sydney, New South Wales, Australia,Department of Gynaecological Oncology, Westmead Hospital, Sydney, New South Wales, Australia
| | - Annette Staebler
- Tübingen University Hospital, Institute of Pathology, Tübingen, Germany
| | - Beth Y Karlan
- Women’s Cancer Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Blake Gilks
- Genetic Pathology Evaluation Centre, Vancouver General Hospital and University of British Columbia, Vancouver, British Columbia,Canada
| | - David D Bowtell
- Cancer Genomics Program, Research Department, Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia,Sir Peter MacCallum Department of Oncology, the University of Melbourne, Parkville, Victoria, Australia,The Garvan Institute, Sydney, New South Wales, Australia
| | - Estrid Høgdall
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark,Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Francisco J Candido dos Reis
- Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Helen Steed
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Royal Alexandra Hospital, Edmonton, Alberta, Canada
| | - Ian G Campbell
- Cancer Genetics Laboratory, Research Division, Peter MacCallum Cancer Centre, Melbourne, Australia,Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia,Department of Pathology, University of Melbourne, Melbourne, Victoria, Australia
| | - Jacek Gronwald
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Javier Benítez
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain,Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany,University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kirsten B Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Linda E Kelemen
- Department of Public Health Sciences, Medical University of South Carolina and Hollings Cancer Center, Charleston, SC, USA
| | - Linda S Cook
- Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM, USA
| | - Marc T Goodman
- Samuel Oschin Comprehensive Cancer Institute, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - María José García
- Human Genetics Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain,Centre for Biomedical Network Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg Comprehensive Cancer Center, Erlangen EMN, Germany,David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, CA, USA
| | - Stefan Kommoss
- Tübingen University Hospital, Department of Women’s Health, Tübingen, Germany
| | - Suha Deen
- Department of Histopathology, Queen’s Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Susanne K Kjaer
- Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark,Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Usha Menon
- Gynaecological Cancer Research Centre, Department of Women’s Cancer, Institute for Women’s Health, University College London, London, UK
| | - James D Brenton
- Department of Oncology, University of Cambridge, Hutchison/MRC Research Centre, Cambridge, UK,Cancer Research UK Cambridge Institute, University of Cambridge, Li Ka Shing Centre, Robinson Way, Cambridge, UK,Cambridge Experimental Cancer Medicine Centre, Cambridge, UK
| | - Paul DP Pharoah
- Department of Oncology, University of Cambridge, Strangeways Research Laboratory, Cambridge, UK,Department of Public Health and Primary Care, University of Cambridge, Strangeways Research Laboratory, Worts Causeway, Cambridge, UK
| | | | - David G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada,Centre for Translational and Applied Genomics, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Stacey J Winham
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Susan J Ramus
- School of Women’s and Children’s Health, University of New South Wales, Sydney, Australia,The Garvan Institute, Sydney, New South Wales, Australia
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Cymbaluk-Płoska A, Chudecka-Głaz A, Pius-Sadowska E, Sompolska-Rzechuła A, Machaliński B, Surowiec A, Menkiszak J. Clinical importance of serum HE4 and MMP2 levels in endometrial cancer patients. Onco Targets Ther 2017; 10:3169-3175. [PMID: 28721066 PMCID: PMC5499930 DOI: 10.2147/ott.s136750] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Endometrial cancer is the one of the most common cancers of the genital organ. HE4 and MMP2 are both proteins whose serum levels increase in endometrial cancer. Aim To explore the diagnostic potential of the serum levels of HE4 and MMP2 in patients with endometrial cancer and benign endometrial diseases. To assess the relationship between the serum levels of HE4 and MMP2 and the typical prognostic factors in patients with endometrial cancer. Materials and methods Included in the study was a group of 112 patients presenting with bleeding abnormalities at the Pomeranian Medical University in years 2012–2016. Serum HE4 concentrations were measured using the Elecsys Electrochemiluminescence Immunoassay (ECLIA). MMP2 concentrations were quantified in the serum using multiplex immunoassays. Results We observed statistically significant differences in mean serum levels of HE4 and MMP2 between the group of endometrial cancer patients and the group of patients with no changes in the endometrium (P=0.002/0.003). The diagnostic potential of HE4 and MMP2 in differentiation of high (International Federation of Gynecology and Obstetrics [FIGO] III and IV) vs low (FIGO I and II) clinical stage of tumor and prediction of cellular differentiation grade (G1 vs G3) on the basis of the analysis of the area under the curve is, respectively, 0.86 and 0.82 for HE4 and 0.82 and 0.74 for MMP2. The HE4 marker was significantly more specific than MMP2 in every study group and amounted to 93% vs 86% in all patients included in the analysis, 94% vs 84% in pre-menopausal patients and 84% vs 79% in post-menopausal patients. Conclusion HE4 and MMP2 are characterized by high specificity and may be useful as biomarkers in the diagnostics of endometrial cancer. When determined preoperatively, HE4 is correlated with the prognostic factors of endometrial cancer and may be helpful in the planning of individual treatment of endometrial cancer patients.
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Affiliation(s)
- Aneta Cymbaluk-Płoska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents
| | | | | | | | - Anna Surowiec
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents
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25
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Strojna A, Chudecka-Głaz A, Cymbaluk-Płoska A, Menkiszak J. Evaluation of HE4 marker in prediction and diagnosis of disease recurrence in female patients with recurrent ovarian cancer. Eur J Cancer 2017. [DOI: 10.1016/s0959-8049(17)30641-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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26
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Cymbaluk-Płoska A, Chudecka-Głaz A, Kuźniak S, Menkiszak J. Ectopic pregnancy treatment by combination therapy. Open Med (Wars) 2016; 11:530-536. [PMID: 28352846 PMCID: PMC5329878 DOI: 10.1515/med-2016-0091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 10/31/2016] [Indexed: 11/18/2022] Open
Abstract
Detectability of early stages of ectopic pregnancies has increased due to improvements in ultrasonographic and biochemical techniques. Since the patients’ future procreative plans must be taken into consideration when commencing treatment, the goal of this work was to compare the effects of treatment methods and their impact on fertility. The study included 91 patients treated surgically for ectopic pregnancy. The choice of treatment depended on patients’ general condition, ultrasonographic evaluation and serum level of beta-hCG. A combination of laparoscopic and conservative systemic treatment was applied in 70% of cases. More rapid beta-hCG reduction was noted when laparoscopy and intra-oviductal injection of hyperosmolar glucose or methotrexate (MTX) were combined with intramuscular administration of MTX at a dose of 50 mg/m2. Follow-up examination of 66 patients revealed that the greatest number of spontaneous pregnancies (48%) resulted after this combination therapy. We conclude that this combination treatment is safe and provides satisfactory results in terms of future fertility.
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Affiliation(s)
- Aneta Cymbaluk-Płoska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Sławomir Kuźniak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
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27
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Menkiszak J, Sopik V, Chudecka-Głaz A, Domagała W, Urasińska E, Symonowicz H, Majdanik E, Waloszczyk P, Sycz K, Świniarska M, Huzarski T, Cybulski C, Debniak T, Oszurek O, Lubinski J, Narod S, Gronwald J. The impact of an expanded genetic testing program and selective oophorectomy on the incidence of ovarian cancer in West Pomerania. Clin Genet 2016; 91:322-327. [DOI: 10.1111/cge.12865] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Revised: 08/26/2016] [Accepted: 09/07/2016] [Indexed: 12/13/2022]
Affiliation(s)
- J. Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents; Pomeranian Medical University; Szczecin Poland
| | - V. Sopik
- Women's College Research Institute; Women's College Hospital; Toronto Canada
| | - A. Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents; Pomeranian Medical University; Szczecin Poland
| | - W. Domagała
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents; Pomeranian Medical University; Szczecin Poland
| | - E. Urasińska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents; Pomeranian Medical University; Szczecin Poland
| | - H. Symonowicz
- Department of Oncology and Chemotherapy; District Hospital; Koszalin Poland
| | - E. Majdanik
- Department of Oncology and Chemotherapy; District Hospital; Koszalin Poland
| | | | - K. Sycz
- Histopathological Laboratory; Independent Public District Hospital; Szczecin Poland
| | - M. Świniarska
- Department of Clinical Oncology; West Pomeranian Center of Oncology; Szczecin Poland
| | - T. Huzarski
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents; Pomeranian Medical University; Szczecin Poland
| | - C. Cybulski
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents; Pomeranian Medical University; Szczecin Poland
| | - T. Debniak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents; Pomeranian Medical University; Szczecin Poland
| | - O. Oszurek
- Women's College Research Institute; Women's College Hospital; Toronto Canada
| | - J. Lubinski
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents; Pomeranian Medical University; Szczecin Poland
| | - S.A. Narod
- Women's College Research Institute; Women's College Hospital; Toronto Canada
| | - J. Gronwald
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents; Pomeranian Medical University; Szczecin Poland
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28
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Chudecka-Głaz A, Szczeblińska J, Cymbaluk-Płoska A, Kohn J, El Fray M. New poly(ester-amide) copolymers modified with polyether (PEAE) for anticancer drug encapsulation. J Microencapsul 2016; 33:702-711. [PMID: 27705049 DOI: 10.1080/02652048.2016.1228708] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
New poly(ester-amide) copolymers modified with polyethers were developed for carboplatin encapsulation. These new copolymers contain hydrophobic blocks made of tyrosine derivative and dimer fatty acid, and poly(ethylene glycol) (PEG) as hydrophilic blocks. Short-term hydrolytic degradation revealed high water absorption, slight increase of pH of simulated body fluid and change of sample shape, which indicated the erosive mechanism of polymers degradation. Poly(ester-amide)-PEG copolymers were used for microspheres preparation and carboplatin encapsulation. A double emulsification process was used to produce microspheres with an average diameter of 20-30 μm. It was found that the amount of drug released was controlled by the molecular mass of PEG used for microspheres preparation. Mathematical models were used to elucidate the release mechanism of the carboplatin from the microspheres. The results demonstrate that poly(ester-amide)-PEG copolymers may be used for targeted carboplatin encapsulation and release.
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Affiliation(s)
- Anita Chudecka-Głaz
- a Chair and Department of Gynaecological Surgery and Gynaecological Oncology of Adults and Adolescents , Pomeranian Medical University , Szczecin , Poland
| | - Joanna Szczeblińska
- b Division of Biomaterials and Microbiological Technologies , West Pomeranian University of Technology, Nanotechnology Centre for Research and Education , Szczecin , Poland
| | - Aneta Cymbaluk-Płoska
- a Chair and Department of Gynaecological Surgery and Gynaecological Oncology of Adults and Adolescents , Pomeranian Medical University , Szczecin , Poland
| | - Joachim Kohn
- c Department of Chemistry, New Jersey Centre for Biomaterials , Rutgers, The State University of New Jersey , Piscataway , NJ , USA
| | - Miroslawa El Fray
- b Division of Biomaterials and Microbiological Technologies , West Pomeranian University of Technology, Nanotechnology Centre for Research and Education , Szczecin , Poland
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29
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Chudecka-Głaz A, Cymbaluk-Płoska A, Luterek-Puszyńska K, Menkiszak J. Diagnostic usefulness of the Risk of Ovarian Malignancy Algorithm using the electrochemiluminescence immunoassay for HE4 and the chemiluminescence microparticle immunoassay for CA125. Oncol Lett 2016; 12:3101-3114. [PMID: 27899969 PMCID: PMC5103905 DOI: 10.3892/ol.2016.5058] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Accepted: 05/13/2016] [Indexed: 11/08/2022] Open
Abstract
The present study aimed to investigate the usefulness of the Risk of Ovarian Malignancy Algorithm (ROMA) in the preoperative stratification of patients with ovarian tumors using a novel combination of laboratory tests. The study group (n=619) consisted of 354 premenopausal and 265 postmenopausal patients. The levels of carbohydrate antigen 125 (CA125) and human epididymis protein 4 (HE4) were determined, and ROMA calculations were performed for each pre- and postmenopausal patient. HE4 levels were determined using an electrochemiluminescence immunoassay, while CA125 levels were determined by a chemiluminescence microparticle immunoassay. A contingency table was applied to calculate the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Receiver operating characteristic curves were also constructed, and areas under the curves (AUCs) were compared between the marker determinations and ROMA algorithms. In terms of distinguishing between ovarian cancer and benign disease, the sensitivity of ROMA was 88.3%, specificity was 88.2%, PPV was 75.3% and NPV was 94.9% among all patients. The respective parameters were 71.1, 90.1, 48.2 and 91.1% in premenopausal patients and 93.6, 82.9, 86.6 and 91.6% in postmenopausal patients. The AUC value for the ROMA algorithm was 0.926 for the ovarian cancer vs. benign groups in all patients, 0.813 in premenopausal patients and 0.939 in postmenopausal patients. The respective AUC values were 0.911, 0.879 and 0.934 for CA125; and 0.879, 0.783 and 0.889 for HE4. In this combination, the ROMA algorithm is characterized by an extremely high sensitivity of prediction of ovarian cancer in women with pelvic masses, and may constitute a precise tool with which to support the qualification of patients to appropriate surgical procedures. The ROMA may be useful in diagnosing ovarian endometrial changes in young patients.
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Affiliation(s)
- Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin PL-70-111, Poland
| | - Aneta Cymbaluk-Płoska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin PL-70-111, Poland
| | - Katarzyna Luterek-Puszyńska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin PL-70-111, Poland
| | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin PL-70-111, Poland
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30
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Menkiszak J, Chudecka-Głaz A, Gronwald J, Cymbaluk-Płoska A, Celewicz A, Świniarska M, Wężowska M, Bedner R, Zielińska D, Tarnowska P, Jakubowicz J, Kojs Z. Prophylactic salpingo-oophorectomy in BRCA1 mutation carriers and postoperative incidence of peritoneal and breast cancers. J Ovarian Res 2016; 9:11. [PMID: 26928677 PMCID: PMC4772302 DOI: 10.1186/s13048-016-0220-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 02/19/2016] [Indexed: 02/06/2023] Open
Abstract
Background There are no effective methods of diagnosis of early-stage ovarian cancer. Conservative care over patients at high risk of ovarian and breast cancers is ineffective. Prophylactic surgery is considered the best prophylaxis among BRCA1/BRCA2 carriers. Methods One hundred ninety-five patients, carriers of one of three most common mutations of the BRCA1 gene (Am J Hum Genet: 66: (6)1963-1968, 2000) in the Polish population (5382insC, 4153delA and C61G), who undergone prophylactic salpingo-oophorectomy. The study group consisted of consecutive mutation carriers living in Poland, in the West Pomeranian province. Histopathological examination of the surgical material failed to reveal presence of malignancy. Results During follow-up we diagnosed two peritoneal cancers and 14 breast cancers. Diagnosis of breast cancer before prophylactic surgery increased the risk of peritoneal cancer almost three times. Time from diagnosis of breast cancer to prophylactic surgery increased the risk of peritoneal cancer after prophylactic surgery. This was strongly expressed (HR = 5.0; p = 0.030) in cases of over five-year-long delay in prophylactic surgery. Diagnosis of breast cancer before prophylactic surgery correlated with the risk of death (p = 0.00010). Presence of 5382insC mutation decreased and C61G mutation increased the risk of peritoneal cancer (p = 0.049 vs. p = 0.013). Conclusions Occurrence of primary peritoneal cancer after prophylactic surgery is similar to that reported in international literature. Primary breast cancer occurred less often than in international literature. We suspect that the risk of development of breast cancer among BRCA1 carriers undergoing prophylactic surgery can differ in a population. The next goal should be to study the molecular basis for the risk of development of malignancies in any population. Carriers of BRCA1 gene diagnosed with breast cancer should undergo prophylactic surgery within five years from the diagnosis of breast cancer.
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Affiliation(s)
- Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, SPSK-2, 70-111 Szczecin Al. Powstańców Wielkopolskich 72, Szczecin, Poland.
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, SPSK-2, 70-111 Szczecin Al. Powstańców Wielkopolskich 72, Szczecin, Poland.
| | - Jacek Gronwald
- Department of Genetics and Pathology; International Hereditary Cancer Center, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland.
| | - Aneta Cymbaluk-Płoska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, SPSK-2, 70-111 Szczecin Al. Powstańców Wielkopolskich 72, Szczecin, Poland.
| | - Aleksander Celewicz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, SPSK-2, 70-111 Szczecin Al. Powstańców Wielkopolskich 72, Szczecin, Poland.
| | - Maria Świniarska
- Department of the Clinical Oncology the West Pomeranian Centre of the Oncology in Szczecin, ul. Strzałowska 22, 71-730, Szczecin, Poland.
| | - Małgorzata Wężowska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, SPSK-2, 70-111 Szczecin Al. Powstańców Wielkopolskich 72, Szczecin, Poland.
| | - Ryszard Bedner
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, SPSK-2, 70-111 Szczecin Al. Powstańców Wielkopolskich 72, Szczecin, Poland.
| | - Dorota Zielińska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, SPSK-2, 70-111 Szczecin Al. Powstańców Wielkopolskich 72, Szczecin, Poland.
| | - Paulina Tarnowska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, SPSK-2, 70-111 Szczecin Al. Powstańców Wielkopolskich 72, Szczecin, Poland.
| | - Jerzy Jakubowicz
- Radiation Oncology Department, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute Cracow Branch, Garncarska 11, 31-115, Kraków, Poland.
| | - Zbigniew Kojs
- Department of Gynecologic Oncology, Centre of Oncology, Maria Sklodowska-Curie Memorial Institute, Cracow Branch, Garncarska 11, 31-115, Kraków, Poland.
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Chudecka-Głaz A, Cymbaluk-Płoska A, Jastrzębska J, Menkiszak J. Can ROMA algorithm stratify ovarian tumor patients better when being based on specific age ranges instead of the premenopausal and postmenopausal status? Tumour Biol 2016; 37:8879-87. [PMID: 26753953 PMCID: PMC4990599 DOI: 10.1007/s13277-015-4733-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 12/21/2015] [Indexed: 12/26/2022] Open
Abstract
After several years of research, HE4 was found to be characterized by slightly worse sensitivity but significantly higher specificity as compared with CA125. Further studies led to the diagnostic potential of both markers (CA125 and HE4) being combined in a single risk of malignancy algorithm (ROMA) algorithm. The objective of this study was to assess the diagnostic capabilities of the ROMA algorithm using age ranges instead of dichotomization of patients according to the pre- and postmenopausal status. A total of 413 female patients were included in the study, including 162 premenopausal and 251 postmenopausal women. Calculation of the final ROMA values was achieved by means of stepwise reduction of coefficients in the proposed formula of: %ROMA = exp(PI)/[1-exp(PI)]*100) and PI = A + W(HE4)*ln(HE4) + W(CA125)*ln (CA125) and the arrangement of values with consideration to the age group, HE4 level, differentiation of modification, and directional coefficients as well as determination of individual deviations affecting the widening of the median. The cutoff value of modified algorithm ROMA P for the entire study population was calculated from receiver operating characteristic (ROC) curve and DeLong method at the levels of 23.5 %. Marked higher sensitivity and negative predictive value (NPV) values are observed for the standard ROMA algorithm while higher specificity and positive predictive value (PPV) values are observed for the modified algorithm ROMA P. The proposed age-related modification of algorithm calculation does not require the patients being dichotomized according to their pre- or postmenopausal status, and satisfactory diagnostic values may be obtained using a single cutoff point for the entire population.
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Affiliation(s)
- Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland.
| | - Aneta Cymbaluk-Płoska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
| | | | - Janusz Menkiszak
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
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Cymbaluk-Ploska A, Chudecka-Głaz A, Chosia M, Ashuryk O, Menkiszak J. Conservative treatment of a young patient with thyroid carcinoma in adult ovarian teratoma - case report. Gynecol Endocrinol 2014; 30:187-91. [PMID: 24397359 DOI: 10.3109/09513590.2013.860122] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The cystic mature teratomas, including dermoid cysts, are one of the most frequently occurring benign ovarian tumors diagnosed in female patients. The process of neoplastic transformation in mature dermoid cysts is applicable only to 1-2% of cases. In our article, we present a rare case of thyroid carcinoma development in adult teratoma in 21-year-old patient. The young age, certain pathomorphological features and clinical data (small size of neoplastic lesion, correct values of tumour markers, unilateral character, regular levels of thyreoglobulin and absence of any significant deviations in imaging examinations), were the basis for attempting to apply the conservative treatment both in the scope of gynecological surgery and in the supplemental endocrinological therapy. In the patient, the one-sided adnexectomy was performed, considering pathological lesions on the adnexa, as well as the other ovary dermoid cyst was enucleated, without the hysteroctomy procedure. Considering the lack of any morphological lesions and functional changes relating to thyroid gland, the treatment was not radicalised in this scope, either. At present, one year after the primary operation treatment, the patient does not manifest any disease symptoms, whereas the other ovary, in the follow-up ultrasound examinations, shows normal size and echostructure. The thyroid-stimulating hormone (TSH) suppression keeps being applied.
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Affiliation(s)
- Aneta Cymbaluk-Ploska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents
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33
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Chudecka-Głaz A, Cymbaluk-Płoska A, Menkiszak J, Sompolska-Rzechuła A, Byra E, Rzepka-Górska I. HE4 tumor marker concentration in neoplastic peritoneal effusion and in peritoneal fluid associated with benign gynecological diseases. J Ovarian Res 2014; 7:22. [PMID: 24528554 PMCID: PMC3940276 DOI: 10.1186/1757-2215-7-22] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 02/11/2014] [Indexed: 11/24/2022] Open
Abstract
Background The aim of our study was to evaluate the behaviour of the human epididymis protein 4 (HE4) in the peritoneal fluid encountered in various female genital diseases. Methods We enrolled 139 patients, 40 with ovarian cancer (group I), 82 with benign diseases (group II), and 17 with other malignant neoplasms (group III). The HE4 tumor marker concentrations were determined in serum, in the peritoneal effusion and ovarian cyst/ tumor fluids, CA125 in the serum only. We compared the groups, examined correlations and determined corresponding ROC curves. We evaluated the relationship between the HE4 marker concentration in the peritoneal effusion in the group I, depending on the selected prognostic parameters. Results The HE4 median value between the study groups did not differ statistically significantly and were as follows: in group I 3322 pmol/L, in the group II 2150 pmol/L and in the group III 627 pmol/L (p = 0.206376 for the groups I and II, p = 0.05929 for the groups I and III and p = 0.0797 for the groups II and III. In group I there were no differences found in the HE4 concentrations in the peritoneal fluid, depending on the stage, grade, the presence of neoplastic cells and the peritoneal dissemination. Conclusions The HE4 marker concentrations in the peritoneal fluid are highly irrespective of the pathology observed in the female sexual organ. Therefore, it seems that its determinations in the peritoneal fluid are completely useless in terms of diagnostics. More research is needed on the role of the HE4 marker, especially the place of its formation and possible use in the targeted therapy.
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Affiliation(s)
- Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Al, Powstańców Wielkopolskich 72, Szczecin PL-70-111, Poland.
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Chudecka-Głaz A, Menkiszak J, Kuźniak S, Lewandowska M, Burak M, Walecka A. A rare case of peritoneal disseminated angiosarcoma 20 years after ovarian cancer diagnosis. Gynecol Obstet Invest 2013; 77:68-72. [PMID: 24334819 DOI: 10.1159/000356690] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 10/24/2013] [Indexed: 11/19/2022]
Abstract
Angiosarcoma is a rare form of sarcoma which may be either a primary tumor or it may result from previous irradiation because of another tumor. In this paper, we present a case of a female patient diagnosed as having peritoneal disseminated angiosarcoma 20 years after ovarian cancer treatment (surgery, chemotherapy and radiotherapy). The case was very atypical because of an extremely rare peritoneal location and disseminated nature of the changes. Based on the initial histological picture, poorly differentiated cancer metastasis was diagnosed, suggesting a recurrence of the ovarian cancer that had been diagnosed earlier. The time elapsed from the ovarian cancer diagnosis, history of the previous irradiation and concentration of tumor markers were the only additional clinical data provided to the pathologists, which ultimately contributed to a correct diagnosis. The case we present herein shows and emphasizes the importance of proper communication between a clinician and a pathologist, which is a prerequisite for a correct diagnosis and, consequently, for proper treatment of patients. It also confirms the high specificity of the HE4 (human epididymis protein 4) marker in the monitoring of ovarian cancer, which was within normal limits in spite of peritoneal tumor dissemination.
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Affiliation(s)
- Anita Chudecka-Głaz
- Departments of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
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Menkiszak J, Chudecka-Głaz A, Gronwald J, Bedner R, Cymbaluk-Płoska A, Wezowska M, Zielińska D, Rzepka-Górska I. [Characteristics of selected clinical features in BRCA1 mutation carriers affected with breast cancer undergoing preventive female genital tract surgeries]. Ginekol Pol 2013; 84:758-64. [PMID: 24191513 DOI: 10.17772/gp/1636] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
AIM Evaluation of patient age and time of the prophylactic surgery as well as incidence of genital cancers and precancerous states observed in histopathology of the postoperative material from BRCA1 gene mutation carriers previously treated for breast cancer. MATERIAL AND METHODS 206 carriers of one of the three most common BRCA1 gene mutations (5382insC, C61G and 4153delA) in the Polish population, who were offered the option of prophylactic salpingo-oophorectomy The study group comprised 85 patients with the diagnosis of breast cancer before gynecological preventive surgery The study group was further divided into two subgroups for more detailed assessment of the tested variables. The first subgroup included 67 patients with breast cancer (unilateral or bilateral synchronous). The second subgroup included 18 patients with bilateral metachronous (the second diagnosis of breast cancer was at least 12 months after the first breast cancer diagnosis). The control group consisted of 121 patients with no cancerous lesions before preventive gynecologic surgery The patients undergoing prophylactic treatment had no prior symptoms in female sexual organ and no changes in the diagnostic tests. RESULTS The patients with a history of breast cancer underwent genetic testing and preventive surgery of the genital tract at a significantly later age than controls (respectively p = 0.0003, p = 0.0006). The patients with bilateral metachronous breast cancer underwent preventive surgery significantly earlier (p = 0.03). There was a trend indicating a 2.5 times higher risk of developing ovarian cancer among BRCA1 mutation carriers who had already been diagnosed and treated for breast cancer when compared to women without breast cancer diagnosis. The incidence of other genital cancers and precancerous states in BRCA1 gene mutation carriers with history of breast cancer was not statistically significant as compared to controls. Data on the clinical stage, morphological grade, histological type, age and type of pathology and the type of BRCA1 gene mutation did not show a statistically significant difference between the groups. CONCLUSIONS Each patient diagnosed with breast cancer should be strongly recommended a genetic test to reduce adverse consequences resulting from postponing the test and, if applicable, the preventive operation until later in life. Preventive surgery should be considered especially in BRCA1 gene mutation carriers previously treated for breast cancer because of the increased risk of ovarian cancer
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Affiliation(s)
- Janusz Menkiszak
- Katedra i Klinika Ginekologii Operacyjnej i Onkologii Ginekologicznej Dorosłych i Dziewczat PUM w Szczecinie, Polska.
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Mędrek K, Magnowski P, Masojć B, Chudecka-Głaz A, Torbe B, Menkiszak J, Spaczyński M, Gronwald J, Lubiński J, Górski B. Association of common WRAP 53 variant with ovarian cancer risk in the Polish population. Mol Biol Rep 2012. [PMID: 23192612 PMCID: PMC3563948 DOI: 10.1007/s11033-012-2273-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Among many alterations within the TP53 gene the rs1042522 (C72G, p.Pro72Arg) has been associated with numerous cancers , however the results differ between populations for opposite Pro or Arg alleles. Similar thus inconclusive results are observed in ovarian cancer, which may suggest that the rs1042522 does not influence ovarian carcinogenesis directly, but might be linked to another pathogenic alteration. WRAP53 which overlaps the TP53 is required to maintain normal levels of p53 upon DNA damage, but also when altered may independently increase the risk of cancer. To evaluate the association between three SNPs located in WRAP53-TP53 region: rs1042522, rs2287497, rs2287498 and ovarian cancer risk in Polish population we genotyped 626 cases and 1,045 healthy controls. Our results provide the evidence for an association between studied SNPs and a risk of invasive ovarian cancer in Poland. We found that CC homozygotes in rs1042522 were more frequent in cancers when compared to controls (OR = 1.46, p = 0.03). Similarly in WRAP53 both TT homozygotes in rs2287497 (OR = 1.95, p = 0.03) and AA homozygotes in rs2287498 (OR = 2.65, p = 0,01) were more frequent among cases than healthy individuals. There is also a suggestive evidence that specific homozygosity of studied SNPs in TP53-WRAP53 region is significantly overrepresented in ovarian cancer patients. In conclusion SNPs in WRAP53 (rs2287497 and rs2287498) have stronger association with an ovarian cancer risk than rs1042522 in TP53.
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Affiliation(s)
- Krzysztof Mędrek
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland.
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Chudecka-Głaz A, Rzepka-Górska I, Wojciechowska I. Human epididymal protein 4 (HE4) is a novel biomarker and a promising prognostic factor in ovarian cancer patients. EUR J GYNAECOL ONCOL 2012; 33:382-390. [PMID: 23091895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE OF INVESTIGATION The aim of this work was to compare serum concentrations of HE4 in patients with benign and malignant epithelial tumors and to determine the association of preoperative concentrations of HE4 with some clinicopathologic factors. METHODS We enrolled 94 patients, including 39 females with freshly diagnosed ovarian cancer. HE4 concentrations were measured with ELISA HE4 EIA assay from Fujirebio Diagnostics. RESULTS Serum concentrations of HE4 differed significantly in patients with ovarian cancer (324.1 pM) compared with benign epithelial tumors (26.1 pM; p < 000.1). There was also a significant difference between HE4 concentrations at diagnosis of ovarian cancer (324.1 pM) and in patients with complete clinical remission (23.3 pM; p < 0.0001). Patients with poorly differentiated tumors had significantly higher concentrations of HE4. Preoperative HE4 levels were higher in patients in whom relapse was noted and who died before the end of the two-year follow-up period. CONCLUSION On the basis of these findings and reports in the literature it appears likely that HE4 can complement CA125 in the monitoring of therapy in ovarian cancer and may also serve for prognostication.
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Affiliation(s)
- A Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents Pomeranian Medical University, Szczecin, Poland.
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Chudecka-Głaz A, Rzepka-Górska I. Favorable effects of long-term therapy with gonadoliberin analogues in three patients with advanced and recurrent ovarian cancer. EUR J GYNAECOL ONCOL 2009; 30:589-591. [PMID: 19899425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Numerous scientific reports indicate a high possibility of gonadotrophin involvement in ovarian cancer neoplasia. CASE PRESENTATION In a 49-year-old patient with recurrent ovarian cancer, a present survival of ten years has been achieved. She has been using GnRH analogues for nine years. A 32-year-old patient with a primary highly advanced ovarian cancer received standard therapy and additional implants with GnRH analogues as consolidation therapy for 20 months. Overall survival is 14 years. In a 56-year-old patient with advanced ovarian cancer GnRH analogues were used as consolidation therapy for seven years, achieving seven years of a complete clinical remission and nine and a half years of survival up to now. CONCLUSION It seems that gonadoliberin analogues should find their place in ovarian cancer therapy.
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Affiliation(s)
- A Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
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Chudecka-Głaz A, Górski B, Zielińska D, Błogowski W, Wojciechowska I, Bedner R, Rzepka-Górska I. Serum YKL-40 levels in patients with ovarian cancer and women with BRCA1 gene mutation--comparison to CA 125 antigen. EUR J GYNAECOL ONCOL 2009; 30:668-671. [PMID: 20099501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
PURPOSE OF INVESTIGATION Our work was undertaken to determine the usefulness ofYKL-40 as a tumor marker in patients with ovarian cancer and women with BRCA 1 gene mutations. METHODS Our study population consisted of 111 patients. They were divided into five study groups: I--newly diagnosed ovarian caner, II--recurrence of ovarian cancer, III--complete remission, IV--benign epithelial tumors and V--patients with BRCA 1 gene mutations. YKL-40 and CA 125 were determined in patient sera. RESULTS YKL-40 in newly diagnosed ovarian cancer patients was significantly higher (181.17 n/ml) than in patients with BRCA 1 gene mutation (97.74 ng/ml, p < 0.01), women with benign epithelial cancer (57.19 ng/ml, p < 0.005) and patients with ovarian cancer at the time of complete remission (58.12 ng/ml, p < 0.005). Taking 124 ng/ml as a cut-off value for YKL-40 (95th percentile for healthly women) we observed higher levels in 50% of patients from group I and in 38% from group II. CONCLUSIONS YKL-40 appears to demonstrate no advantage over CA 125 as a biomarker of ovarian cancer, particularly in women with early-stage tumors. More research is needed on carriers of the BRCA 1 gene muation in view of the elevated YKL-40 concentrations in this group.
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Affiliation(s)
- A Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents Pomeranian Medical University, Szczecin, Poland
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Torbé A, Gutowska-Czajka D, Chudecka-Głaz A, Czajka R. [Giant benign ovarian tumor coexisting with late pregnancy--a case report]. Ginekol Pol 2008; 79:441-444. [PMID: 18652134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
We have reported a rare case of a giant ovarian tumor which, due to the lack of proper health care on the side of the patient, had not been diagnosed until 27 weeks of pregnancy. The patient did not demonstrate any clinical symptoms till the moment of the diagnosis. Peripheral blood analysis showed severe anemia at the admission. The right adnex with the multilocular cystic tumor containing bloody fluid and measuring 40 cm in diameter, was removed in the course of the surgical procedure. The histological diagnosis of the tumor was: serous cyst. Surgical removal of the giant tumor allowed for further development of pregnancy and enabled vaginal delivery of healthy newborn at term.
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Affiliation(s)
- Andrzej Torbé
- Klinika Połoznictwa i Ginekologii Katedry Połoznictwa, Ginekologii i Neonatologii Pomorskiej Akademii Medycznej w Szczecinie.
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Rzepka-Górska I, Bedner R, Cymbaluk-Płoska A, Chudecka-Głaz A. Serum adiponectin in relation to endometrial cancer and endometrial hyperplasia with atypia in obese women. EUR J GYNAECOL ONCOL 2008; 29:594-597. [PMID: 19115685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVES The aim of this work was to compare concentrations of adiponectin in the serum of obese women with endometrial cancer, endometrial hyperplasia with atypia, and normal endometrium. METHODS We enrolled 105 obese women treated at the Department of Gynecological Surgery and Oncology of Adults and Adolescents. The patients were allocated to groups depending on the histological diagnosis (R - endometrial cancer, P - polyps, K - normal endometrium). We subdivided group R depending on the stage and grade of cancer. RESULTS Significantly lower concentrations of adiponectin were found in patients with endometrial cancer (mean 15.28 microg/ml) as compared with polyps (29.94 microg/ml, p < 0.001) or normal endometrium (22.7 microg/ml, p < 0.05). Stage of cancer had no significant effect on the adiponectin level. When cancer grade was compared, lower levels of adiponectin were observed in patients with G3 (12.86 microg/ml) than G1 (19.04 microg/ml, p < 0.05). CONCLUSION Reduced levels of adiponectin may represent an independent risk factor for endometrial cancer.
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Affiliation(s)
- I Rzepka-Górska
- Department of Gynecological Surgery and Oncology of Adults and Adolescents, Pomeranian Medical University of Szczecin, Poland.
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Chudecka-Głaz A, Rzepka-Górska I. Concentrations of follicle stimulating hormone are increased in ovarian tumor fluid: implications for the management of ovarian cancer. EUR J GYNAECOL ONCOL 2008; 29:37-42. [PMID: 18386461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE OF INVESTIGATION Significant progress has been made in recent years in the understanding of the mechanisms postulated by the gonadotropin theory of ovarian carcinogenesis. In the present study we compare FSH concentrations between serum and fluid from cysts or the rectouterine pouch of patients with epithelial tumors and non-neoplastic lesions. METHODS We enrolled 277 patients. They were divided into five groups: I (n = 44)--ovarian cancer patients, II (n = 16)--borderline tumors, III (n = 40)--benign epithelial cystadenomas, IV (n = 137)--non-neoplastic lesions and V (n = 22)--admitted for "second-look" laparoscopy. RESULTS There were any significant differences between FSH concentrations in serum and tumor fluid in patients with ovarian cancer (36.46 vs 28.11 mIU/ml) and borderline epithelial tumors (31.5 vs 22.7 mIU/ml). For benign cystadenomas the respective concentrations were 28.96 mIU/ml in serum and 6.93 mIU/ml in tumor fluid in these groups p < 0.0000001. The same highly significant differences were found in non-neoplastic lesions (24.97 vs 4.77 mIU/ml), p < 0.0000001. Patients who underwent "second-look" laparoscopy demonstrated significant differences (p < 0.05) as FSH concentration in serum and peritoneal fluid when neoplastic cells were not disclosed, but the difference was not significant (p = 0.752) when fluid from the rectouterine pouch was positive for carcinoma cells. CONCLUSIONS The results of our study can reflect an ineffective tumor: blood barrier and easy diffusion of gonadotropins into the tumor tissue. Local reduction of FSH levels through administration of GnRH analogs may in some clinical situations produce clear therapeutic benefits for the management of ovarian malignancies.
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Affiliation(s)
- A Chudecka-Głaz
- Department of Gynecological Surgery and Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
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Cymbaluk A, Chudecka-Głaz A, Rzepka-Górska I. Leptin levels in serum depending on Body Mass Index in patients with endometrial hyperplasia and cancer. Eur J Obstet Gynecol Reprod Biol 2006; 136:74-7. [PMID: 17007993 DOI: 10.1016/j.ejogrb.2006.08.012] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2006] [Revised: 06/21/2006] [Accepted: 08/29/2006] [Indexed: 11/25/2022]
Abstract
UNLABELLED Leptin levels in serum depending on Body Mass Index (BMI) in patients with endometrial hyperplasia and cancer. OBJECTIVES Concentrations of leptin, a hormone secreted by white adipose tissue, correlate strongly with body mass. Leptin interacts with several other hormones, modifies the activities of some enzymes and proinflammatory cytokines, participates in hematopoiesis, thermogenesis, and angiogenesis, and is involved in the control of carbohydrate and lipid metabolism. This study was undertaken to determine whether serum concentrations of leptin in obese patients with endometrial hyperplasia and cancer deviate from values in patients with normal endometrium. STUDY DESIGN We enrolled 86 obese postmenopausal women, including 40 with endometrial cancer and hyperplasia and 46 with normal endometrium. Depending on BMI, three subgroups were formed: I<30; II = 30-40; III > 40. Leptin concentrations were measured with immunoenzymatic test kits from IBL. Statistical comparison was done with the chi square (chi(2)) test and Statistica software package. RESULTS Mean serum concentration of leptin in endometrial cancer and hyperplasia was 16737.1 pg/ml as opposed to 9048.7 pg/ml in patients without endometrial pathology (p<0.0001). Significantly, higher concentrations of leptin were noted in every BMI subgroup of patients with endometrial pathology in comparison to controls (p<0.005). CONCLUSIONS Leptin appears to participate in proliferative processes of the endometrium. Obesity is an important risk factor in endometrial cancer.
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Affiliation(s)
- Aneta Cymbaluk
- Chair and Department of Gynecological Surgery and Oncology of Adults and Adolescents, Pomeranian Medical University, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
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Rzepka-Górska I, Tarnowski B, Chudecka-Głaz A, Górski B, Zielińska D, Tołoczko-Grabarek A. Premature menopause in patients with BRCA1 gene mutation. Breast Cancer Res Treat 2006; 100:59-63. [PMID: 16773440 DOI: 10.1007/s10549-006-9220-1] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2005] [Accepted: 03/02/2006] [Indexed: 12/30/2022]
Abstract
This study was undertaken with regard to the gonadotropin theory of ovarian cancer advocated in the literature and was designed to disclose specific features of ovarian morphology in carriers of the BRCA1 gene mutation. We enrolled 171 patients and divided them into two groups: A (n=90)--operated for breast cancer (30 patients with and 60 without the BRCA1 mutation); B (n=81)--with the BRCA1 mutation qualified for preventive adnexectomy. According to the authors' classification described herein, some patients without the BRCA1 mutation retained "signs of estrogenization" in menopausal ovaries, revealing the role of estrogens as a factor promoting mammary carcinogenesis in these patients. A tendency to premature menopause was observed in BRCA1 mutation carriers of groups A and B as evidenced by the final menorrhea appearing at a younger age and almost total absence of "signs of estrogenization" in menopausal ovaries. It is concluded from these findings that earlier menopause in carriers of the BRCA1 mutation is associated with hypergonadotropic activity and may predispose to ovarian cancer at younger age.
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Affiliation(s)
- Izabella Rzepka-Górska
- Department of Gynecological Surgery and Oncology of Adults and Adolescents, Pomeranian Medical University of Szczecin, Poland, ul. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland.
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Tarnowski B, Chudecka-Głaz A, Górski B, Rzepka-Górska I. Vascular endothelial growth factor (VEGF) levels and mutation of the BRCA1 gene in breast cancer patients. Breast Cancer Res Treat 2005; 88:287-8. [PMID: 15609132 DOI: 10.1007/s10549-004-0779-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of the study was to compare VEGF serum levels in breast cancer patients with and without BRCA1 gene mutation. We enrolled 80 patients, 22 premenopausal and 58 postmenopausal. We found statistically significant lower levels of VEGF in patients with BRCA1 gene mutation as compared with breast cancer patients without this mutation.
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Affiliation(s)
- B Tarnowski
- Department of Gynecological Surgery and Oncology of Adults and Adolescents, Hereditary Cancer Center, Szczecin, Poland
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Chudecka-Głaz A, Rzepka-Górska I. Activin A levels in serum and cyst fluid in epithelial tumors of the ovary. Int J Gynaecol Obstet 2005; 89:160-2. [PMID: 15847888 DOI: 10.1016/j.ijgo.2004.11.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2004] [Revised: 11/09/2004] [Accepted: 11/29/2004] [Indexed: 11/23/2022]
Affiliation(s)
- A Chudecka-Głaz
- Department of Gynecological Surgery and Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland
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Chudecka-Głaz A, Rzepka-Górska I, Kosmowska B. Gonadotropin (LH, FSH) levels in serum and cyst fluid in epithelial tumors of the ovary. Arch Gynecol Obstet 2004; 270:151-6. [PMID: 12883823 DOI: 10.1007/s00404-003-0519-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2002] [Accepted: 04/09/2003] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this work was to determine gonadotropin (LH, FSH) levels in serum and cyst fluid in various type of ovarian epithelial neoplasms (benign, borderline, malignant) and to compare them with levels in benign cysts. Additionally we decided to estimate if there were some significant correlations between serum and ovarian cyst fluid in gonadotropin levels in all investigated groups. MATERIALS AND METHODS The study group included 74 patients before (n=36) and after (n=38) menopause, divided into four groups depending on the histopathologic diagnosis. Serum and cyst fluid levels of LH and FSH were determined in all patients. RESULTS We found statistically significant differences concerning LH and FSH levels in serum and cyst fluid between malignant and borderline tumors, between malignant tumors and benign cystadenomas and between malignant tumors and non-neoplastic cysts. We also found statistically significant correlations between serum and cyst fluid as to FSH and LH levels in patients with borderline tumors. There were no statistically significant correlations between serum and cyst fluid as to FSH and LH levels in patients with malignant epithelial tumors (group 1) and in patients with benign cystadenomas (group 3). CONCLUSIONS High FSH and LH levels in cyst fluid of malignant epithelial tumors of the ovary are in line with the gonadotropin theory of tumor growth. Simultaneous determination of various types inhibin levels appears to be an interesting topic for our future research.
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MESH Headings
- Adenocarcinoma, Mucinous/blood
- Adenocarcinoma, Mucinous/diagnosis
- Adenocarcinoma, Mucinous/metabolism
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/blood
- Biomarkers, Tumor/metabolism
- Carcinoma, Endometrioid/blood
- Carcinoma, Endometrioid/diagnosis
- Carcinoma, Endometrioid/metabolism
- Case-Control Studies
- Child
- Cyst Fluid/metabolism
- Cystadenocarcinoma, Serous/blood
- Cystadenocarcinoma, Serous/diagnosis
- Cystadenocarcinoma, Serous/metabolism
- Female
- Follicle Stimulating Hormone/blood
- Follicle Stimulating Hormone/metabolism
- Gonadotropins/blood
- Gonadotropins/metabolism
- Humans
- Luteinizing Hormone/blood
- Luteinizing Hormone/metabolism
- Middle Aged
- Ovarian Cysts/blood
- Ovarian Cysts/diagnosis
- Ovarian Cysts/metabolism
- Ovarian Neoplasms/blood
- Ovarian Neoplasms/diagnosis
- Ovarian Neoplasms/metabolism
- Predictive Value of Tests
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Affiliation(s)
- Anita Chudecka-Głaz
- Department of Gynecological Surgery and Oncology of Adults and Adolescents, Pomeranian Medical University, Ul. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
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Abstract
The aim of this work was to compare mean concentrations of gonadotropins in serum and fluid from malignant and benign ovarian tumors. We enrolled 126 patients diagnosed with malignant epithelial tumors (n=40), borderline epithelial tumors (n=14), benign cystadenomas (n=28) and simple cysts (n=44) of the ovary. Premenopausal and postmenopausal subgroups were formed in each group. The concentration of FSH and LH was measured in serum and tumor fluid and the serum/tumor fluid ratio was calculated. The results in each group were compared and the sensitivity, specificity, positive and negative predictive values were determined. Mean concentrations of both gonadotropins in ovarian cancer fluid were significantly higher than in the remaining groups (P ranged from <0.005 to <0.0001). Mean serum/fluid ratios were lowest in ovarian cancer (FSH=2.91, LH=4.19). Our findings support the hypothesis that gonadotropins are involved in ovarian carcinogenesis and suggest that gonadotropin serum/tumor fluid ratios could be of value in the differential diagnosis of functional and organic cysts of the ovary.
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Affiliation(s)
- I Rzepka-Górska
- Department of Gynecological Surgery and Oncology of Adults and Adolescents, Pomeranian Medical University, Szczecin, Poland.
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Affiliation(s)
- Anita Chudecka-Głaz
- Department of Gynecologic Surgery and Oncology of Adults and Adolescents, Pomeranian University of Szczecin, 70-111 Szczecin, Poland
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Chudecka-Głaz A, Rzepka-Górska I, Błogowska A, Zielińska D. [Granulosa cell tumor in different periods of women's life]. Ginekol Pol 2003; 74:689-94. [PMID: 14674109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
UNLABELLED Ovarian granulosa cell tumor is uncommon malignancies. By virtue of histopathological examination we distinguish two subtype of GCT: adult type granulosa cell tumor typically in older women and juvenile granulosa cell tumor recognized primarily in children and young adults. GCTs behave unpredictably. Depending on histological type patients suffer recurrences in different time after treatment, even many years from diagnosis. OBJECTIVES The aim of our study is clinical analysis of patients with AGCT and JGCT, especially the problem of choice of treatment, time to occurring recurrences and new possibility in long term follow up. MATERIAL AND METHODS We analyzed 22 patients treated in Department of Gynecological Surgery and Oncology of Adults and Adolescent Pomeranian Academy of Medicine and then observed in our outpatient clinic. RESULTS Among analyzed 22 patients 18 had adult type of granulosa cell tumor, mean age of these women was 47 years (32-72). Juvenile type of granulosa cell tumor were recognized in 4 patients and they were from 4 to 7 years old. All young girls were underwent sparing surgery, one of them was treated with radiotherapy. In histopathological examination of 4 years old girl atypia and a lot of mitosis was observed and she was treated with chemotherapy. Unfortunately after 18 months from diagnosis she died due to very dynamic recurrence. Remained 3 girls live without evidence of disease and the longest time of follow up is 36 years. 16 women with AGCT were underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy and omentectomy, 2 were performed conservative surgery because they wish to preserve their fertility. 16 patients were treated with radiotherapy as an adjuvant treatment, two additionally with GnRH analogues. Recurrences in patients with AGCT were recognized in 5 cases. Mean time to recurrence from diagnosis were 11.7 years. In two patients it happened after 21 and 22 years. Despite of aggressive chemotherapy four of these patients died during one year. Remained 13 women with adult granulosa cell tumours live without evidence of disease and the longest time of observation is 9 years. In histopathological examination of all patients who died were describe cellular atypia and high mitotic rates. During long time follow up our patients were performed second-look laparoscopies, tested of estradiol levels and 5 of them also inhibin B levels which always correlated with actual condition. CONCLUSION Granulosa cell tumor is ovarian neoplasm of different behaviour. Patients with this diagnosis should be monitoring for many years. Inhibin is valuable examination in long term follow up.
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