Study on the zona pellucida 4 (ZP4) gene sequence and its expression in the ovaries of patients with polycystic ovary syndrome

BACKGROUND

Polycystic ovary syndrome (PCOS) is a common endocrine disorder of unknown pathology, involving reproductive and metabolic abnormalities. Oocyte-specific genes are a group of genes expressed exclusively in ovarian tissue; therefore, they can play an important role in ovarian pathologies such as PCOS. The zona pellucida 4 (ZP4) gene encodes glycoprotein which is a part of the extracellular matrix of oocyte.

MATERIALS AND METHODS

We analyzed 87 patients with PCOS, which were divided into four groups depending on their phenotype. In each patient, we performed profound clinical and biochemical analysis, including the measurement of serum androgens. The ovarian tissue samples were used to perform a real-time polymerase chain reaction and immunohistochemical staining using anti-ZP4 monoclonal antibodies. The ZP4 gene was sequenced from peripheral lymphocytes.

RESULTS

The expression of ZP4 was present in early antral follicles and was stronger in mature follicles. The subgroup of patients with eumenorrhea and without hyperandrogenism presented the highest expression of ZP4 in ovarian tissue. In one case, we found a mutation of the ZP4 gene. No correlations were found between the ZP4 expression level and biochemical or clinical indices.

CONCLUSIONS

Data from this and animal studies suggest a possible relationship between androgens and ZP4 expression. ZP4 expression is highest among patients with PCOS and a regular cycle, and this is a consequence of the presence of mature follicles in this group. In some patients with PCOS and infertility, ZP4 mutation can be found.

Bilateral androblastoma (Sertoli-stromal cell tumor) of the ovary: a rare cause of virilization in a teenager

A case of a 17-year-old patient diagnosed with bilateral androblastoma of the ovary is presented. The patient was admitted because of secondary amenorrhea, hirsutism and acne. After clinical, ultrasonographic and hormonal examinations an androgen-producing ovarian tumor was suspected and consequently laparotomy with right ovarian tumor excision and left ovary exploration was carried out. During surgery the right ovarian tumor was excised and exploration of the left ovary revealed an ovarian tumor with a diameter of 10 mm, which was then also excised. The pathologic diagnosis was a bilateral androblastoma of the ovary measuring 40 mm x 30 mm x 20 mm in the right ovary and 10 mm in diameter in the left ovary. We concluded that androblastomas, in spite of their low incidence, are a possibility that should always be considered in women of all ages presenting with signs of virilization.

[Preinvasive vulvar and cervical cancer in a 32-year-old woman, DNA HPV 16 positive with mtDNA mutation--case study]

Coincidence of preinvasive vulvar and cervical cancer in young women is very rare. Lesions like VIN 3/preinvasive vulvar cancer and CIN 3/preinvasive cervical cancer are strictly connected with viral infection and are multilocular. In the presented case the following tests have been performed: HPV DNA test for the presence of 13 oncogenic HPV types, mRNA HPV test for the presence of transcripts for HPV 16, 18, 31, 33, 45 and the analysis of mtDNA D-Loop region. In the examined patient HPV 16 infection, as well as the presence of transcripts for HPV 16 E6/7 were diagnosed. The analysis of mtDNA D-Loop region showed nucleotide lesions like: T>C 16.192, T>C 16.223, T>C 16.292, C>T 16.325, C>T 16.579.

Analysis of hMLH1 and hMSH2 expression in cisplatin-treated ovarian cancer patients

BACKGROUND

Loss of DNA mismatch repair may result in resistance to platinum- based anticancer drugs. The hMLH1 and hMSH2 proteins play a critical role in the maintenance of genome integrity and are involved in resistance to platinum-based therapy in colorectal cancer, which is deficient in hMLH1 protein and endometrial cancer, as well as in hMSH2 protein. However, the predictive value of MLH1 and MSH2 expression in ovarian cancer cisplatin-resistance is still to be determined.

OBJECTIVE

The aim of this study was to investigate the expression of hMLH1 and hMSH2 proteins in ovarian carcinoma specimens and to evaluate their prognostic significance by means of overall survival (OS) and progression-free survival rates (PSF).

MATERIAL

Ovarian cancer tissues were obtained from 61 patients: 45 platinum-sensitive and 16 platinum-resistant. hMLH1 and hMSH2 proteins expression was evaluated by immunohistochemistry, with the use of mouse monoclonal antibodies clone 14 for hMLH1 and clone FE11 for hMSH2. The log-rank test and Kaplan-Meier statistics were used to analyze the relationship between proteins expression and progression free survival, as well as the overall survival.

RESULT

No significant correlation was found between hMLH1 and hMSH2 expression and overall survival and progression free survival in the group of patients sensitive and resistant to cisplatin. No significant difference was found in proteins expression intensity between the two compared groups of patients. Age of patients, type of cancer histology, FIGO staging, grading, clinical response and CA 125 did not reveal correlation with the expression of the analyzed proteins.

CONCLUSION

The immunohistochemical expression of hMLH1 and hMSH2 proteins in ovarian cancer has no predictive value in resistance to cisplatin.

The 3020insC NOD2 gene mutation in patients with ovarian cancer

OBJECTIVE

There is an increasing evidence that genetic factors play a role in the etiology of malignant tumors. Mutations of BRCA1 and BRCA2 genes are responsible for an increased risk of ovarian cancer. The role of mutations in NOD2 gene in this type of neoplasm is still under investigation.

THE AIM

The aim of this study was to determine: 1. incidence of NOD 2 3020insC constitutional mutation in a group of consecutive women with ovarian cancer, 2. risk of developing ovarian cancer in patients with NOD2 gene mutation, 3. clinical and pathological features of ovarian cancer in NOD2 gene mutation carriers.

PATIENTS AND METHODS

Clinical and pathological data were collected from 257 non-selected patients with primary epithelial ovarian cancer. The researches identified NOD2 3020insC gene mutation. On the basis of patient source documentation we obtained the data concerning the age of patients at diagnosis, histopathological recognition, FIGO stage and morphological grade G.

RESULTS

19 out of 257 women were identified with germ-line 3020insC mutation of NOD2 gene (7.39%). An increased risk of ovarian cancer in NOD2 mutation carriers was not revealed (OR=1.01; p=0.928; 95% Cl=0.61-1.66). The mean age at diagnosis of patients with NOD2 mutation was 54.8 (SD=9.9), while for non-carriers it was 53.2 (SD=10.2). The difference between these frequencies was statistically irrelevant (p=0.550). Clinical and pathological profile of ovarian cancer was made. We assessed the following features: age at disease onset, histopathology, FIGO stage and morphological grade G. For NOD2 mutation carriers no statistically significant features of ovarian cancer were revealed.

CONCLUSION

1. Despite high frequency of constitutional mutations occurrence in NOD2 gene in women with ovarian cancer, genetic testing seem not to be justified in all women diagnosed with this disease. 2. Due to a lack of increased risk of ovarian cancer in NOD2 gene mutation carriers, proceedings for them may not differ from recommendations for general population. 3. It is difficult to determine characteristic clinical and pathological features of ovarian cancer for NOD2 gene mutation carriers.

[Assesment of real optoelectronic method in the detection of cervical intraepithelial neoplasia]

INTRODUCTION

Biophysics is becoming an important factor in prevention of cervical cancer. One of the most promising concepts of biophysical program for the prevention of cervical cancer is the optoelectronic method--Truscreen.

OBJECTIVE

The objective of the work was to determine the usefulness of the real optoelectronic device in the detection of cervical intraepithelial neoplasia

MATERIAL AND METHOD

From August 2006 till September 2007, 147 patients were examined in the Laboratory of Pathophysiology of Uterine Cervix in Gynecology and Obstetrics Clinical Hospital of Karol Marcinkowski University of Medical Sciences. The study reports prospective, blind trial. The following diagnostic examinations were carried out: examination with the use of optoelectronic method, DNA HPV HIGH RISK test, colposcopy examination and histopatologic biopsy.

RESULTS

The specificity of the optoelectronic method for positive diagnoses amounted to 84%. The sensitivity for intraephitelial changes (CIN 1, CIN 2) was estimated at 53%, and for severe grades (CIN 3, Carcinoma planoepitheliale) at 80%.

CONCLUSIONS

Optoelectronic diagnostics is useful in the detection of cervical neoplastic changes. The optoelectronic method may prove to be a significant diagnostic device at the basic and advanced level of cervical screening. The advantage of the optoelectronic method over prevention based on cytodiagnostics and colposcopy, includes the immediate result of the examination and its automation as well as standardization.

Serum and tissue levels of insulin-like growth factor-I in women with dysplasia and HPV-positive cervical cancer

The ectocervical epithelium is the target of the oncogenic human papillomavirus (HPV), which acts as an etiological agent in the development of cervical carcinoma. However, the HPV-mediated transformation of human epithelial cells is a multi-step process dependant on unknown factors additional to the virus, which is a necessary but, in and of itself, insufficient catalyst. In the present study, we characterized the role of insulin-like growth factor-I (IGF-I) in this process. IGF-I is an endocrine hormone with an autocrine and paracrine role in many tissues. Our data demonstrated that autocrine secretion of IGF-I can contribute to HPV-induced carcinogenesis of the epithelium. An immunohistochemical study showed that IGF-I was present in the nuclei of the reproductive layer of the paraepidermal epithelium in 89% of cases of intraepithelial neoplasia (CIN I-III) and 60% of cases of invasive cervical cancer. The presence of IGF-I at a nuclear localization in the cells studied suggests that it may also have intranuclear actions.

[Agresive variants of uterine cervical cancers]

Three different variants of biologically agressive cervical cancers, such as: basaloid carcinoma, glassy cell carcinoma and small cell endocrine carcinoma, have been reported. Hematoxylin and eosin, periodic acid-Schiff and immunohistochemical stains were used. The course of disease and aplication of treatment has been analyzed as well. Characteristic morphologic features of these cancers have been emphasized. Rather limited susceptibility for radiotherapy and chemiotherapy of these cancers has not gone unnoticed. The description of these types of cervical cancers might enable us to arrive at right conclusions, both clinical and diagnostic.

The level of antibody against E6 HPV 16 oncoprotein in blood sera of women with chronic HPV 16 infection and cervical cancer

The aim of this study was to estimate of the role of chronic HPV 16 infection and the presence of anti E6 HPV 16 in the initiation of the cancerogenesis process of cervical cancer.

MATERIAL AND METHODS

The study included two groups of patients. The first group comprised 323 women observed for three consecutive years (1998-2000), in whom the presence of HPV 16 viruses was estimated by PCR, and the level of anti E6 HPV 16 antibodies was estimated in the plasma with ELISA. A similar test was performed in a group of 46 patients with cervical intraepithelial neoplasia (CIN), 91 patients with invasive cervical cancer and 22 women after hysterectomy and RTG-therapy.

RESULTS

In 32 patients, chronic HPV 16 infection showed a steady rise in the mean absorbance level of anti E6 HPV 16 antibodies from 0.04 in 1998 to 0.06 in 2000, while in HPV-negative women the mean absorbance value was 0.03-0.04. Mean absorbance value in patients with CIN III and invasive cancer rose with advancing stage of the cancer process and lowered after completion of oncological treatment. The values were 0.14, 0.33 and 0.13, respectively.

CONCLUSION

The persistence of chronic HPV 16 infection and accompanying steady rise in absorbance index caused by an increase in the level of antiviral antibodies are a clear warning signal preceding in time the histological process of cancerogenesis.

[Diagnosis of papilloma viruses in cervical cancer in 414 women from Wielkopolska region by the immunohistochemical assessment]

OBJECTIVES

Cervical cancer in Poland is second most common type of cancer, after breast cancer. There are known risk factors of cervical cancer development and the most serious one is human papilloma virus infection (HPV).

DESIGN

The aim of our paper is present the result study 414 cervical cancer of women from Wielkopolska region treated at the Department of Gynecology and Obstetrics, Karol Marcinkowski University of Medical Sciences in Poznań.

MATERIALS AND METHODS

In morphological study grading, staging and vascular invasion were estimated. In cervical cancer tissue papillomaviruses PCR method were used. In immunohistochemical study, expression of proteins checking the cell cycle, share in signal transduction to nucleus, cell receptors for steroid hormones and viruses oncogenic proteins were investigated. In the part of cancer gene mutation of p53 (60 cancers) i k-RAS (40 cancers) were searched.

RESULTS

In cancers HPV 16/18 infected vascular invasion were more frequently (p < 0.013). No statistically significant difference in cellular proteins expression in the HPV16/18 positive cancers, HPV16/18 negative and cancers without HPV was observed. However significant difference were demonstrated in proteins expression depending from degree of cancer stage.

CONCLUSIONS

The result of these studies suggest that super expression for EGFr is poor prognostic factor in the early stage of cancers (I-II0).

[Immunohistochemical examination oncogenic c-erb-b2, egf-r proteins and antioncogenic p53 protein in vulvar cancers HPV-16 positive and negative]

In vulvar cancers HPV 16 positive, HPV 16 negative, and vulvar and vaginal precancerous status (VIN, VAIN) immunohistochemical technik onko- and antioncogenic proteins were evaluated. The contrary correlation between HPV 16 presence and overexpression p53 were detected. It suggest the heterogenic etiology of these cancers. There was payed attention to high activity of virus replication and intensive virion production in VAIN. Nontreated vaginal lesion may make difficult to obtain a positive cervical HPV infection treatment.

[Biomarkers in primary ovarian cancers and after chemotherapy]

The authors analyzed the expression of oncogen and antioncogen proteins using immunoperoxidase technique with monoclonal antibodies in 49 primary ovarian carcinomas and 38 cancers after chemotherapy (second look) There was not found independent prognostic marker. But some results suggest, that in the individual cases estimate proliferative activity and overexpression P53 may give some information about intensitivity and quality of chemotherapy.

[Androblastoma in a female patient with the signs of virility: a clinical-morphological and genetic study]

We report a case of 24 year old patient with secondary amenorrhea, virilization and elevated serum testosterone concentration, in which cystic-solid tumor in right ovary was found. Surgical treatment was applied--adnexectomy. Histopathologic examination supported suspicion of androblastoma. After treatment regulation of menses and serum testosterone level was obtained.

[Ovarian gonadal tumors in materials of the clinic of gynecological endocrinology of the Medical Academy in Poznań (1970-1998)]

11 patients with ovarian gonadal tumors were treated at Clinic of Endocrinological-Gynecology of Academy of Medicine in Poznań. All presented symptoms of hormonal ovetproduction. In 9 cases we performed adnexectomy, only in 1 case (patient after menopause) hysterectomy with bilateral adnexectomy.

Study on interaction of proteins isolated from epithelial cervical tissue with glucocorticoid-response element of HPV16

Genital HPV16 has tropism to cervical epithelial tissue which is highly steroid hormone dependent. Protein/DNA interaction with the fragment of viral DNA containing the glucocorticoid-response element (GRE/PRE) did not indicate the proteins which can bind to the GRE element in normal epithelial cervical tissue. NFI is one of the cellular factors which can participate in the transcription of viral genes in study tissue.

[Frequency of human papillomavirus-herpes simplex-cytomegalovirus and Chlamydia trachomatis infection in genital tracts of sexual partners]

OBJECTIVES

Much attention is given nowadays to the role of Human Papillomavirus, Herpes simplex virus, Cytomegalovirus, and Chlamydia trachomatis--infections in cervical carcinogenesis. Cytomegalovirus, Herpes simplex and Chlamydia trachomatis are now thought to be teratogenic to humans.

DESIGN

We investigated the prevalence of HPV, HSV, CMV and Chlamydia trachomatis in genital tracts of sexual partners.

MATERIALS AND METHODS

90 sexual partners were qualified for the research. Examination smears were taken with the dacron swab from the vaginal part of the uterine cervix, cervical canal, the lower vagina from women and from fossa navicularis penis in men. In the group of 67 men we have investigated semen as well. HPV, HSV, CMV and Chlamydia trachomatis were identified using PCR (Polymerse Chain Reaction)--method.

RESULTS AND CONCLUSIONS

In 48% of investigated sexual partners we proved the presence of Human Papillomavirus, in 2.2% of women and 2.9% of men--Cytomegalovirus and in 11.1% of women and 14.9% of men--Chlamydia trachomatis. In the investigated biological material we did not find any HSV infection.

[Doppler ultrasonography for detection of pathologic changes in uterine body endometrium]

This study was conducted to evaluate the role of transvaginal color Doppler ultrasonography in detecting endometrial pathology in postmenopausal women A group of 140 women with abnormal postmenopausal bleeding was examined by TVS with color Doppler before D & C. Histopathologic and blood flow characteristics were evaluated. Abnormal blood flow characteristics were evaluated. Abnormal blood flow within endometrium was visualized in 78% cases of cancer. RI and PI values were lowered in hyperplasia and significantly in cancer groups. Transvaginal color Doppler ultrasonography can depict endometrial pathology, even in asymptomatic women.

Lymphocyte subpopulations in the blood of women with HPV 16 positive and negative cervical cancer

In this study the morphologic features and subpopulation of lymphocytes in the blood of women with uterine cervical cancer HPV 16 positive and HPV 16 negative was compared. The essential morphological differentiation in two groups of cancer was not found, but a statistically significant increase in CD 19 lymphocytes in the blood of women with cervical cancer HPV 16 positive was discovered. The authors suggest, that an increase in CD 19 might be connected with stronger expression of virus-oncogenic antigens on the neoplasma cells.

Human papillomavirus (HPV) in upper genital tract carcinomas of women

Using nucleic acid hybridization and polymerase chain reaction (PCR) HPV-DNA sequence was detected in endometrial and ovarian carcinomas. This sequence was amplified with primer specific for E1 region of DNA-HPV 18 and hybridized with DNA-HPV 18. The presence of HPV-DNA in cancer studies suggests that human papillomavirus can also be involved in carcinogenesis of the upper genital tract of women.

[Primary melanoma of the uterine cervix in a 19 year old woman--case report]

Only 5% of all melanocytic malignancies in women originate in the genitalia, the most unusual of which is melanoma involving the uterine cervix.

CASE

a 19 year old woman, presented with abnormal genital bleeding. In our hospital the clinical examination showed an exophytic bleeding tumor growing in the cervix uteri. A first vaginal biopsy showed a sarcoma colli uteri. A new biopsy confirmed the clinical diagnosis of malignant melanoma. Subsequently a Wertheim-Meigs hysterectomy with bilateral adnexectomy and removal of upper half of the vagina and regional lymphadenectomy was performed. Next the patient received several courses of chemotherapy (DTIC).

[Markers of proliferation and morpho-immunologic parameters in evaluation of prognostic factors in endometrial tumors]

There were analysed prognostic factors in endometrial carcinomas. To essential prognostic factors were counted; proportion of cells in S-phase, DNA ploidy, proportion of Ki-67 positive cells and vascular invasion by cancer cells. All above-mentioned factors were not correlated to either the stage or the histopathologic subtype of the cancers. Application of proliferating markers may be useful for selecting a subgroup of patients for adjuvant therapy.

[Human gonadal hilar cells--histogenesis, differentiation, role]

Identification hilar cells in fetus and adult gonads two sex and dysgenetic gonads were based on histochemical and immunohistochemical methods. The hilar cells were detected in 40% of fetus gonads (ovarian testis), two time more in adult and dysgenetic gonads. The attention was put to their connection with nervous system. On the bases of specific markers there was established their mesenchymal origin, ability to response to gonadotropin induction and synthetization steroid hormones, mainly androgens. Hilar cells in dysgenetic gonads and postmenopausal women may be responsible for clinical manifestation of virilisation.

[Uterine papillary serous carcinoma]

Two cases of uterine papillary serous carcinoma are presented. Attention to propensity for deep myometrial invasion, upper abdominal spread and high relapse rate are paid. Patients require combined treatment.

[HPV 16 in lymph nodes of the lesser pelvis in women with cervical cancer]

HPV 16 was detected in cancer tissue, blood and pelvic lymph node of cervical cancer patients. The role of these discovery is discusses.

[Conservative treatment of two young women with cancer and precancerous lesions of the endometrium]

Two women with endometrial cancer and precancerous lesion treated with medroxyprogesterone are presented. In both patients outcome of neoplasm is obtained.

[Partial excision of the anterior uterine wall for placenta accreta]

Rapid accumulation of blood from placental separation site during cesarean delivery for placenta accreta obscures the surgical field and quickly leads to deterioration of the patient's vital signs. In turn, these conditions such as uterine rupture, placenta previa, placenta accreta, increase the risk of hysterectomy, blood transfusions and prolonged hospital stay. We used the following technique in one case of intractable bleeding during cesarean for placenta accreta. Following failure to control the bleeding by suture at the placental separation site via the lower segment cesarean incision, the lower uterine segment with the abnormal adherence of placenta to myometrium, was excised. Our experience suggests that this technique could reduce the use of hysterectomy in cesarean for some cases of placenta accreta.

[Diagnosis and treatment outcome in patients with grade Ia neoplasms of the uterine cervix]

The material collected from 449 women with cervical cancer Ia was carefully studied (359 women with Ia1, and 90 with Ia2). All the methods and results of treatment were presented. 5-years survival after treatment was obtained in 93% of women.

[Ovarian gonadal tumor and reproduction in women]

Seven young patients with ovarian gonadal tumor treated conservative operation are presented. The attention to clinical and pathological difficulties is drown. The treatment advantage these patients at Gynecologic Institute with pathological department is emphasized.

[Small cell carcinoma of the ovary]

Three cases of small cell carcinoma of the ovary are presented. Attention to diagnostic difficulties, extremely aggressive course and low sensitivity to oncologic treatment was paid.

[Usefulness of transvaginal ultrasound and hysteroscopy in diagnosing endometrial hyperplasia and endometrial carcinoma]

Modern methods enabling evaluation of endometrium in all phases of the menstrual cycle were presented. Transvaginal ultrasound does not give characteristic pictures. The most frequently observed sonographic features in endometrial hyperplasia and endometrial carcinoma were compared. Most frequently, in 29% we observed the thickening of the endometrium. The enlargement of the uterine body was detected in 27%. The dominant feature in endometrial carcinoma was distortion or lack of medium-focus echo-90%. Different echogenicity was observed in 69% of all cases. Application of hysteroscopy enables us to visualize changed endometrium and also to sample focal lesions for histopathological examination. Endometrial carcinoma was detected in all analyzed cases with application of hysteroscopy and ultrasound. Pathological endometrial hyperplasia was diagnosed by ultrasound only in 44% and with application of hysteroscopy in 84% of all material.

[Diagnostic and therapeutic procedures in preinvasive disease of the cervix and cervical cancer in pregnancy]

154 pregnant women with dysplasia and cervical carcinoma of the uterus treated in the Institute in years 1953-1990 underwent investigation. We notice that only 50 pathologies were diagnosed in I trimester of pregnancy and 85% constituted precancerous and early forms of carcinoma of the uterine cervix. Authors presented the model of management and care of pregnancy, labour and puerperium in these patients. Due to this procedure we obtained 90% compatibility of preliminary and final diagnosis.

Gonadoblastoma: structures and background of development

Based on earlier studies relative to development and maturation of human gonads, a hypothesis is presented, namely, that the production of "psammoma bodies" in gonadoblastoma, as well as intensification of calcification and hyalinization processes, may be an expression of recapitulation of the involution phase of the indifferent gonad and the terminal phase of proliferating activity in the sex cords of such lesions. It is also suggested that pathologic structures found in the medulla of the ovaries of fetuses and newborn infants favor the development of gonadoblastomas and that the latter are formed as the result of dysfunction of a genetic system controlling gonadal maturation and thus are not "neoplasms."

Evaluation of germ cells development in gonads of human fetuses and newborns

Germ cells development at particular stages of gonad differentiation during the period of fetal intrauterine life were investigated. The study was performed on 101 ovaries obtained from 76 fetuses and neonates. The earliest ovary obtained was from a 12-week old fetus, the oldest one was from a full-term fetus. The examination of germ cells was based on the analysis of the morphology and enzymatic activity. The morphology of the cells was studied by the use of light and electromicroscopy. In germ cells development three forms were distinguished: gonocytes, oogonia and oocytes. Gonocytes were observed in all the ovaries analyzed. They were found mostly among cells covering the gonad. Basing on the difference in their size, shape of nucleus and cytoplasm gonocytes were divided into older ones and younger ones. In the ovaries of fetuses, as early as the 14th week of the intrauterine life, oogonia were observed. Their fairly regular shape, abundance of cytoplasm and large nucleus, often with nucleolus, made their observation possible even in light microscopy. In the cytoplasm of regularly differentiating oogonia organelles were more numerous than in gonocytes. Oocytes constituted a more differentiated form of germ cells. In comparison to the cells surrounding them, they had a larger size, were rounded in shape and had a centrally located nucleus. In the cytoplasm separated into the surrounding space was observed. In a large number of different germ cells signs of degeneration were found. The study has confirmed that irrespective of the duration of pregnancy, all forms of germ cells are present in the fetal ovaries and that the differentiation continues throughout the whole period of intrauterine life.

Histochemistry of hormonally active ovarian tumors

Thirty-five ovarian tumors were examined (7 granulosa-cell tumors, 2 thecomas, 4 dysgerminomas, 6 mucinous cystadenomas, 10 serous cystadenomas, 2 adenocarcinomas, 3 Krukenberg tumors and 1 early embryonic tumor). The granulosa-cell tumors showed high activity of alpha-glycerophosphate dehydrogenase, and the changed cells of their stroma--that of glucose-6 phosphate and isocitrate dehydrogenases. The activity of the latter enzymes was striking also in thecomas. Dysgerminomas showed high alkaline phosphatase, acid phosphatase and nonspecific esterase activities. The authors emphasize the role of stromal cells in the hormonal activity of ovarian neoplasms.