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Saha C, Bojdo J, Dunne NJ, Duary RK, Buckley N, McCarthy HO. Nucleic acid vaccination strategies for ovarian cancer. Front Bioeng Biotechnol 2022; 10:953887. [PMID: 36420446 PMCID: PMC9677957 DOI: 10.3389/fbioe.2022.953887] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/26/2022] [Indexed: 09/19/2023] Open
Abstract
High grade serous carcinoma (HGSC) is one of the most lethal ovarian cancers that is characterised by asymptomatic tumour growth, insufficient knowledge of malignant cell origin and sub-optimal detection. HGSC has been recently shown to originate in the fallopian tube and not in the ovaries. Conventional treatments such as chemotherapy and surgery depend upon the stage of the disease and have resulted in higher rates of relapse. Hence, there is a need for alternative treatments. Differential antigen expression levels have been utilised for early detection of the cancer and could be employed in vaccination strategies using nucleic acids. In this review the different vaccination strategies in Ovarian cancer are discussed and reviewed. Nucleic acid vaccination strategies have been proven to produce a higher CD8+ CTL response alongside CD4+ T-cell response when compared to other vaccination strategies and thus provide a good arena for antitumour immune therapy. DNA and mRNA need to be delivered into the intracellular matrix. To overcome ineffective naked delivery of the nucleic acid cargo, a suitable delivery system is required. This review also considers the suitability of cell penetrating peptides as a tool for nucleic acid vaccine delivery in ovarian cancer.
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Affiliation(s)
- Chayanika Saha
- School of Pharmacy, Queen’s University of Belfast, Belfast, United Kingdom
| | - James Bojdo
- School of Pharmacy, Queen’s University of Belfast, Belfast, United Kingdom
| | - Nicholas J. Dunne
- School of Mechanical and Manufacturing Engineering, Dublin City University, Dublin, Ireland
- Centre for Medical Engineering Research, School of Mechanical and Manufacturing Engineering, Dublin City University, Dublin, Ireland
- Department of Mechanical and Manufacturing Engineering, School of Engineering, Trinity College Dublin, Dublin, Ireland
- Advanced Manufacturing Research Centre (I-Form), School of Mechanical and Manufacturing Engineering, Dublin City University, Dublin, Ireland
- Advanced Materials and Bioengineering Research Centre (AMBER), Royal College of Surgeons in Ireland and Trinity College Dublin, Dublin, Ireland
- Advanced Processing Technology Research Centre, Dublin City University, Dublin, Ireland
- Trinity Centre for Biomedical Engineering, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Raj Kumar Duary
- Department of Food Engineering and Technology, Tezpur University, Tezpur, India
| | - Niamh Buckley
- School of Pharmacy, Queen’s University of Belfast, Belfast, United Kingdom
| | - Helen O. McCarthy
- School of Pharmacy, Queen’s University of Belfast, Belfast, United Kingdom
- School of Chemical Sciences, Dublin City University, Dublin, Ireland
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2
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Santoro A, Travaglino A, Inzani F, Straccia P, Arciuolo D, Valente M, D’Alessandris N, Scaglione G, Angelico G, Piermattei A, Cianfrini F, Raffone A, Zannoni GF. Prognostic Value of Chemotherapy Response Score (CRS) Assessed on the Adnexa in Ovarian High-Grade Serous Carcinoma: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2022; 12:diagnostics12030633. [PMID: 35328186 PMCID: PMC8946962 DOI: 10.3390/diagnostics12030633] [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: 02/13/2022] [Revised: 02/28/2022] [Accepted: 03/02/2022] [Indexed: 02/04/2023] Open
Abstract
Background: chemotherapy response score (CRS) is widely used to assess the response of ovarian high-grade serous carcinoma (HGSC) to chemotherapy and is based on pathological examination of omental specimens. We aimed to assess the prognostic value of CRS assessed on the uterine adnexa. Methods: a systematic review and meta-analysis were performed by searching three electronic databases from 2015 inception to September 2021. We included all studies reporting either hazard ratio (HR) with 95% confidence interval (CI) for progression-free survival (PFS) or primary PFS data, for both adnexal and omental CRS in HGSC. HRs with 95% CI were extracted and pooled by using a significant p-value < 0.05. Statistical heterogeneity was assessed by using Higgins’ I2. Results: six studies with 691 HGSC patients were included. Adnexal CRS3 vs. CRS1-2 significantly stratified PFS, with a HR of 0.572 (0.447−0.733; p < 0.001). Omental CRS3 vs. CRS1-2 significantly stratified PFS with a similar HR (HR = 0.542; 95% CI 0.444−0.662; p < 0.001). Statistical heterogeneity was 0% in both analyses. Conclusions: adnexal CRS significantly stratifies PFS in HGSC and might be used when omental CRS is not assessable.
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Affiliation(s)
- Angela Santoro
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (A.S.); (A.T.); (F.I.); (P.S.); (D.A.); (M.V.); (N.D.); (G.S.); (G.A.); (A.P.); (F.C.)
| | - Antonio Travaglino
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (A.S.); (A.T.); (F.I.); (P.S.); (D.A.); (M.V.); (N.D.); (G.S.); (G.A.); (A.P.); (F.C.)
| | - Frediano Inzani
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (A.S.); (A.T.); (F.I.); (P.S.); (D.A.); (M.V.); (N.D.); (G.S.); (G.A.); (A.P.); (F.C.)
| | - Patrizia Straccia
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (A.S.); (A.T.); (F.I.); (P.S.); (D.A.); (M.V.); (N.D.); (G.S.); (G.A.); (A.P.); (F.C.)
| | - Damiano Arciuolo
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (A.S.); (A.T.); (F.I.); (P.S.); (D.A.); (M.V.); (N.D.); (G.S.); (G.A.); (A.P.); (F.C.)
| | - Michele Valente
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (A.S.); (A.T.); (F.I.); (P.S.); (D.A.); (M.V.); (N.D.); (G.S.); (G.A.); (A.P.); (F.C.)
| | - Nicoletta D’Alessandris
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (A.S.); (A.T.); (F.I.); (P.S.); (D.A.); (M.V.); (N.D.); (G.S.); (G.A.); (A.P.); (F.C.)
| | - Giulia Scaglione
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (A.S.); (A.T.); (F.I.); (P.S.); (D.A.); (M.V.); (N.D.); (G.S.); (G.A.); (A.P.); (F.C.)
| | - Giuseppe Angelico
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (A.S.); (A.T.); (F.I.); (P.S.); (D.A.); (M.V.); (N.D.); (G.S.); (G.A.); (A.P.); (F.C.)
| | - Alessia Piermattei
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (A.S.); (A.T.); (F.I.); (P.S.); (D.A.); (M.V.); (N.D.); (G.S.); (G.A.); (A.P.); (F.C.)
| | - Federica Cianfrini
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (A.S.); (A.T.); (F.I.); (P.S.); (D.A.); (M.V.); (N.D.); (G.S.); (G.A.); (A.P.); (F.C.)
| | - Antonio Raffone
- Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, Italy;
| | - Gian Franco Zannoni
- Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy; (A.S.); (A.T.); (F.I.); (P.S.); (D.A.); (M.V.); (N.D.); (G.S.); (G.A.); (A.P.); (F.C.)
- Istituto di Anatomia Patologica, Università Cattolica del Sacro Cuore, Largo A. Gemelli 8, 00168 Roma, Italy
- Correspondence: ; Tel.: +39-06-30154433
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Papakonstantinou E, Androutsopoulos G, Logotheti S, Adonakis G, Maroulis I, Tzelepi V. DNA Methylation in Epithelial Ovarian Cancer: Current Data and Future Perspectives. Curr Mol Pharmacol 2020; 14:1013-1027. [PMID: 32778046 DOI: 10.2174/1874467213666200810141858] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 08/27/2019] [Revised: 11/10/2019] [Accepted: 02/03/2020] [Indexed: 11/22/2022]
Abstract
Ovarian cancer is an aggressive disease and only a few cases are diagnosed at early stages due to the absence of symptoms. Τhe majority of malignant ovarian tumors (>90%) are of epithelial origin and subdivided in five histological sybtypes with different molecular pathogenesis and clinical behavior. High-grade serous ovarian cancer is the most common subtype (70%), however, the different histotypes of ovarian cancer should be viewed as separate diseases both clinically and in biomarker studies. At present, surgical debulking and platinum/taxane - based chemotherapy is the standard of care for epithelial ovarian cancer. Most patients show initial response to this therapeutic approach, but the majority of them experience disease recurrence at which point cure is no longer possible, due to acquired resistance in those chemotherapeutic regimens. Nevertheless, the current treatment model is still a "one size fits all" approach. Epigenetic modifications represent heritable modifications in gene expression without alteration of the DNA sequence. DNA methylation is the best studied epigenetic mechanism and in epithelial ovarian cancer, the methylenome is widely altered. In addition, patterns of DNA methylation may represent potential diagnostic and prognostic markers as well as markers predictive of chemoresistance and potential therapeutic targets. This article systematically reviews the complicated era of DNA methylation in ovarian carcinoma and summarizes the current implications and future perspectives of its use as a screening, diagnostic, prognostic and predictive tool as well as in personalized cancer therapy.
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Affiliation(s)
| | - Georgios Androutsopoulos
- Department of Obstestrics and Gynecology, School of Medicine, University of Patras, Patras. Greece
| | - Souzana Logotheti
- Department of Pathology, School of Medicine, University of Patras, Patras. Greece
| | - Georgios Adonakis
- Department of Obstestrics and Gynecology, School of Medicine, University of Patras, Patras. Greece
| | - Ioannis Maroulis
- Department of General Surgery, School of Medicine, University of Patras, Patras. Greece
| | - Vassiliki Tzelepi
- Department of Pathology, School of Medicine, University of Patras, Patras. Greece
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Chan AM, Enwere E, McIntyre JB, Wilson H, Nwaroh C, Wiebe N, Ou Y, Liu S, Wiedemeyer K, Rambau PF, Grevers X, Morris DG, Neri P, Gilks CB, Visser F, Le N, Luo L, Cook LS, Köbel M. Combined CCNE1 high-level amplification and overexpression is associated with unfavourable outcome in tubo-ovarian high-grade serous carcinoma. J Pathol Clin Res 2020; 6:252-262. [PMID: 32391646 PMCID: PMC7578325 DOI: 10.1002/cjp2.168] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 01/11/2023]
Abstract
CCNE1 amplification is a recurrent alteration associated with unfavourable outcome in tubo‐ovarian high‐grade serous carcinoma (HGSC). We aimed to investigate whether immunohistochemistry (IHC) can be used to identify CCNE1 amplification status and to validate whether CCNE1 high‐level amplification and overexpression are prognostic in HGSC. A testing set of 528 HGSC samples stained with two optimised IHC assays (clones EP126 and HE12) was subjected to digital image analysis and visual scoring. DNA and RNA chromogenic in situ hybridisation for CCNE1 were performed. IHC cut‐off was determined by receiver operating characteristics (ROC). Survival analyses (endpoint ovarian cancer specific survival) were performed and validated in an independent validation set of 764 HGSC. Finally, combined amplification/expression status was evaluated in cases with complete data (n = 1114). CCNE1 high‐level amplification was present in 11.2% of patients in the testing set and 10.2% in the combined cohort. The optimal cut‐off for IHC to predict CCNE1 high‐level amplification was 60% positive tumour cells with at least 5% strong staining cells (sensitivity 81.6%, specificity 77.4%). CCNE1 high‐level amplification and overexpression were associated with survival in the testing and validation set. Combined CCNE1 high‐level amplification and overexpression was present in 8.3% of patients, mutually exclusive to germline BRCA1/2 mutation and significantly associated with a higher risk of death in multivariate analysis adjusted for age, stage and cohort (hazard ratio = 1.78, 95 CI% 1.38–2.26, p < 0.0001). CCNE1 high‐level amplification combined with overexpression identifies patients with a sufficiently poor prognosis that treatment alternatives are urgently needed. Given that this combination is mutually exclusive to BRCA1/2 germline mutations, a predictive marker for PARP inhibition, CCNE1 high‐level amplification combined with overexpression may serve as a negative predictive test for sensitivity to PARP inhibitors.
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Affiliation(s)
- Angela My Chan
- Precision Oncology Hub, Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Emeka Enwere
- Precision Oncology Hub, Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - John B McIntyre
- Precision Oncology Hub, Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Holly Wilson
- Precision Oncology Hub, Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Chidera Nwaroh
- Precision Oncology Hub, Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Nicholas Wiebe
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Young Ou
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Shuhong Liu
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Katharina Wiedemeyer
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
| | - Peter F Rambau
- Department of Pathology, Catholic University of Health and Allied Sciences-Bugando, Mwanza, Tanzania
| | - Xin Grevers
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services-Cancer Control Alberta, Calgary, AB, Canada
| | - Donald G Morris
- Precision Oncology Hub, Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - Paola Neri
- Precision Oncology Hub, Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, AB, Canada
| | - C Blake Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Frank Visser
- Hotchkiss Brain Institute Molecular Core Facility, Health Research Innovation Centre, University of Calgary, Calgary, AB, Canada
| | - Nhu Le
- Cancer Control Research, BC Cancer Research Centre, Vancouver, BC, Canada
| | - Li Luo
- Division of Epidemiology, Biostatistics and Preventive Medicine, Department of Internal Medicine and UNM Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
| | - Linda S Cook
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services-Cancer Control Alberta, Calgary, AB, Canada.,Division of Epidemiology, Biostatistics and Preventive Medicine, Department of Internal Medicine and UNM Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
| | - Martin Köbel
- Department of Pathology and Laboratory Medicine, University of Calgary, Foothills Medical Center, Calgary, AB, Canada
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Harmankaya İ, Akar S, Uğraş S, Güler AH, Ezveci H, Aydoğdu M, Çelik Ç. Nicotinamide N-methyltransferase overexpression may be associated with poor prognosis in ovarian cancer. J OBSTET GYNAECOL 2020; 41:248-253. [PMID: 32285726 DOI: 10.1080/01443615.2020.1732891] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Ovarian cancer is the fifth leading cause of cancer-related mortality in women. Nicotinamide N-methyltransferase (NNMT) is a metabolic enzyme and there is growing evidence to suggest that it plays an important role in cancer progression. This is the first study to examine the expression of NNMT in serous ovarian cystadenomas, serous borderline tumours, low grade serous carcinomas (LGSC) and high grade serous carcinomas (HGSC) and investigate the potential independent association of NNMT expression with survival. Tissue samples were analysed immunohistochemically for NNMT expression. The stromal NNMT score was significantly higher in HGSC compared to serous cystadenomas and serous borderline tumours (p < .001, p < .043, respectively). The mean stromal NNMT score of patients with HGSC was significantly higher than patients with LGSC (p = .043). Patients with low expression of NNMT had a significantly higher mean recurrence-free survival than patients with high expression (p = .036). NNMT may support tumour progression in ovarian cancer by promoting desmoplastic stromal tumour reaction. NNMT overexpression may be associated with poor prognosis and can be a therapeutic target in ovarian cancer.IMPACT STATEMENTWhat is already known on this subject? Nicotinamide N-methyltransferase (NNMT) is a cytosolic enzyme that is overexpressed in many malignancies. Its overexpression was shown to lead to histone hypomethylation, which in turn can decrease and increase the expression of tumour suppressor proteins and onco-proteins, respectively. NNMT was also shown to play a role in epithelial-to-mesenchymal transition, which is critical in tumour progression and the stromal tumour reaction. The stromal tumour reaction was recently targeted with promising therapeutic results in ovarian cancer.What do the results of this study add? The expression of NNMT in various ovarian neoplasms including serous cystadenomas, borderline tumours and serous carcinomas has not been studied and independently associated with poor survival, previously. This study suggests that NNMT is progressively overexpressed in the stroma of ovarian neoplasms from benign cysts to HGSCs. NNMT overexpression appears to be independently associated with poor survival in ovarian cancer.What are the implications of these findings for clinical practice and/or further research? The implications of these findings are that NNMT may play an important role in the stromal tumour reaction, and therefore its overexpression may contribute to poor survival. NNMT overexpression may be an important target of ovarian cancer therapy.
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Affiliation(s)
- İsmail Harmankaya
- Department of Pathology, Selcuk University Medical School, Konya, Turkey
| | - Serra Akar
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Selcuk University Medical School, Konya, Turkey
| | - Serdar Uğraş
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Selcuk University Medical School, Konya, Turkey
| | - Abdül Hamid Güler
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Selcuk University Medical School, Konya, Turkey
| | - Huriye Ezveci
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Selcuk University Medical School, Konya, Turkey
| | - Meltem Aydoğdu
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Selcuk University Medical School, Konya, Turkey
| | - Çetin Çelik
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Selcuk University Medical School, Konya, Turkey
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Abstract
Ovarian borderline serous tumors present with peritoneal involvement in 20% of cases, either as non-invasive or invasive implants, the latter also known as extraovarian low-grade serous carcinoma. The coexistence of high-grade serous carcinoma is rare, suggesting a synchronous neoplasia with a distinct and independent tumor biology and behavior. We aim to describe a case of a synchronous ovary-peritoneum neoplasia: serous borderline tumor and primary peritoneal high-grade serous carcinoma. A discussion and literature review concerning the optimal diagnostic and therapeutic approach is provided.
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Affiliation(s)
- Mariana Rei
- Department of Obstetrics and Gynecology, Centro Hospitalar Universitário São João, Porto, Porto, 4200-319, Portugal.,Unit of Obstetrics and Gynecology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Sofia Raposo
- Department of Gynecology, Instituto Português de Oncologia Francisco Gentil de Coimbra, Coimbra, Portugal
| | - Paulo Figueiredo
- Department of Pathology, Instituto Português de Oncologia Francisco Gentil de Coimbra, Coimbra, Portugal
| | - Rita Sousa
- Department of Gynecology, Instituto Português de Oncologia Francisco Gentil de Coimbra, Coimbra, Portugal
| | - Luís Sá
- Department of Gynecology, Instituto Português de Oncologia Francisco Gentil de Coimbra, Coimbra, Portugal
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7
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Soong TR, Kolin DL, Teschan NJ, Crum CP. Back to the Future? The Fallopian Tube, Precursor Escape and a Dualistic Model of High-Grade Serous Carcinogenesis. Cancers (Basel) 2018; 10:cancers10120468. [PMID: 30486509 PMCID: PMC6316244 DOI: 10.3390/cancers10120468] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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: 10/17/2018] [Revised: 11/16/2018] [Accepted: 11/21/2018] [Indexed: 01/06/2023] Open
Abstract
Beginning with the discovery of the BRCA-associated ovarian cancer susceptibility genes and subsequent detailed examination of risk-reducing salpingo-oophorectomy (RRSO) specimens, a new paradigm of ovarian carcinogenesis has unfolded with attention to the distal fallopian tube. The primary focus has been an early cancer or neoplasm in the fallopian tube which is seen in virtually all incidentally discovered high-grade serous cancers in asymptomatic women. This high-frequency of tubal involvement in early serous neoplasm (usually in the form of serous tubal intraepithelial carcinoma—STIC) has galvanized attention to this organ as a primary source of this disease. However, an enduring mystery has been the relatively low frequency of STIC in the fallopian tubes of women with advanced malignancy. This paradox, a high frequency of tubal involvement early on and a low frequency of involvement later in the disease process, has spurred interest in other potential sources, such as the ovarian surface epithelium or cortical inclusions and the secondary Mullerian system. However, because essentially all high-grade serous carcinomas are linked by TP53 mutations, and because fallopian tubes frequently contain early serous proliferations (ESPs) with these mutations, attention has turned to the possibility that the nonmalignant but TP53 mutated tubal epithelium could be responsible for an eventual malignancy. Recent data have shown evidence of a lineage continuity between ESPs and concurrent serous carcinomas prompting the concept of “precursor escape”. This creates a second component of the paradigm by which cells from early precursors are shed from the tube and undergo subsequent malignant transformation, emerging suddenly as widespread intraperitoneal malignancy. This dualistic model thus provides a unique pathway by which the future outcome (wide spread high-grade serous carcinomas—HGSC) is ultimately explained by going back in time to an early serous proliferation. This paradigm also brings the peritoneal cavity into focus, raising new questions about the potential co-variables or exposures that might facilitate the occasional malignant transformation of an ESP in the peritoneal cavity or on the peritoneal surface.
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Affiliation(s)
- T Rinda Soong
- Department of Pathology, University of Washington Medical Center, Seattle, WA 98195, USA.
| | - David L Kolin
- Department of Pathology, Division of Women's and Perinatal Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA.
| | - Nathan J Teschan
- Department of Pathology, Division of Women's and Perinatal Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA.
| | - Christopher P Crum
- Department of Pathology, Division of Women's and Perinatal Pathology, Brigham and Women's Hospital, Boston, MA 02115, USA.
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8
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Ramanayake N, Russell P, Yang V. High grade serous intraepithelial carcinoma arising in a benign ovarian serous cyst - a bridge too far? Pathology 2018; 50:485-489. [PMID: 29960723 DOI: 10.1016/j.pathol.2018.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 03/02/2018] [Accepted: 03/07/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Nimeka Ramanayake
- GynaePath, Douglass Hanly Moir Pathology, Macquarie Park, NSW, Australia
| | - Peter Russell
- GynaePath, Douglass Hanly Moir Pathology, Macquarie Park, NSW, Australia; Department of Obstetrics, Gynaecology and Neonatology, University of Sydney, Sydney, NSW, Australia.
| | - Vivian Yang
- Private Clinical Practice, Sydney, NSW, Australia
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9
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Goranova T, Ennis D, Piskorz AM, Macintyre G, Lewsley LA, Stobo J, Wilson C, Kay D, Glasspool RM, Lockley M, Brockbank E, Montes A, Walther A, Sundar S, Edmondson R, Hall GD, Clamp A, Gourley C, Hall M, Fotopoulou C, Gabra H, Freeman S, Moore L, Jimenez-Linan M, Paul J, Brenton JD, McNeish IA. Safety and utility of image-guided research biopsies in relapsed high-grade serous ovarian carcinoma-experience of the BriTROC consortium. Br J Cancer 2017; 116:1294-1301. [PMID: 28359078 PMCID: PMC5482731 DOI: 10.1038/bjc.2017.86] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 01/19/2017] [Revised: 02/28/2017] [Accepted: 03/03/2017] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Investigating tumour evolution and acquired chemotherapy resistance requires analysis of sequential tumour material. We describe the feasibility of obtaining research biopsies in women with relapsed ovarian high-grade serous carcinoma (HGSC). METHODS Women with relapsed ovarian HGSC underwent either image-guided biopsy or intra-operative biopsy during secondary debulking, and samples were fixed in methanol-based fixative. Tagged-amplicon sequencing was performed on biopsy DNA. RESULTS We screened 519 patients in order to enrol 220. Two hundred and two patients underwent successful biopsy, 118 of which were image-guided. There were 22 study-related adverse events (AE) in the image-guided biopsies, all grades 1 and 2; pain was the commonest AE. There were pre-specified significant AE in 3/118 biopsies (2.5%). 87% biopsies were fit-for-purpose for genomic analyses. Median DNA yield was 2.87 μg, and was higher in biopsies utilising 14 G or 16 G needles compared to 18 G. TP53 mutations were identified in 94.4% patients. CONCLUSIONS Obtaining tumour biopsies for research in relapsed HGSC is safe and feasible. Adverse events are rare. The large majority of biopsies yield sufficient DNA for genomic analyses-we recommend use of larger gauge needles and methanol fixation for such biopsies, as DNA yields are higher but with no increase in AEs.
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Affiliation(s)
- T Goranova
- Cancer Research UK Cambridge Institute, Cambridge CB2 0RE, UK
| | - D Ennis
- Institute of Cancer Sciences, University of Glasgow, G61 1QH, UK
| | - A M Piskorz
- Cancer Research UK Cambridge Institute, Cambridge CB2 0RE, UK
| | - G Macintyre
- Cancer Research UK Cambridge Institute, Cambridge CB2 0RE, UK
| | - L A Lewsley
- Cancer Research UK Clinical Trials Unit, Glasgow G12 0YN, UK
| | - J Stobo
- Cancer Research UK Clinical Trials Unit, Glasgow G12 0YN, UK
| | - C Wilson
- Cancer Research UK Clinical Trials Unit, Glasgow G12 0YN, UK
| | - D Kay
- Department of Radiology, Gartnavel General Hospital, Glasgow G12 0YN, UK
| | - R M Glasspool
- Beatson West of Scotland Cancer Centre, Glasgow G12 0YN, UK
| | - M Lockley
- Barts Cancer Institute, London EC1M 6BQ, UK
- University College Hospital, London WC1E 6BD, UK
| | | | - A Montes
- Guy’s Hospital, London SE1 9RT, UK
| | - A Walther
- Bristol Haematology and Oncology Centre, Bristol BS2 8ED, UK
| | - S Sundar
- City Hospital, Birmingham B18 7QH, UK
| | | | - G D Hall
- St James Hospital, Leeds LS9 7TF, UK
| | - A Clamp
- The Christie Hospital, Manchester M20 4BX, UK
| | - C Gourley
- Edinburgh Cancer Research Centre, Edinburgh EH4 2XR, UK
| | - M Hall
- Mount Vernon Cancer Centre, Northwood HA6 2RN, UK
| | | | - H Gabra
- Imperial College, London W12 0HS, UK
| | - S Freeman
- Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK
| | - L Moore
- Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK
| | | | - J Paul
- Cancer Research UK Clinical Trials Unit, Glasgow G12 0YN, UK
| | - J D Brenton
- Cancer Research UK Cambridge Institute, Cambridge CB2 0RE, UK
- Addenbrooke’s Hospital, Cambridge CB2 0QQ, UK
| | - I A McNeish
- Institute of Cancer Sciences, University of Glasgow, G61 1QH, UK
- Beatson West of Scotland Cancer Centre, Glasgow G12 0YN, UK
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10
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Darb-Esfahani S, Kunze CA, Kulbe H, Sehouli J, Wienert S, Lindner J, Budczies J, Bockmayr M, Dietel M, Denkert C. Prognostic impact of programmed cell death-1 (PD-1) and PD-ligand 1 (PD-L1) expression in cancer cells and tumor-infiltrating lymphocytes in ovarian high grade serous carcinoma. Oncotarget. 2016;7:1486-1499. [PMID: 26625204 PMCID: PMC4811475 DOI: 10.18632/oncotarget.6429] [Citation(s) in RCA: 201] [Impact Index Per Article: 25.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 11/15/2015] [Indexed: 12/12/2022] Open
Abstract
Aims Antibodies targeting the checkpoint molecules programmed cell death 1 (PD-1) and its ligand PD-L1 are emerging cancer therapeutics. We systematically investigated PD-1 and PD-L1 expression patterns in the poor-prognosis tumor entity high-grade serous ovarian carcinoma. Methods PD-1 and PD-L1 protein expression was determined by immunohistochemistry on tissue microarrays from 215 primary cancers both in cancer cells and in tumor-infiltrating lymphocytes (TILs). mRNA expression was measured by quantitative reverse transcription PCR. An in silico validation of mRNA data was performed in The Cancer Genome Atlas (TCGA) dataset. Results PD-1 and PD-L1 expression in cancer cells, CD3+, PD-1+, and PD-L1+ TILs densities as well as PD-1 and PD-L1 mRNA levels were positive prognostic factors for progression-free (PFS) and overall survival (OS), with all factors being significant for PFS (p < 0.035 each), and most being significant for OS. Most factors also had prognostic value that was independent from age, stage, and residual tumor. Moreover, high PD-1+ TILs as well as PD-L1+ TILs densities added prognostic value to CD3+TILs (PD-1+: p = 0.002,; PD-L1+: p = 0.002). The significant positive prognostic impact of PD-1 and PD-L1 mRNA expression could be reproduced in the TCGA gene expression datasets (p = 0.02 and p < 0.0001, respectively). Conclusions Despite their reported immune-modulatory function, high PD-1 and PD-L1 levels are indicators of a favorable prognosis in ovarian cancer. Our data indicate that PD-1 and PD-L1 molecules are biologically relevant regulators of the immune response in high-grade serous ovarian carcinoma, which is an argument for the evaluation of immune checkpoint inhibiting drugs in this tumor entity.
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11
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Li HX, Lu ZH, Shen K, Cheng WJ, Malpica A, Zhang J, Wei JJ, Zhang ZH, Liu J. Advances in serous tubal intraepithelial carcinoma: correlation with high grade serous carcinoma and ovarian carcinogenesis. Int J Clin Exp Pathol 2014; 7:848-57. [PMID: 24696706 PMCID: PMC3971287] [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] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 12/29/2013] [Accepted: 01/23/2014] [Indexed: 06/03/2023]
Abstract
Early serous carcinoma in fallopian tube or serous tubal intraepithelial carcinoma (STIC), an early lesion limited to the epithelium of the fallopian tube and firstly identified from specimen obtained by prophylactic salpingo-oophorectomy, has provided insight into pelvic high grade serous carcinoma (HGSC). Increasing evidence indicates that STIC is a likely precursor for HGSC and several studies have focused on this lesion and its clinical significance. This review addresses recent advances in recognizing STIC and its correlation with HGSC and ovarian carcinogenesis. It also describes evidence regarding the fallopian tube as a source of some HGSCs, the protocol for optimizing histological evaluation of the tubes, the spectrum of tubal lesions from benign to noninvasive carcinoma, changes in diagnostic criteria from purely morphologic characteristics to a combination of morphologic features and molecular biomarkers, and new studies about potential biomarkers. However, the direct evidence regarding STIC as the precursor of HGSC is still tantalizing due to other possibilities that may also explain the origin of pelvic HGSC. Further molecular genetic studies are required to address this important question.
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Affiliation(s)
- Hong-Xia Li
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical UniversityNanjing, Jiangsu, P. R. China
- Department of Pathology, The University of Texas MD Anderson Cancer CenterHouston, TX, USA
| | - Zhao-Hui Lu
- Department of Pathology, The University of Texas MD Anderson Cancer CenterHouston, TX, USA
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing, P. R. China
| | - Keng Shen
- Department of Obstetric and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing, P. R. China
| | - Wen-Jun Cheng
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Nanjing Medical UniversityNanjing, Jiangsu, P. R. China
| | - Anais Malpica
- Department of Pathology, The University of Texas MD Anderson Cancer CenterHouston, TX, USA
| | - Jing Zhang
- Department of Pathology, Forth Military Medical UniversityXi’an, Shanaxi, P. R. China
| | - Jian-Jun Wei
- Department of Pathology, Feinberg School of Medicine, Northwestern UniversityChicago, IL, USA
| | - Zhi-Hong Zhang
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical UniversityNanjing, Jiangsu, P. R. China
| | - Jinsong Liu
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical UniversityNanjing, Jiangsu, P. R. China
- Department of Pathology, The University of Texas MD Anderson Cancer CenterHouston, TX, USA
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12
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Zheng J, Mercado-Uribe I, Rosen DG, Chang B, Liu P, Yang G, Malpica A, Naora H, Auersperg N, Mills GB, Bast RC, Liu J. Induction of papillary carcinoma in human ovarian surface epithelial cells using combined genetic elements and peritoneal microenvironment. Cell Cycle 2010; 9:140-6. [PMID: 20016289 PMCID: PMC2931318 DOI: 10.4161/cc.9.1.10264] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Papillary differentiation is one of the most common histological features of ovarian cancer, although the underlying mechanism that leads to such differentiation is not known. We hypothesized that human ovarian surface epithelial cells can be transformed into carcinoma with papillary differentiation by overexpressing HER2/neu in these cells. Mice were injected either subcutaneously or intraperitoneally with two immortalized human ovarian surface epithelial cell lines after enforced expression of HER-2/neu. Mice subcutaneously injected with tumor cells from either the T29Nt or T80Nt developed undifferentiated carcinomas. In contrast, mice injected intraperitoneally with T29Nt cells developed papillary carcinoma, and those injected intraperitoneally with T80Nt cells developed undifferentiated carcinoma. Our results demonstrate that ovarian surface epithelial cells can develop into papillary carcinoma in mice, and that the induction of papillary differentiation depends not only on specific genetic modifications but also on the tumor microenvironment and epithelial cell type from ovary from different patients.
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Affiliation(s)
- Jingfang Zheng
- Department of Pathology, The University of Texas MD Anderson Cancer Center; Houston, TX USA
- Department of Obstetric and Gynecology; Shandong University; Qilu Hospital; Jinan, Shandong China
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center; Houston, TX USA
| | - Imelda Mercado-Uribe
- Department of Pathology, The University of Texas MD Anderson Cancer Center; Houston, TX USA
| | - Daniel G. Rosen
- Department of Pathology, The University of Texas MD Anderson Cancer Center; Houston, TX USA
| | - Bin Chang
- Department of Pathology, The University of Texas MD Anderson Cancer Center; Houston, TX USA
| | - Peishu Liu
- Department of Obstetric and Gynecology; Shandong University; Qilu Hospital; Jinan, Shandong China
| | - Gong Yang
- Department of Pathology, The University of Texas MD Anderson Cancer Center; Houston, TX USA
| | - Anais Malpica
- Department of Pathology, The University of Texas MD Anderson Cancer Center; Houston, TX USA
| | - Honami Naora
- Department of Systems Biology, The University of Texas MD Anderson Cancer Center; Houston, TX USA
| | - Nelly Auersperg
- Department of Obstetrics and Gynecology; University of British Columbia; Vancouver, BC Canada
| | - Gordon B. Mills
- Department of Systems Biology, The University of Texas MD Anderson Cancer Center; Houston, TX USA
| | - Robert C. Bast
- Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center; Houston, TX USA
| | - Jinsong Liu
- Department of Pathology, The University of Texas MD Anderson Cancer Center; Houston, TX USA
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