CLINICAL DIAGNOSIS AND TREATMENT OF SMALL OVARIAN TUMOR IN POSTMENOPAUSAL WOMEN

Objective： To investigate the clinical symptom, ultrasonographic scan finding, serum CA125 value, histopathological type and treatment of small ovarian tumor （〈5 cm） in postmenopausal women. Methods： Retrospective analysis was carried out for 52 clinical materials of ovarian tumor cases in women more than one year after menopausal between Jan 1997 and Dec 2004. The largest diameter of the ovarian mass is less than 5 cm. Results： There were 11 ovarian cancers and 1 borderline ovarian tumor among 52 small ovarian tumors （23.1%）. 10 ovarian cancers were epithelial neoplasms and 2 were sex cord-stromal tumors, and 8 cases were in late stage according to FIGO staging system （33.3%）. Compared with benign tumor, there is no significant difference in the onset age, interval after menopausal and duration of history. The main clinical feature is abdominal symptoms, such as abdominal pain and distension in the malignant cases. The patients with benign tumors often showed the ovarian mass during the annual screening or admitted into hospital for other causes. The ultrasonography finding and serum CA125 level showed much difference between benign and malignant cases. Unilocular smooth-walled ovarian cysts mostly were found in benign tumor and the CA125 values were always less than 35 U/ml; but the solid or complex sonographic structures （multilocular, or with a papillary projections on the wall） often indicated a high risk of cancer, especially there was ascites in the pelvic cavity. Serum CA125 level in many cancer cases was elevated （〉35 U/ml）, over 300 U/ml in more than half of the patients. Surgery is still the first choice to treat ovarian cancer, and chemotherapy would be an auxiliary method. Till now, 3 ovarian cancer patients died of complications of cancer and 2 cases had recurrence. Conclusion： Small ovarian tumor in postmenopausal women has a comparatively low malignant occurrence but more in later stage. Many are epithelial carcinoma. If there is complex or parenchymal sonographic structure accompanied with a high serum CA125 level, operation should be considered, while it can be followed up when the ultrasound shows a smooth cyst with normal CA125 value.     

人组织型激肽释放酶6在卵巢上皮性肿瘤中的表达及其与临床病理特征和预后的关系

Objective To approach the relationship between the expression of hK6 in ovarian neoplasm and clinicopathological variables and prognosis in ovarian cancer patients for finding a new tumor marker of the ovarian cancer. Methods The expression of hK6 was detected by immunohistochemistry in 19 cases of benign, 11 cases of borderline and 45 cases of malignant ovarian neoplasms and statistically analyzed whether its expression correlate with clinicopathological variables and prognosis in patients with ovarian cancer. Results The expression of hK6 in ovarian cancer tissues (60.0%) was significantly higher than that in the benign (15.8%) and borderline (27.3%) ovarian neoplasm tissues (P < 0.01). The expression of hK6 in higher-grade ovarian cancer tissues (68.4%) was higher than that in low-grade ones (14.3%, P<0.05). The expression of hK6 in late-stage (stage Ⅲ ,76.7%) was significantly higher than that in early-stage (stage Ⅰ or Ⅱ ,26.7%, P < 0.01). The expression of hK6 was significantly higher in patients with lymph node metastasis (77.8%) than that in patients without (33.3% ,P<0.01). The expression of hK6 in the cancer tissues in the patients died, or with reeeurence or metastasis within 3 years after surgery was higher (75.0%) than that in the patients with stable disease (42.9%, P < 0. 05). Conclusion The expression of hK6 in ovarian cancer was higher than that in benign and borderline ovarian neoplasms. The expression of hK6 is higher in the ovarian cancer of late stage, higher-grade, with lymph node metastasis and is associated with a poorer prognosis, hK6 may become a new markers in prediction of prognosis of the patients with ovarian tumors.     

人组织型激肽释放酶6在卵巢上皮性肿瘤中的表达及其与临床病理特征和预后的关系

Objective To approach the relationship between the expression of hK6 in ovarian neoplasm and clinicopathological variables and prognosis in ovarian cancer patients for finding a new tumor marker of the ovarian cancer. Methods The expression of hK6 was detected by immunohistochemistry in 19 cases of benign, 11 cases of borderline and 45 cases of malignant ovarian neoplasms and statistically analyzed whether its expression correlate with clinicopathological variables and prognosis in patients with ovarian cancer. Results The expression of hK6 in ovarian cancer tissues (60.0%) was significantly higher than that in the benign (15.8%) and borderline (27.3%) ovarian neoplasm tissues (P < 0.01). The expression of hK6 in higher-grade ovarian cancer tissues (68.4%) was higher than that in low-grade ones (14.3%, P<0.05). The expression of hK6 in late-stage (stage Ⅲ ,76.7%) was significantly higher than that in early-stage (stage Ⅰ or Ⅱ ,26.7%, P < 0.01). The expression of hK6 was significantly higher in patients with lymph node metastasis (77.8%) than that in patients without (33.3% ,P<0.01). The expression of hK6 in the cancer tissues in the patients died, or with reeeurence or metastasis within 3 years after surgery was higher (75.0%) than that in the patients with stable disease (42.9%, P < 0. 05). Conclusion The expression of hK6 in ovarian cancer was higher than that in benign and borderline ovarian neoplasms. The expression of hK6 is higher in the ovarian cancer of late stage, higher-grade, with lymph node metastasis and is associated with a poorer prognosis, hK6 may become a new markers in prediction of prognosis of the patients with ovarian tumors.     

人组织型激肽释放酶6在卵巢上皮性肿瘤中的表达及其与临床病理特征和预后的关系

Objective To approach the relationship between the expression of hK6 in ovarian neoplasm and clinicopathological variables and prognosis in ovarian cancer patients for finding a new tumor marker of the ovarian cancer. Methods The expression of hK6 was detected by immunohistochemistry in 19 cases of benign, 11 cases of borderline and 45 cases of malignant ovarian neoplasms and statistically analyzed whether its expression correlate with clinicopathological variables and prognosis in patients with ovarian cancer. Results The expression of hK6 in ovarian cancer tissues (60.0%) was significantly higher than that in the benign (15.8%) and borderline (27.3%) ovarian neoplasm tissues (P < 0.01). The expression of hK6 in higher-grade ovarian cancer tissues (68.4%) was higher than that in low-grade ones (14.3%, P<0.05). The expression of hK6 in late-stage (stage Ⅲ ,76.7%) was significantly higher than that in early-stage (stage Ⅰ or Ⅱ ,26.7%, P < 0.01). The expression of hK6 was significantly higher in patients with lymph node metastasis (77.8%) than that in patients without (33.3% ,P<0.01). The expression of hK6 in the cancer tissues in the patients died, or with reeeurence or metastasis within 3 years after surgery was higher (75.0%) than that in the patients with stable disease (42.9%, P < 0. 05). Conclusion The expression of hK6 in ovarian cancer was higher than that in benign and borderline ovarian neoplasms. The expression of hK6 is higher in the ovarian cancer of late stage, higher-grade, with lymph node metastasis and is associated with a poorer prognosis, hK6 may become a new markers in prediction of prognosis of the patients with ovarian tumors.     

人组织型激肽释放酶6在卵巢上皮性肿瘤中的表达及其与临床病理特征和预后的关系

Objective To approach the relationship between the expression of hK6 in ovarian neoplasm and clinicopathological variables and prognosis in ovarian cancer patients for finding a new tumor marker of the ovarian cancer. Methods The expression of hK6 was detected by immunohistochemistry in 19 cases of benign, 11 cases of borderline and 45 cases of malignant ovarian neoplasms and statistically analyzed whether its expression correlate with clinicopathological variables and prognosis in patients with ovarian cancer. Results The expression of hK6 in ovarian cancer tissues (60.0%) was significantly higher than that in the benign (15.8%) and borderline (27.3%) ovarian neoplasm tissues (P < 0.01). The expression of hK6 in higher-grade ovarian cancer tissues (68.4%) was higher than that in low-grade ones (14.3%, P<0.05). The expression of hK6 in late-stage (stage Ⅲ ,76.7%) was significantly higher than that in early-stage (stage Ⅰ or Ⅱ ,26.7%, P < 0.01). The expression of hK6 was significantly higher in patients with lymph node metastasis (77.8%) than that in patients without (33.3% ,P<0.01). The expression of hK6 in the cancer tissues in the patients died, or with reeeurence or metastasis within 3 years after surgery was higher (75.0%) than that in the patients with stable disease (42.9%, P < 0. 05). Conclusion The expression of hK6 in ovarian cancer was higher than that in benign and borderline ovarian neoplasms. The expression of hK6 is higher in the ovarian cancer of late stage, higher-grade, with lymph node metastasis and is associated with a poorer prognosis, hK6 may become a new markers in prediction of prognosis of the patients with ovarian tumors.     

人组织型激肽释放酶6在卵巢上皮性肿瘤中的表达及其与临床病理特征和预后的关系

Objective To approach the relationship between the expression of hK6 in ovarian neoplasm and clinicopathological variables and prognosis in ovarian cancer patients for finding a new tumor marker of the ovarian cancer. Methods The expression of hK6 was detected by immunohistochemistry in 19 cases of benign, 11 cases of borderline and 45 cases of malignant ovarian neoplasms and statistically analyzed whether its expression correlate with clinicopathological variables and prognosis in patients with ovarian cancer. Results The expression of hK6 in ovarian cancer tissues (60.0%) was significantly higher than that in the benign (15.8%) and borderline (27.3%) ovarian neoplasm tissues (P < 0.01). The expression of hK6 in higher-grade ovarian cancer tissues (68.4%) was higher than that in low-grade ones (14.3%, P<0.05). The expression of hK6 in late-stage (stage Ⅲ ,76.7%) was significantly higher than that in early-stage (stage Ⅰ or Ⅱ ,26.7%, P < 0.01). The expression of hK6 was significantly higher in patients with lymph node metastasis (77.8%) than that in patients without (33.3% ,P<0.01). The expression of hK6 in the cancer tissues in the patients died, or with reeeurence or metastasis within 3 years after surgery was higher (75.0%) than that in the patients with stable disease (42.9%, P < 0. 05). Conclusion The expression of hK6 in ovarian cancer was higher than that in benign and borderline ovarian neoplasms. The expression of hK6 is higher in the ovarian cancer of late stage, higher-grade, with lymph node metastasis and is associated with a poorer prognosis, hK6 may become a new markers in prediction of prognosis of the patients with ovarian tumors.     

人组织型激肽释放酶6在卵巢上皮性肿瘤中的表达及其与临床病理特征和预后的关系

Objective To approach the relationship between the expression of hK6 in ovarian neoplasm and clinicopathological variables and prognosis in ovarian cancer patients for finding a new tumor marker of the ovarian cancer. Methods The expression of hK6 was detected by immunohistochemistry in 19 cases of benign, 11 cases of borderline and 45 cases of malignant ovarian neoplasms and statistically analyzed whether its expression correlate with clinicopathological variables and prognosis in patients with ovarian cancer. Results The expression of hK6 in ovarian cancer tissues (60.0%) was significantly higher than that in the benign (15.8%) and borderline (27.3%) ovarian neoplasm tissues (P < 0.01). The expression of hK6 in higher-grade ovarian cancer tissues (68.4%) was higher than that in low-grade ones (14.3%, P<0.05). The expression of hK6 in late-stage (stage Ⅲ ,76.7%) was significantly higher than that in early-stage (stage Ⅰ or Ⅱ ,26.7%, P < 0.01). The expression of hK6 was significantly higher in patients with lymph node metastasis (77.8%) than that in patients without (33.3% ,P<0.01). The expression of hK6 in the cancer tissues in the patients died, or with reeeurence or metastasis within 3 years after surgery was higher (75.0%) than that in the patients with stable disease (42.9%, P < 0. 05). Conclusion The expression of hK6 in ovarian cancer was higher than that in benign and borderline ovarian neoplasms. The expression of hK6 is higher in the ovarian cancer of late stage, higher-grade, with lymph node metastasis and is associated with a poorer prognosis, hK6 may become a new markers in prediction of prognosis of the patients with ovarian tumors.     

人组织型激肽释放酶6在卵巢上皮性肿瘤中的表达及其与临床病理特征和预后的关系

Objective To approach the relationship between the expression of hK6 in ovarian neoplasm and clinicopathological variables and prognosis in ovarian cancer patients for finding a new tumor marker of the ovarian cancer. Methods The expression of hK6 was detected by immunohistochemistry in 19 cases of benign, 11 cases of borderline and 45 cases of malignant ovarian neoplasms and statistically analyzed whether its expression correlate with clinicopathological variables and prognosis in patients with ovarian cancer. Results The expression of hK6 in ovarian cancer tissues (60.0%) was significantly higher than that in the benign (15.8%) and borderline (27.3%) ovarian neoplasm tissues (P < 0.01). The expression of hK6 in higher-grade ovarian cancer tissues (68.4%) was higher than that in low-grade ones (14.3%, P<0.05). The expression of hK6 in late-stage (stage Ⅲ ,76.7%) was significantly higher than that in early-stage (stage Ⅰ or Ⅱ ,26.7%, P < 0.01). The expression of hK6 was significantly higher in patients with lymph node metastasis (77.8%) than that in patients without (33.3% ,P<0.01). The expression of hK6 in the cancer tissues in the patients died, or with reeeurence or metastasis within 3 years after surgery was higher (75.0%) than that in the patients with stable disease (42.9%, P < 0. 05). Conclusion The expression of hK6 in ovarian cancer was higher than that in benign and borderline ovarian neoplasms. The expression of hK6 is higher in the ovarian cancer of late stage, higher-grade, with lymph node metastasis and is associated with a poorer prognosis, hK6 may become a new markers in prediction of prognosis of the patients with ovarian tumors.     

人组织型激肽释放酶6在卵巢上皮性肿瘤中的表达及其与临床病理特征和预后的关系

Objective To approach the relationship between the expression of hK6 in ovarian neoplasm and clinicopathological variables and prognosis in ovarian cancer patients for finding a new tumor marker of the ovarian cancer. Methods The expression of hK6 was detected by immunohistochemistry in 19 cases of benign, 11 cases of borderline and 45 cases of malignant ovarian neoplasms and statistically analyzed whether its expression correlate with clinicopathological variables and prognosis in patients with ovarian cancer. Results The expression of hK6 in ovarian cancer tissues (60.0%) was significantly higher than that in the benign (15.8%) and borderline (27.3%) ovarian neoplasm tissues (P < 0.01). The expression of hK6 in higher-grade ovarian cancer tissues (68.4%) was higher than that in low-grade ones (14.3%, P<0.05). The expression of hK6 in late-stage (stage Ⅲ ,76.7%) was significantly higher than that in early-stage (stage Ⅰ or Ⅱ ,26.7%, P < 0.01). The expression of hK6 was significantly higher in patients with lymph node metastasis (77.8%) than that in patients without (33.3% ,P<0.01). The expression of hK6 in the cancer tissues in the patients died, or with reeeurence or metastasis within 3 years after surgery was higher (75.0%) than that in the patients with stable disease (42.9%, P < 0. 05). Conclusion The expression of hK6 in ovarian cancer was higher than that in benign and borderline ovarian neoplasms. The expression of hK6 is higher in the ovarian cancer of late stage, higher-grade, with lymph node metastasis and is associated with a poorer prognosis, hK6 may become a new markers in prediction of prognosis of the patients with ovarian tumors.     

人组织型激肽释放酶6在卵巢上皮性肿瘤中的表达及其与临床病理特征和预后的关系

Objective To approach the relationship between the expression of hK6 in ovarian neoplasm and clinicopathological variables and prognosis in ovarian cancer patients for finding a new tumor marker of the ovarian cancer. Methods The expression of hK6 was detected by immunohistochemistry in 19 cases of benign, 11 cases of borderline and 45 cases of malignant ovarian neoplasms and statistically analyzed whether its expression correlate with clinicopathological variables and prognosis in patients with ovarian cancer. Results The expression of hK6 in ovarian cancer tissues (60.0%) was significantly higher than that in the benign (15.8%) and borderline (27.3%) ovarian neoplasm tissues (P < 0.01). The expression of hK6 in higher-grade ovarian cancer tissues (68.4%) was higher than that in low-grade ones (14.3%, P<0.05). The expression of hK6 in late-stage (stage Ⅲ ,76.7%) was significantly higher than that in early-stage (stage Ⅰ or Ⅱ ,26.7%, P < 0.01). The expression of hK6 was significantly higher in patients with lymph node metastasis (77.8%) than that in patients without (33.3% ,P<0.01). The expression of hK6 in the cancer tissues in the patients died, or with reeeurence or metastasis within 3 years after surgery was higher (75.0%) than that in the patients with stable disease (42.9%, P < 0. 05). Conclusion The expression of hK6 in ovarian cancer was higher than that in benign and borderline ovarian neoplasms. The expression of hK6 is higher in the ovarian cancer of late stage, higher-grade, with lymph node metastasis and is associated with a poorer prognosis, hK6 may become a new markers in prediction of prognosis of the patients with ovarian tumors.     

上皮性卵巢癌中血小板计数与聚集功能的变化及临床意义

  目的  探讨上皮性卵巢癌（epithelial ovarian cancer, EOC）中血小板聚集功能与计数的变化及其对卵巢癌早期诊断、病情监测和预后评估的临床意义。  方法  选取天津医科大学总医院妇科2010年1月至2012年6月收治的61例上皮性卵巢癌患者（EOC组）, 57例卵巢良性肿瘤患者（良性肿瘤组）和80例健康查体患者（健康对照组）, 应用血小板聚集测量仪以二磷酸腺苷（ADP）为诱导剂, 比浊法检测血小板最大聚集率（maximum aggregation rate, MAR）及聚集曲线坡度（Platelet Aggregation Slope, PtS）, 全血细胞自动检测分析仪检测血小板计数及血红蛋白浓度, 并与卵巢癌临床病理因素进行相关性分析。  结果  24.59% EOC患者伴有血小板增多症, EOC组平均血小板计数及MAR显著高于良性肿瘤组和健康对照组（P < 0.05）; EOC组PtS显著高于健康对照组（P < 0.05）。EOC患者血小板增多及MAR水平升高与组织学高分级、FIGO分期晚期、术后残余灶≥1 cm及术前CA125升高显著相关（P < 0.05）, 与病理类型无关（P>0.05）。PtS与EOC患者临床病理特征无明显相关性（P>0.05）。  结论  卵巢癌患者外周血血小板数量与聚集功能均明显增强, 并且血小板计数增多及MAR水平升高与组织学分级、FIGO分期、术后残余灶以及CA125水平等卵巢癌不良预后因素密切相关。      

The role of changes in systemic inflammatory response markers during neoadjuvant chemotherapy in predicting suboptimal surgery in ovarian cancer

AimThe aim of this study was to investigate the possibility of using the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, and platelet count and their dynamic changes during chemotherapy to predict suboptimal interval debulking surgery (IDS) in stage IIIC-IVA serous ovarian cancer (OC).MethodPatients who underwent IDS after neoadjuvant chemotherapy (NAC) for stage IIIC-IVA serous OC at 3 centers between January 2008 and March 2018 were analyzed retrospectively. All women with complete blood counts both at diagnosis (T0) and after the completion of NAC but prior to IDS (T1) were included. An average of 3 weeks passed between IDS and the last cycle of NAC.ResultsA total of 214 patients were found suitable for the study. Suboptimal surgery was performed in 25.2% of the patients and optimal surgery was performed in 74.8%. The rate of change in NLR was calculated as [(NLR T0 – NLR T1)/NLR T0] × 100. A higher rate of change in NLR was found in the optimal surgery group. Recovery of thrombocytosis (When platelet count before NAC was >400,000/mm³, recovery of thrombocytosis was defined as ≤400,000/mm³ after NAC.) was found to have 85.7% sensitivity and 64.8% specificity in predicting suboptimal surgery (P < 0.001). According to both multivariate and univariate regression analysis, a large change in NLR (>17%) and recovery of thrombocytosis significantly predicted suboptimal surgery.ConclusionTo identify the likelihood of suboptimal surgery in advanced stage OC patients who undergo IDS after NAC, the dynamic change in NLR values can be examined.     

Day +100 Platelet Count Predicts Survival After Allogeneic Hematopoietic Stem-Cell Transplantation in Children With Hematologic Malignancies

IntroductionRecovery of platelet count by day 100 after hematopoietic stem-cell transplantation (HSCT) is affected by many factors and has been reported to be a predictor of overall survival (OS) in a variety of diseases and donor types. We investigated the correlation between day +100 platelet count and OS after allogeneic HSCT in a relatively homogeneous cohort of pediatric patients with hematologic malignancies.Patients and MethodsWe conducted a retrospective study of 152 consecutive patients who underwent allogeneic HSCT at the Children’s Cancer Hospital Egypt between 2009 and 2015 with a minimum follow-up duration of 1 year after transplantation. All eligible patients received myeloablative conditioning, and all had matched related donors. Patients who survived without relapse until day 100 after HSCT were divided into 2 groups: early platelet recovery (EPR; platelet count ≥ 100 × 10⁹/L at day +100 after transplantation) and delayed platelet recovery (DPR; platelet count < 100 × 10⁹/L at day +100 after transplantation).ResultsAt day +100, 113 patients (74%) had EPR and 39 patients (26%) had DPR. With a median follow-up of 41 months (range, 12-93 months), 41 patients (27.2%) died, 35 of relapsed disease. The 3-year disease-free survival (DFS) and OS were 68 ± 7.84% and 71.9 ± 7.84%, respectively. The 3-year OS was 77.9% in the EPR group and 57.1% in the DPR group (P = .006). Three-year DFS of the EPR and DPR groups were 73.2 ± 9% and 54.8 ± 16.3%, respectively (P = .02). Incidence of disease relapse for EPR and DPR patients was 22.6% and 39.5%, respectively (P = .04). Multivariate analysis for survival identified DPR as a predictor of decreased survival (P = .002).ConclusionPatients with a robust platelet count at day 100 are likely to do well. However, patients who do not experience a platelet count of ≥ 100 × 10⁹/L have inferior long-term OS and DFS and may require further evaluation at the day 100 time point.     

Significance of Thrombocytosis in Clinicopathologic Characteristics and Prognosis of Gastric Cancer

Purpose: We aimed to study the relationship between thrombocytosis and clinical features of gastric cancerfocussing on platelet counts and gastric cancer progression through different TNM stages. Methods: According to the normal range of platelet count in our institution, 1,596 patients were divided to two groups:a thrombocytosis group (120 patients, >400×1000/μL) and a control group (1,476 patients, ≤400×1000/μL). Results: The incidence of thrombocytosis was 7.5%. Higher platelet counts were observed in patients with older age, larger tumor size, deeper invasion, lymph node metastasis, distant metastasis and advanced TNM stage. In multivariate logistic regression, tumor size, depth of tumor invasion, lymph node metastasis and TNM stage were independent risk factors for thrombocytosis of gastric cancer patients. On prognostic analysis, age, tumorsize, tumor location, histologic type, depth of tumor invasion, lymph node metastasis, distant metastasis and TNM stage and platelet count were important factors. Tumor size, invasion depth, lymph node metastasis, TNM stage and the platelet count were independent prognostic factors. Conclusion: Thrombocytosis is associated with clinical features of gastric cancer patients and correlates with a poor prognosis.     

Mean platelet volume increase after tamoxifen,but not after anastrazole in adjuvant therapy of breast cancer

Aim To investigate differences of platelet indices in breast cancer patients after tamoxifen (tmx) and anastrazole adjuvant treatment. Methods In this retrospective study, 46 postmenopausal women (20 with tmx and 26 with anastrazole) with breast cancer who received adjuvant hormone therapy were enrolled. The biochemical and complete blood count (CBC) parameters were documented before hormone treatment start and after 1 year. Results The lymphocyte count was higher after tmx use, but not anastrazole. Total white blood cells were increased both after 1-year tmx and anastrazole using. Mean platelet volume (MPV) increased after tmx use (8.2 ± 0.94–8.97 ± 0.97; P: 0.041), while it was not different after anastrazole use (7.96 ± 1.08–7.89 ± 0.99; P: 0.585). Other platelet parameters did not alter with tmx or anastrazole treatment. Conclusion We found increased MPV after tmx treatment, but did not after anastrazole treatment. The advanced studies which explore biological significance of high MPV in breast cancer patients used endocrine therapy, should be established.     

EpCAM-autoantibody levels in the course of disease of ovarian cancer patients

EpCAM is a tumor-associated antigen, which is frequently expressed in ovarian cancer. Recently, autoantibodies against EpCAM have been identified in patients with ovarian cancer. It is not clear whether these autoantibodies are of prognostic importance. We evaluated whether EpCAM-autoantibodies have an impact on the clinical course of patients with ovarian cancer. EpCAM-autoantibodies were determined in sera of 28 healthy voluntary age-matched women and 84 patients with primary epithelial ovarian cancer before and after platinum-based chemotherapy using a recombinant EpCAM-protein for antibody detection by ELISA technique. The median follow-up time was 18 months. Samples exceeding the mean antibody titer of healthy controls plus 2 standard deviations were considered positive. The antibody titer of healthy controls was 0.061 ± 0.015. Using a cut-off value of 0.091, we found 3/84 (4%) patients before and 12/61 (20%) patients with ovarian cancer to be positive for EpCAM-autoantibodies after first-line treatment. Using the paired T-Test, we noted a significant post-therapeutic increase of AABs (P < 0.0001). Notably, AAB-levels after first-line therapy were found to be correlated with the tumor resection status in primary surgery. Analysis of progression-free survival, FIGO stage, grading, age and sensitivity to platinum-based chemotherapy did not reveal significant associations with EpCAM-AAB titers. We observed an increase in AAB-levels during the first-line treatment of patients with ovarian cancer. EpCAM-AAB-levels after first-line treatment appear to correlate with macroscopic tumor residuals after initial surgery.     

Tumor anemia and thrombocytosis in patients with vulvar cancer.

The aim of our study was to determine the prevalence of tumor anemia and thrombocytosis in patients with vulvar cancer, and to evaluate the prognostic value or pretreatment hemoglobin (Hb) and platelet count regarding disease-free and overall survival of patients with vulvar cancer. We measured pretreatment Hb and platelet count in 62 patients with squamous cell vulvar cancer. The results were correlated to clinical data. Median Hb and platelet count in patients with vulvar cancer were 13.1 g/dl (range 8.3-16.2) and 268, 500/microl (range 88,000-778,000), respectively. Cut-off levels of 12 g/dl and 300,000/microl were selected for tumor anemia and tumor thrombocytosis, respectively according to published criteria. Tumor anemia and tumor thrombocytosis were present in 30.6 and 27.4% of patients with vulvar cancer, respectively. In a univariate analysis tumor stage and tumor thrombocytosis were significantly associated with a shortened disease-free (log-rank test, p < 0.001 and p = 0. 003, respectively) and overall survival (log-rank test, p < 0.001 and p < 0.001, respectively). Tumor anemia was not associated with a shortened disease-free, but with a shortened overall survival of patients with vulvar cancer (log-rank test, p = 0.1 and p = 0.002, respectively). A multivariate Cox regression model considering tumor stage, tumor anemia, and tumor thrombocytosis showed, however, that pretreatment Hb and platelet count did not confer additional prognostic information to that already obtained by the established prognosticator tumor stage on disease free (multivariate Cox regression model, p = 0.8, p = 0.2, and p = 0.003, respectively) and overall survival (multivariate Cox regression model, p = 0.4, p = 0. 5, and p = 0.04, respectively). Pretreatment tumor anemia and tumor thrombocytosis were associated with a poor prognosis, but were not an independent predictor of outcome in patients with vulvar cancer.     

Interaction of monocytes/macrophages with ovarian cancer cells promotes angiogenesis in vitro

It has been established that macrophages and endothelial cells infiltrate peritoneum in the vicinity of tumor implants of epithelial ovarian cancer (EOC). This study investigates whether the interaction of ovarian cancer cells and tumor‐associated macrophages could promote the involvement of endothelial cells in angiogenesis. Macrophage phenotypes were detected by fluorescence‐activated cell sorting, and cytokine/chemokine secretion was measured by enzyme linked immunosorbent assay. The effect of co‐culture of ovarian cancer cells and tumor‐associated macrophage (TAM) cells on endothelial cell migration and tube formation was investigated. Signaling pathway mediators were also evaluated for their potential roles in endothelial cell activation by ovarian cancer cells co‐cultured with TAM cells. Our results showed that higher expression of interleukin‐8 (IL‐8) expression associated with 54.26 ± 34.46% of TAM infiltration of peritoneum was significantly higher than 16.58 ± 17.74% of CD3⁺ T‐cell by immunofluorescence co‐staining and confocal microscopy. THP‐1 cells exhibited M2‐polarized phenotype markers with high proportion of CD68⁺, CD206⁺ and CD204⁺ markers after phorbol 12‐myristate 13‐acetate (PMA) treatment, After co‐culturing with TAM cells in a transwell chamber system, EOC cells (SKOV3) increased their IL‐8 expression at the level of mRNA and protein. After exposure to the conditioned medium obtained by co‐culturing TAM and SKOV3 cells, the migration and tube formation of endothelial cells were enhanced significantly. Furthermore, the upregulation of IL‐8 expression in ovarian cancer cells induced by macrophages could be inhibited by pyrollidine dithiocarbamate, an inhibitor of nuclear factor (NF)‐ κB signal pathway. We suggest that the interaction of ovarian cancer cells and tumor‐associated macrophages enhances the ability of endothelial cells to promote the progression of ovarian cancer.     

May the Platelet to Lymphocyte Ratio be a Prognostic Factor for Epithelial Ovarian Cancer?

Background: The study aimed to evaluate changes in hematologic parameters, including white blood cell,platelet count, platelet indices, the platelet to lymphocyte and neutrophil to lymphocyte ratios in patients withearly and advanced stages of epithelial ovarian cancers. Materials and Methods: The study included 100 patientswith epithelial ovarian cancer who underwent primary staging exploratory laparotomy. Preoperative hematologicparameters, tumor histopathologic type, grade, stage and serum CA-125 levels were retrospectively analyzed.These parameters were compared between the patients with early (stage I-II) and advanced (stage III-IV) ovariancancer. Results: White blood cell count and platelet indices, including mean platelet volume, platelet distributionwidth and platelet crit did not show a statistically significant difference between groups with early and advancedovarian cancer. However, the neutrophil to lymphocyte ratio, platelet count, the platelet to lymphocyte ratioand CA-125 level showed a statistically significant difference between the two groups (p<0.05, p<0.01, p<0.001,p<0.01 respectively). Conclusions: It was found that the neutrophil to lymphocyte ratio, platelet count and theplatelet to lymphocyte ratio increased with the increasing stage of ovarian cancer. Furthermore, it was seen thatthe platelet to lymphocyte ratio is an independent prognostic factor related to the stage of epithelial ovariancancer.     

Androgen mediation of thrombocytosis in epithelial ovarian cancer biology.

PURPOSE: Preoperative thrombocytosis (platelet count > 400 x 10(9)/L) at initial exploration for epithelial ovarian carcinoma is associated with decreased surgical cytoreducibility and poor survival. Platelets express androgen receptor (AR), which contains a polymorphic CAG trinucleotide repeat sequence of which the length inversely correlates with AR transactivation function. We hypothesized that androgen-mediated thrombocytosis promotes aggressive ovarian cancer biology. EXPERIMENTAL DESIGN: Sixty-three patients with epithelial ovarian carcinoma underwent genotype analysis of the CAG repeat polymorphism in AR. Medical records were reviewed to assess preoperative thrombocytosis, surgical findings, and survival. Data were examined using the Fisher's exact, logistic regression, and Kaplan-Meier analyses. RESULTS: AR CAG repeat lengths ranged from 8 to 27, with a median of 23. Fifteen of 63 patients (23.8%) showed preoperative thrombocytosis. Short AR allelotype (< or = 20 CAG repeats) was associated with a higher incidence of thrombocytosis (P = 0.04). The combination of short AR allelotype and thrombocytosis was the only significant factor that predicted inability to achieve optimal surgical cytoreduction (P = 0.02). Women with short AR allelotype and thrombocytosis showed statistically decreased progression-free survival (13 versus 37 months, P = 0.01) and overall survival (37 versus 65 months, P = 0.02) when compared with women with long AR allelotype and normal platelet counts. On multivariate analyses, suboptimal cytoreduction was the only significant factor predictive of disease-specific overall survival (P = 0.0002) but the combination of short AR allelotype and thrombocytosis approached statistical significance (P = 0.08). CONCLUSIONS: Androgen modulation of thrombocytosis may promote aggressive epithelial ovarian cancer biology.