细胞周期素D1与p53蛋白在卵巢上皮性肿瘤的表达及意义

目的　探讨细胞周期素D1(CyclinD1)与 p5 3蛋白在卵巢上皮性肿瘤的表达及意义。 方法　 1990～1995年应用免疫组化法对 4 0例恶性卵巢上皮性肿瘤及 2 0例良性卵巢上皮性肿瘤组织进行CyclinD1与 p5 3蛋白检测。结果　良性卵巢上皮性肿瘤CyclinD1阳性表达为 10 0 % ,而恶性卵巢上皮性肿瘤CyclinD1阳性表达为37 5 %。良性卵巢上皮性肿瘤p5 3阳性表达为 15 0 % ,恶性卵巢上皮肿瘤 p5 3阳性表达为 4 7 5 %。CyclinD1在卵巢上皮癌G1与G2 、G3 中的阳性表达统计学差异有显著性 (P <0 0 5 ) ,p5 3蛋白在早期卵巢上皮癌与晚期卵巢上皮癌组织中的阳性表达 ,统计学差异有显著性 (P <0 0 5 ) ,p5 3蛋白的阳性表达在卵巢癌G1与G2 、G3 比较差异有显著性 (P <0 0 5 )。CyclinD1过表达的细胞同时也有 p5 3的过表达。 结论　CyclinD1与 p5 3蛋白在卵巢上皮性肿瘤的共同表达可能是促进卵巢上皮性肿瘤发展的因素。     

GnRH analogues as an adjuvant therapy for ovarian cancer patients.

OBJECTIVES: Lowering gonadotropin levels with gonadotropin-releasing hormone (GnRH) analogues in patients with ovarian cancer remains open to debate. The aim of this study was to assess the results of treatment in stage III and stage IV ovarian cancer patients who had surgery supplemented with chemotherapy, radiotherapy, and GnRH analogues. Gonadotropin levels were monitored during treatment. METHODS: The study group comprised 69 patients aged 27-70 years, stratified according to the type of treatment. The overall disease-free, 5-year survival rates and the frequency of remissions were analyzed. Hormonal tests [follicle-stimulating hormone (FSH) and luteinizing hormone (LH)] were performed in 58 patients. Associations were checked between gonadotropin levels, clinical findings, and survival. The results were statistically compared. RESULTS: Statistically significant differences were noted when chemotherapy was supplemented with GnRH analogues and/or radiotherapy. Administration of GnRH analogues resulted in significantly lower levels of LH than of FSH. Levels of FSH were significantly lower in patients surviving at least 5 years or in complete remission at the time of this study. CONCLUSIONS: Combined therapy can produce favorable results in late-stage ovarian cancer, and GnRH analogues have an important role in treatment strategy.     

Exposure to 1-bromopropane causes ovarian dysfunction in rats.

Although 1-bromopropane has been used in chemical and electronic industries as an alternative to ozone layer-depleting solvents, its toxicity on female reproductive organs has not been fully elucidated. The aim of this experiment was to determine the effect of 1-bromopropane on female reproductive function in rats. Forty female Wistar rats were divided into four equal groups. Each group was exposed daily to 0, 200, 400, or 800 ppm of 1-bromopropane for eight h a day. After exposure for 7 weeks, all rats in the 800-ppm group became seriously ill and were sacrificed during the 8th week. The other dose groups were exposed for 12 weeks. In the 800-ppm group, but not in the other two exposed groups, body weight was significantly less than the control at each time point from 2 to 7 weeks after the beginning of exposure. Tests of vaginal smears showed a significant increase in the number of irregular estrous cycles with extended diestrus in the 400- and 800-ppm groups. Histopathological examination of the ovary showed a significant dose-dependent reduction of the number of normal antral follicles and a decrease in the number of normal growing follicles in the 400-ppm group. No significant change was found in plasma concentrations of LH or FSH in any group when compared with the control. Our results indicate that 1-bromopropane can induce a dose-dependent ovarian dysfunction in nonpregnant female rats associated with disruption in follicular growth process.     

The importance of angiogenesis in ovarian cancer

Advanced stage ovarian cancer has a high rate of recurrence even after surgery followed by chemotherapy combining carboplatin and a taxane. New strategies are currently under way to combat this situation and one of the most promising ones is based on the knowledge that angiogenesis, the mechanism of formation of new blood vessels coupled with the degradation of the extracellular matrix for metalloproteinases, could be crucial in the development of this tumor. The principal molecule implicated in angiogenesis process of ovarian cancer is the vascular endothelial growth factor (VEGF). Several studies are now in progress to clarify its role as a diagnostic tool or its therapeutic implication. Presently, there is no indication for the use of VEGF in a preliminary diagnosis seeing that an increase in levels can be seen in both benign and malignant ovarian conditions. VEGF is also responsible for an increase in vascular permeability and is directly related to symptoms such as ascites and pleural effusion, both of which are frequent in ovarian cancer. Several papers have analised the role of VEGF as a prognostic factor and some of them do confirm VEGF as an independent prognostic factor in ovarian cancer. VEGF and the metalloproteinase system coupled with angiogenesis are currently being evaluated as therapeutic targets but no positive results have yet to be seen in this field.      

c-raf-1反义寡核苷酸对人卵巢癌细胞放射敏感性的影响

目的　探讨癌基因 c- raf- 1的反义寡核苷酸对人卵巢癌细胞放射敏感性的影响。方法　设立 c- raf- 1正义寡核苷酸组和非处理组 (仅加入等量的脂质体 )作对照 ,用 RT- PCR检测卵巢癌细胞处理前后 c- raf- 1表达水平的变化。用平板克隆形成试验检测人卵巢癌细胞株 SKOV3在脂质体 - c- raf- 1反义寡核苷酸作用前后受 6 0 Coγ射线不同剂量照射后的集落形成率。结果　 c- raf- 1反义寡核苷酸能抑制 c- raf- 1癌基因的表达 ,经脂质体介导的 c- raf- 1反义寡核苷酸作用的卵巢癌细胞经γ射线照射后其集落形成率较转染正义寡核苷酸组及单纯照射组明显下降 (P<0 .0 1) ,而转染 c- raf- 1正义寡核苷酸组的集落形成率与单纯照射组相比无明显差异 (P>0 .0 5 )。结论　 c- raf- 1反义寡核苷酸通过抑制 c- raf- 1的表达降低人卵巢癌细胞株 SKOV 3放射抗拒性。该作用可能与 c- raf- 1反义寡核苷酸抑制了引起细胞辐射抗拒的细胞信号转导途径有关     

Adult granulosa-cell tumor of the ovary: a retrospective study of 45 cases

This study describes 45 cases of adult granulosa-cell tumors seen in our institution between 1976 and 1993. The median age was 46.5 years (12–77) and 18 women were postmenopausal. Vaginal bleeding was present in one-third of cases; other complaints were abdominal pain (28%) and the presence of a pelvic mass (47%). The tumor size was variable (<3 cm to 30 cm, median 11.5 cm). FIGO stages were: stage I: 30 (73%) (19 Ia, seven Ic, four I unknown); stage II: seven (17%) (two IIa, five IIC); stage III: three (7%) (one IIIb, two IIIc). Two adenocarcinomas and 13 cases of hyperplasia were found in 25 endometrial samples available. The initial therapy for all the cases was surgery, consisting in 34 patients of hysterectomy, bilateral salpingo-oophorectomy, ± tumor resection. Sixteen patients received adjuvant therapy as well: chemotherapy (CT) alone for 12, radiotherapy (RT) alone for two, and CT + RT for two patients. Among the 39 patients who achieved a complete response after initial therapy, 15 patients have relapsed (pelvic recurrences) (38.5%) including six stage Ia (three received only conservative surgery). All the recurrent tumors were resected and 14/15 had CT (13/14 with cisplatin). The overall survival rate was 77.2% at 5 years, 66.5% at 10 years, and 41.2% at 20 years. A statistically significant difference was found between the survival of patients with stage Ia disease (75% at 10 and 15 years) and that of other patients (60% at 10 years, and <50% at 15 years). Serum estradiol and serum inhibin were measured in some patients and the results are described.     

Prognostic value of serial CA125 measurements during chemotherapy for patients with advanced ovarian cancer

Serum CA125 concentrations measured before and during chemotherapy may provide additional information for prognostic assessment of patients with epithelial ovarian cancer (EOC), and enable discrimination between patients who are likely to benefit from further therapy and those who will not. Medical records of 40 patients with advanced EOC, treated at the Department of Obstetrics and Gynecology of the University Hospital Nijmegen between July 1984 and April 1993, were examined. All patients had primary cytoreductive surgery followed by platinum-based chemotherapy. Serum samples were obtained before surgery and during chemotherapy. Follow-up information and patient and tumor characteristics were abstracted from medical records until December 1, 1994. By using multivariate Cox proportional hazards models for disease-free and overall survival it was evaluated whether outcome prediction was improved by inclusion of serum CA125 quantitations.
  Only FIGO stage and extent of residual tumor were significant independent prognostic factors before the start of chemotherapy. When such regression models were constructed after subsequent courses of chemotherapy, serum CA125 measurements conducted after each of the first three chemotherapy courses improved the prediction of disease-free survival. Prediction of overall survival was improved by inclusion of serum CA125 measurements after courses 1–6. Inclusion of serum CA125 measurements during chemotherapy improved prognostic assessment of patients with advanced EOC.     

Primary carcinoma of the pelvic peritoneum intercepted by screening for ovarian cancer

An asymptomatic woman found to have primary pelvic peritoneal carcinoma following serum CA125 assay and ultrasound examination is reported. The close proximity of this screen detected tumor to the normal ovary supports the possibility that an extra ovarian primary origin of carcinoma with subsequent involvement of the ovary may be more common than has previously been recorded.