Cases Of Epithelial Ovarian Carcinoma Research Articles

Downregulation of INPP4B is Associated with Poor Prognosis in Epithelial Ovarian Carcinoma.

INPP4B is a tyrosine-specific phosphatase in the human body, which plays an important role in the developing process of carcinogenesis. However, The correlation between INPP4B and epithelial ovarian cancer is rarely explored. In this study, the expression of INPP4B in human epithelial ovarian carcinoma and normal ovaries was detected, to explore the correlation between INPP4B expression and clinicopathological risk factors of epithelial ovarian carcinoma and to clarify its significance in the developing process of and prognosis of epithelial ovarian carcinoma. The expression of INPP4B in various tumors was detected by bioinformatics method, and the expression in epithelial ovarian cancer and normal control group was detected by Elisa. The immunohistochemical method was used in this experiment to analyze the expression of INPP4B in specimens of 100 cases of epithelial ovarian carcinoma and 20 cases of normal ovaries. Analysis of clinicopathological risk factors and related survival analysis was carried out on the expression of INPP4B in 100 cases of epithelial ovarian carcinoma. The results showed that the positive expressed INPP4B protein in epithelial ovarian carcinoma was significantly less, compared with that in normal ovaries (P < 0.05). The expression of INPP4B was significantly associated with many clinicopathologic factors, such as tumor differentiation (P < 0.001), FIGO stage (P < 0.001), lymph node metastasis (P < 0.001) and distant metastasis at recurrence (P=0. 009), but not with age, pathologic type of tumor, serum CA125 at recurrence and chemotherapy sensitivity. In epithelial ovarian carcinoma, there is a downregulation of INPP4B expression, which may be related to poor tumor differentiation, late FIGO stage, lymph node metastasis, distant metastasis at recurrence and insensitivity to chemotherapy. Under-expression of INPP4B, lymph node metastasis, FIGO stage, and distant metastasis at recurrence are factors of poor prognostic. The under-expression level of INPP4B may be involved in the progression of epithelial ovarian carcinoma.

A PROSPECTIVE CLINICAL STUDY OF SERUM BIOMARKERS WITH TREATMENT OUTCOME OF EPITHELIAL OVARIAN CANCER CASES

Introduction: Ovarian cancer has worst prognosis and high mortality rate due to delayed onset of symptoms and lack of proper screening test that leads to late diagnosis in the advanced stages. Folate and vitamin B12 are involved in one carbon metabolism as cofactor and also has a role in conversion of homocysteine to methionine. Aberration in these processes may amplify carcinogenesis. Objective: To analyse the role of serum level of CA125, Folate, Vitamin B12 &amp; Homocysteine as diagnostic tool in Epithelial Ovarian Cancer. Methods &amp; Materials: 35 diagnosed cases of epithelial ovarian carcinoma were collected from Outpatient and Inpatient Department of Obstetrics &amp; Gynaecology as per Eastern Cooperative Oncology Group performance status. Serum levels of CA125, Folate, Vitamin B12 and Homocysteine were assayed at the time of diagnosis, 3 months and 6 months post treatment. Comparison between pre and post treatment serum levels of parameters were analysed by Graph Pad Prism version 8.4.3. Results: Mean age of developing ovarian cancer is 51± 9 years. Pre-treatment Serum CA125 levels (mean 1021 ± 800.5 units/ml) &amp; Serum Homocysteine levels (mean 11.23 ± 2.164 ng/ml) were signicantly higher than 3 months &amp; 6 months post-treatment serum levels. Pretreatment Serum Folate levels (mean 3.231 ± 1.506 ng/ml) &amp; Serum Vitamin B12 levels (mean 280.6 ± 140.8 ng/ml) were signicantly lower than 3 months &amp; 6 months post-treatment serum levels. Conclusion: The serum levels of selected parameters were signicantly altered in cases of epithelial ovarian cancer &amp; plays an important role in process of carcinogenesis

The expression and significance of protease activated receptor 2 in ovarian epithelial carcinoma

Objective: To investigate the expression and significance of protease activated receptor 2 (PAR2) in ovarian epithelial carcinoma. Methods: PAR2 mRNA expression levels in 410 cases of epithelial ovarian carcinoma and 88 cases of human normal ovary were analyzed from cancer Genome Atlas (TCGA) database and tissue genotypic expression database (GTEx). Immunohistochemical (IHC) staining of PAR2 protein was performed in 149 patients with ovarian cancer who underwent primary surgical treatment at Cancer Hospital of Chinese Academy of Medical Sciences. Then the relationship between mRNA/protein expression of PAR2 and clinicopathological features and prognosis was analyzed. Gene functions and related signaling pathways involved in PAR2 were studied by enrichment analysis. Results: The mRNA expression of PAR2 in epithelial ovarian carcinoma was significantly higher than that in normal ovarian tissue (3.05±0.72 vs. 0.33±0.16, P=0.004). There were 77 cases showing positive and 19 showing strong positive of PAR2 IHC staining among the 149 patients, accounting for 64.4% in total. PAR2 mRNA/protein expression was closely correlated with tumor reduction effect and initial therapeutic effect (P<0.05). Survival analysis showed that the progression free survival time (P=0.033) and overall survival time (P=0.011) in the group with high PAR2 mRNA expression was significantly lower than that in the low PAR2 mRNA group. Multivariate analysis showed tumor reduction effect, initial therapeutic effect were independent prognostic factors on both progression-free survival and overall survival (P<0.05). The progression-free survival (P=0.016) and overall survival (P=0.038) of the PAR2 protein high expression group was significantly lower than that of the low group. Multivariate analysis showed PAR2 expression, initial treatment effect and chemotherapy resistance were independent prognostic factors on both progression-free survival and overall survival (P<0.05). Based on Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG), PAR2 target genes were mainly enriched in function related to intercellular connection, accounting for 40%. Gene enrichment analysis (GSEA) showed that the Wnt/β-catenin signaling pathway (P=0.023), the MAPK signaling pathway (P=0.029) and glycolysis related pathway (P=0.018) were enriched in ovarian cancer patients with high PAR2 mRNA expression. Conclusions: PAR2 expression is closely related to tumor reduction effect, initial treatment effect and survival of ovarian cancer patients. PAR2 may be involved in Wnt/β-catenin signaling pathway and intercellular connection promoting ovarian cancer invasion and metastasis.

An assessment of mismatch repair deficiency in ovarian tumours at a public hospital in Johannesburg, South Africa

&#x0D; &#x0D; &#x0D; &#x0D; Background. Epithelial ovarian carcinomas (EOCs) are lethal female genital tract malignancies with high-grade serous, low-grade serous, endometrioid, clear cell, mucinous and malignant Brenner subtypes. The lifetime risk for developing ovarian carcinoma (OC) is 15% in females who have mismatch repair deficiency (MMR-d). MMR-d is associated with Lynch syndrome, a cancer predisposition condition. Patients who have MMR-d may benefit from immunotherapy. To the best of the authors’ knowledge, MMR-d testing of OCs in South Africa (SA) has not been undertaken to date.&#x0D; Objectives. To assess the clinicopathological characteristics and mismatch repair (MMR) status of non-serous EOCs at a single institution in SA.Methods. Following ethical clearance and application of exclusion criteria, 19 cases of non-serous EOC from the Department of Anatomical Pathology at Charlotte Maxeke Johannesburg Academic Hospital were retrieved and assessed. Four immunohistochemical markers (MLH1, MSH2, MSH6 and PMS2) were used to evaluate MMR status.&#x0D; Results. Most tumours were early-stage, unilateral, mucinous EOCs, without capsular breach or lymphovascular invasion (LVI). A single case of grade 1, stage I, unilateral, endometrioid EOC showed MMR-d for MLH1 and PMS2 MMR proteins. This patient had been diagnosed with endometrioid endometrial carcinoma 2 years prior to the diagnosis of OC.Conclusion. Our study documented a lower proportion of MMR-d OCs compared with international studies. However, our results are concordant with global studies regarding tumour subtype, laterality, grade, stage, LVI and capsular breach. Larger studies are required to estimate the true incidence of MMR-d OCs in SA and to direct effective treatment options globally.&#x0D; &#x0D; &#x0D; &#x0D;

Clinicopathological Characteristics and Surgical Findings of Epithelial Ovarian Carcinoma

Introduction: Ovarian cancer was the third most common gynecological cancer globally in 2020. The objective of this study was to delineate clinicopathological characteristics and surgical findings of epithelial ovarian carcinoma in our context.&#x0D; Methods: This is a descriptive cross-sectional study conducted at Bhaktapur Cancer Hospital, from March, 2023 to May, 2023. Ethical approval was obtained from Institutional Review Board (Ref. No. 773/2079/80). Data pertaining patient characteristics, initial symptoms, pre-operative CA-125 level, risk of malignancy index, stage, histology, type and extent of surgery and residual disease were evaluated in 35 cases of epithelial ovarian carcinoma. Data were analyzed using SPSS version 16.0.&#x0D; Results: Among 35 cases of epithelial ovarian carcinoma, majority occurred in postmenopausal women (57.1%) with mean age 53 years. The most common presentation was abdominal distension (51.4%). Majority of patients had raised preoperative serum CA-125 level (94.2%) and RMI score (91.4%). Most of them presented in advanced stage III and IV (85.7%) with histology type high grade serous 2 carcinoma (82.8%). Eleven patients (31.4%) underwent primary cytoreductive surgery and 24 (68.5%) patients received neoadjuvant chemotherapy with three to six cycles of Carboplatin and Paclitaxel and underwent interval cytoreductive surgery. At surgery, majority had no residual disease (R 0 94.2%).&#x0D; Conclusions: Majority of epithelial ovarian carcinoma occurred in postmenopausal women with abdominal distension. Most of them presented in advanced stage III-IV with histology high grade serous carcinoma. They underwent interval cytoreductive surgery more than primary cytoreductive surgery. At surgery, majority had no residual disease.

Abstract 775: Evaluation of Erb-B2 expression from archival tumor tissue in early stage epithelial ovarian carcinoma patient prognosis

Abstract In this retrospective study, Erb-B2 expression was assessed in 106 patients using Paraffin-Embedded Tissue (PET) to determine the prognostic value in Epithelial Ovarian Carcinoma (EOC) patients diagnosed at Saskatoon Cancer Center between the years 1983-1995. Relationship between Erb-B2 positivity and patient tumor characteristics was assessed for Overall Survival (OS) and Relapse-Free Survival (RFS) by Kaplan-Meier method. Based on the intensity of stain with a polyclonal antibody (A485, 1/400 dilution), cases with markedly intense cytoplasmic and membranous immunoreactivity were classified as Erb-B2 over-expressors. Erb-B2 was overexpressed in 13 (12%) cases. The mean age of the patients was 56 years (range 18-84 years). The patient population consisted of 64 Stage I and II, Early Stage (ES) and 36 cases with Stage III and IV Advanced Stage (AS). Data on histologic grade was available in 81 cases. 58 patients received platinum-containing regimen, 13 melphalan, and in 9 cases combination chemotherapy. Erb-B2 expression did not influence OS and RFS in these patients. Similarly, there was no significant relation to OS and RFS between Erb-B2 and age, grade, and patients with No Evidence of Disease (NED). Of the 64 cases with ES disease, 16 cases had Grade 2 tumor with Erb-B2 over-expression in 4 cases. Grade 2 tumors with Erb-B2 overexpression indicated significant relationship to OS and RFS, p=0.01, (median = 30 months, CI: 26 - 68) and p=0.05, (median = 15 months, CI: 13 - 68). Furthermore, in 21 cases with ES, Endometrioid histology and Erb-B2 expressors 6/21 (28%) experienced significantly shorter OS compared to non-expressors p=0.005, (median = 48 months, CI: 22 - 74) (mean = 134 months, CI: 124 - 144). In conclusion, Erb-B2 overexpression could be detected in only limited EOC cases in PET and appears to have no prognostic influence. Additionally, endometrioid carcinoma and grade 2, ES certainly reflect the importance of sub-group analysis. In ovarian carcinoma distribution of stage, histology, and grading of tumor cells are conventional markers for prognosis. Finally, Erb-B2 status detected by immunohistochemistry, in a subgroup of patients with high-degree of HER2 positivity/focal amplification may likely have better clinical outcome with anti-HER2 agents. Citation Format: Kavitha Advikolanu Rao, Anthony Magliocco, Andrew Maksymiuk. Evaluation of Erb-B2 expression from archival tumor tissue in early stage epithelial ovarian carcinoma patient prognosis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 775.

Endocan-microvascular Density in Primary Ovarian Carcinoma.

Background:Epithelial ovarian cancer is among the leading causes of death in women and is driven by angiogenesis. Microvascular density (MVD) can be used to evaluate angiogenesis in carcinomas and thus it can be used as a potential biomarker for ovarian cancer. This study is aimed to establish the association between endocan-MVD with clinicopathological factors in primary epithelial ovarian cancer. Methods:The clinicopathological characteristics were acquired from the medical records filed between January 2008 and December 2018 of 89 epithelial ovarian cancer cases in Hospital Universiti Sains Malaysia, Kelantan, Malaysia. Sectioned samples were analyzed for endocan through immunohistochemistry followed by the quantification of MVD. The association between clinicopathological characteristics and endocan-MVD was analyzed using the Pearson chi-square test and Fischer’s exact test. Results:All cases of epithelial ovarian carcinomas were positive for endocan. The mean ± standard deviation value of endocan-MVD level was 21.6±14.60 microvessels per 200x field. A total of 53 (59.6%) cases had low and 36 (40.04%) had high endocan-MVD values. High endocan-MVD level had a significant association with the older age group (p-value = 0.009), smaller tumor size (p-value<0.001), type II tumor (p-value<0.001), high-grade tumor (p-value<0.001), advanced FIGO stage (p-value=0.002), and presence of tumor recurrence (p-value=0.017). No significant association was found between endocan-MVD and the other clinicopathological characteristics such as race, pre-operative serum CA-125 level, presence of diabetes mellitus, endometriosis, lymph node involvement, distant metastasis, and family history of malignancy. Conclusion:Endocan-MVD showed a significant association with age, tumor size, tumor type, tumor grade, FIGO stage, and recurrence in primary epithelial ovarian cancer. Thus, endocan-MVD could be implemented as a reliable marker to predict prognosis in epithelial ovarian cancer in the future.

Alpha-fetoprotein (AFP)-producing epithelial ovarian carcinoma (EOC): a retrospective study of 27 cases.

ObjectiveThe aim of the study was to investigate the relative risk factors associated with the prognosis and effective treatments of alpha-fetoprotein (AFP)-producing epithelial ovarian carcinoma (EOC).MethodWe presented three cases of AFP-producing EOC and performed a brief review to summarize the clinicopathological features and prognostic factors of 24 cases that have been previously reported. We evaluated the correlations among prognostic and clinical parameters, such as stage, pathology and chemotherapy regimens. In addition, a retrospective review of these 27 cases was conducted, and survival curves were estimated using the Kaplan–Meier method.ResultsThe patients were aged between 23 and 77 years. The median overall survival was 10 months, and ten (37.04%) patients died within 18 months. We compared the overall mean survival times of all patients in different stages, and the results suggest that the postoperative pathological staging is hardly correlated with prognosis (P = 0.76). There was a correlation between pathology and prognosis (P = 0.0018). The mean survival time was longer for patients who had undergone chemotherapy than for those without chemotherapy (14.88 vs 0.65 months) (P < 0.0001). Moreover, although patients had a good response to the regimens for PEB and TC (P = 0.004), there was no significant difference between PEB and TC (P = 0.386).ConclusionsAFP-producing EOC is uncommon and regarded as an extremely malignant type of tumor. Patients with chemotherapy may have a longer survival time; additionally, PEB and TC may be an optimal selection for this kind of tumor. Further large-scale studies are needed to confirm our findings.

Ultrasound, macroscopic and histological features of endometrioid and clear cell ovarian cancer

The objective of [Video 1][1] is to present two cases of epithelial ovarian carcinomas, examined at the Gynecologic Oncology Unit of the Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, in Rome,...

The frequency of epithelial ovarian cancer subtypes in Sudanese women at Omdurman Maternity Hospital, 2013-2018: A cross-sectional study

Background: Globally, epithelial ovarian carcinoma (EOC) is considered the gynecological cancer with the highest mortality. In Sudan, there are scarce publications about the frequency of this carcinoma. Therefore, the present study intended to perform a cross-sectional study to review the morphological sub-types and sort EOC according to age and grade in Omdurman Maternity Hospital (OMH) in Sudan. Methods: This cross-sectional, hospital-based study included 70 EOC cases diagnosed at OMH in the period 2013-2018. The data were collected from OMH records in the period 2016-2018, and included ovarian cancer types, ages of patients, and tumor grades. Results: The participants’ median age was 50 years, and the majority of EOC cases were in younger patients (48.6%; n=34; ≤ 50 years (18 to 50 years)). The most familiar tumor sub-type was serous carcinoma (44.3%; n=31), followed by endometrioid carcinoma (27.1%; n=19), mucinous carcinoma (17.1%; n=12), clear cell carcinoma (8.6%; n=6) and undifferentiated carcinoma (2.9%; n=2). The majority of cases were categorized as low grade (51.4%; n=36). Our results revealed significant relationships between EOC types and grades (Fisher’s Exact test, p=0.000). Conclusion: In Sudanese patients with EOC, serous carcinoma is the most common histological subtype, and EOC is likely to occur in women of a younger age (&lt;50 years). Our results indicate a younger presentation of EOC and warrants quick and thorough investigation of any vague abdominal complaint in women of a younger age (&lt;50 years). Also, it may help in guiding researchers developing screening programs especially for younger women, pay attention to the serous type as the common type and finding novel biomarkers especially for treatment and prognosis of this type.

Assessment of High Risk of Hereditary Breast and Ovarian Cancer (HBOC) and Acceptance for Genetic Testing Among Cases of Ovarian and Breast Cancer in Indian Set-up

To identify cases needing genetic testing for hereditary breast and ovarian cancer (HBOC) syndrome among cases of breast and ovarian cancer and assess their acceptability for genetic testing. One hundred patients of breast and/or ovarian cancer were recruited. A series of family meetings were done with patient and close family members. The first meeting was for pedigree chart preparation and identification of cases for genetic testing (HBOC) as per NCCN 2013 criteria. Second family meeting was held for counselling about genetic testing. Third meeting was held for recording acceptance or refusal for genetic testing. For those refusing the test, reasons for refusal were recorded. Outcome measures including prevalence of high-risk cases, acceptance rate for genetic testing and factors affecting the above acceptance rates among high-risk women were statistically analysed. Out of 100 patients of breast and ovarian cancer recruited in the study, 88 were found to be at high risk of HBOC. The most common criterion for high risk among breast cancer cases was age below 45 years. Family history of breast or ovarian cancer was present in 3.03% cases of ovarian cancer and 11.76 cases of breast cancer. Eleven (16.66%) cases of epithelial ovarian carcinoma and six (27.27%) cases of breast carcinoma accepted genetic testing. Socioeconomic status was found to have statistically significant correlation (p < 0.001 and p = 0.030) with acceptance for genetic testing. Though it is a small sample study, there is huge burden of women needing genetic testing for HBOC. There is lack of awareness about familial nature of disease and low acceptance for genetic testing in our population. There is a significant effect of socioeconomic status on acceptance for genetic testing.

Cancer-associated fibroblasts in epithelial ovarian carcinoma: relation to clinicopathologic characteristics and microvessel density

Background Epithelial ovarian carcinoma (EOC) is the leading cause of mortality among all gynecologic cancers. Recent studies have emphasized the role of the tumor microenvironment in tumor progression. Cancer-associated fibroblasts (CAFs) are the most frequent component in the tumor microenvironment, and α-smooth muscle actin (α-SMA) is the most commonly used marker to identify CAF. This study aimed to investigate the potential role of CAFs in the progression of EOC. Furthermore, we analyzed the relation between the presence of CAF in EOC and clinicopathologic characteristics and tumor microvessel density (MVD). Methods Immunohistochemical staining was performed on 75 cases of epithelial ovarian neoplasms using α-SMA (as a marker of CAFs) and CD34 (for assessment of MVD in EOC cases). Results The presence of CAFs, as assessed by α-SMA intensity and percentage of positive stained area, was significantly more prominent in malignant cases, as compared with borderline and benign cases. It was found that abundant CAFs were significantly associated with high-grade tumors, stage III tumors and tumors with vascular invasion and omental metastasis. A significant positive correlation was detected between the presence of CAFs and tumor MVD in EOC. Conclusion CAFs significantly increase from benign through borderline to malignant ovarian neoplasms. CAFs are significantly higher in high-grade tumors, advanced stage tumors and in tumors with vascular invasion or omental metastasis. CAFs are significantly correlated with tumor MVD in EOC. Thus, CAFs may serve as a poor prognostic indicator in patients with EOC.

GDF15 predict platinum response during first-line chemotherapy and can act as a complementary diagnostic serum biomarker with CA125 in epithelial ovarian cancer

BackgroundGrowth differentiation factor 15 (GDF15) has attracted much interest as a novel biomarker for epithelial ovarian carcinoma (EOC). Research focus has been directed at GDF15 as a diagnostic detection, while the prognostic determination of GDF15 in EOC patients remains to be clearly elucidated. The present study aimed to investigate GDF15 level relative to clinicopathological characters, chemoresponse, and clinical outcome of EOC patients.MethodsSerum from 122 patients with primary diagnosed EOC were analyzed for GDF15 and serum cancer antigen 125 (CA125). All cases were treated with debulking surgery and first-line chemotherapy, and samples were obtained just before debulking surgical treatment and first-line chemotherapy. Subsequently, clinical characteristics, responses to chemotherapy and progression-free survival (PFS) were recorded.ResultsIncreasing levels of serum GDF15 was significantly associated with FIGO stage and lymphonodus metastasis. GDF15 and CA125 detection are complementary in the diagnosis of EOC and can be simultaneously profiled. The chemo-resistant EOC patients (median, 1225.0 pg/mL) showed significantly higher GDF15 than chemo-sensitive patients (median, 824.2 pg/mL; P = 0.013). Highly expressed GDF15 was an independent negative prognostic indicator in the PFS (P = 0.026) of the 122 EOC cases in the multivariate analysis. Additionally, patients with high level of serum CA125 significantly associated with suboptimal (P = 0.043) debulking surgery.ConclusionsOur results provide valuable evidence that GDF15 is related with first-line chemo-resistance, with highly expressed GDF15 being a strong and an independent indicator of shorter PFS in EOC patients.

Overexpression and clinical significance of IBP in epithelial ovarian carcinoma.

Interferon regulatory factor-4 binding protein (IBP) is as a type of ρ GTPase suggested to serve an important role in tumor occurrence and development through the effects of cytoskeletal remodeling, and cell conduction mechanism. IBP is widely expressed in the immune system and expressed in several types of tumors. However, its expression and prognostic value in epithelial ovarian carcinoma (EOC) remain unclear. The present study aimed to investigate the expression of IBP in EOC, and its effect on clinicopathological variables and prognosis. A total of 107 and 30 cases of epithelial ovarian carcinoma and benign ovarian disease tissue sections, respectively, were examined using immunohistochemistry. The results indicated that the IBP expression status was negative or markedly weak in normal tissues, but highly expressed in EOC tissues. A significant association was observed between IBP overexpression and various clinicopathological factors, including advanced International Federation of Gynecology and Obstetrics stage (P<0.001), poor histologic grade (P=0.002), peritoneal carcinomatosis (P<0.001), lymph-node metastasis (P=0.023) and recurrence (P<0.001). Multivariate Cox regression analysis additionally suggested that IBP overexpression was an independent factor affecting recurrence-free survival [hazard ratio (HR)=4.099; 95% confidence interval (CI), 2.209-7.606; P<0.001) and overall survival (HR=2.317; 95% CI, 1.484-3.617; P<0.001) in patients with EOC. The results of the present study demonstrated that IBP overexpression may be associated with tumor development and progression in EOC, and therefore may serve as a novel target for treating this disease.

Significance of blood and salivary IEX-1 expression in diagnosis of epithelial ovarian carcinoma.

AimThis study assesses a clinical potential of immediate early responsive gene X‐1 (IEX‐1), also named IER3, in the diagnosis of epithelial ovarian carcinoma using blood and salivary specimens.MethodsImmediate early responsive gene X‐1 was quantified in blood and saliva by real‐time quantitative reverse transcription polymerase chain reaction in 26 cases of epithelial ovarian carcinoma, 37 cases of benign ovarian tumor and 55 cases of healthy women. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of IEX‐1.ResultsImmediate early responsive gene X‐1 was expressed in blood and saliva of the benign ovarian tumor group and the healthy women group, both at a level significantly higher than that of the ovarian carcinoma group (P < 0.017). There were no significant differences in IEX‐1 expression in blood and saliva (P = 0.376 or 0.621, respectively) between the benign ovarian tumor and the healthy women group. Comparison of IEX‐1 expression in blood between the ovarian carcinoma group and the benign ovarian tumor group or the healthy women group demonstrated the ROC‐area under curves (AUC) of 0.947 or 0.929, respectively. In discriminating the ovarian carcinoma group from the benign ovarian tumor group, IEX‐1 expression in blood demonstrated a sensitivity and specificity of 84.6% and 94.6%, respectively. Similarly, blood IEX‐1 expression conferred a sensitivity of 84.6% and specificity of 90.9% in distinguishing the ovarian carcinoma group from the healthy women group. Moreover, salivary IEX‐1 expression had ROC‐AUC of 0.851 when compared between the ovarian carcinoma group and the benign ovarian tumor group or 0.896 when compared between the ovarian cancer group and the healthy women group. IEX‐1 expression was able to discriminate the ovarian carcinoma group from the benign ovarian tumor group with a sensitivity and specificity of 65.4% and 94.6%, respectively, or the ovarian carcinoma from the healthy women with 92.3% sensitivity and 72.5% specificity.ConclusionThese results suggest the clinical potential of IEX‐1 expression in blood and saliva as a sensitive and specific diagnosis for epithelial ovarian carcinoma.

Profile of human epidermal growth factor receptor 2 expression in epithelial ovarian carcinomas: A multicenter study from Southeast Nigeria

Background: Human epidermal growth factor receptor 2 (HER2/neu) in epithelial ovarian cancers (EOCs) has been proposed in targeted oncological therapy as a way forward in the treatment of ovarian cancer. Currently, there is a paucity of data on the expression of HER2 in EOC in Nigeria. Objective: This study, therefore, aims to carry out an immunohistochemical study of histologically diagnosed EOC in Nnewi, Southeast Nigeria. Materials and Methods: The hematoxylin and eosin slides and formalin-fixed-paraffin-embedded tissue blocks of histologically diagnosed cases of epithelial ovarian carcinomas in the two histopathology laboratories in Nnewi, Anambra state, over a 12-year period were retrieved from the archives. Archival formalin-fixed-paraffin-embedded tissue blocks of histologically normal ovaries in these laboratories were also retrieved to serve as controls. Sections were made from the tissue blocks and stained with HER2 immunostain. Results: Fifty EOC specimens and 20 histologically normal ovaries were stained with HER2 immunostain. There was statistically significant difference in HER2 expression between normal ovaries and EOC (P = 0.016). HER2/neu- positive staining was not observed in the histologically normal ovaries. However, nine (18%) of the EOC showed HER2/neu- positive staining. HER2 positivity within EOC was independent of age (P = 0.134), tumor grade (P = 0.141), histological subtyping (P = 0.080), and molecular subtyping (P = 0.168). However, there was more HER2 positivity among those older than 50 years, low-grade carcinomas, mucinous EOC, and Type 1 EOC. Conclusion: Overall, these data support the dualistic model of ovarian carcinogenesis in Nigerian patients and therefore recommend further studies to determine the efficacy of anti-HER2/neu monoclonal antibodies in the treatment of EOC in these patients.

Profile of p53 expression in epithelial ovarian carcinomas: A multicenter study from South-East Nigeria

Background: Therapeutic targeting of mutated protein 53 (p53) will require the knowledge of mutated p53 expression. Currently, there is paucity of data on the expression of p53 in epithelial ovarian cancer (EOC) in Nigeria. Objective: This study therefore aims to carry out an immunohistochemical study of histologically diagnosed EOCs in Nnewi, South-East Nigeria. Materials and Methods: Hematoxylin and eosin slides and paraffin blocks of all histologically diagnosed cases of epithelial ovarian carcinomas in the two histopathology laboratories in Nnewi, Anambra State, over a 7-year period, were retrieved from the archives. Archival paraffin blocks of histologically normal ovaries in these laboratories were also retrieved to serve as controls. Sections were made from the tissue blocks and stained with p53 immunostain. Results: Fifty EOC specimen and twenty histologically normal ovaries were enrolled in this study. While 58% of EOC showed p53 positivity, none of the histologically normal ovaries showed p53 positivity. p53 expression was more common in those above 50 years of age, yet no association was found between p53 expression and age of patient. However, there was a statistically significant association between p53 positivity and tumor grade (P

Expressions and clinical significance of pAkt1 and hTERT in epithelial ovarian carcinoma

Objective To evaluate the expressions and prognostic significance of phosphorylation of protein kinase B1 (pAkt1) and human telomere reverse transcriptase (hTERT) in epithelial ovarian carcinoma. Methods The expressions of pAkt1 and hTERT were examined by immunohistochemical SP method in 72 cases of epithelial ovarian carcinoma and 10 normal endometrial tissues to analyze the correlation between pAkt1 and hTERT and their relationships with clinic-pathological features and prognosis. Results The positive expression rate of pAkt1 in epithelial ovarian carcinoma was 73.6%, and the positive expression rate of hTERT was 56.9%, compared with normal ovarian tissues, with statistical significance (χ2=20.814, P<0.001; χ2=11.389, P<0.001). The expression of pAkt1 was not associated with hTERT expression (r=0.075, P=0.532) in epithelial ovarian carcinoma. The expressions of pAkt1 and hTERT in epithelial ovarian carcinoma were correlated with tumor differentiation status (χ2=6.475, P=0.011; χ2=1.370, P=0.001). The di-sease-free survival of patients with pAkt1 and hTERT positive coexpression was significantly shorter than others (8.585 months vs. 11.227 months, χ2=4.361, P=0.037), but there was no significant difference in overall survival (11.107 months∶11.695 months, χ2=0.394, P=0.530). Conclusion pAkt1 and hTERT are highly expressed in epithelial ovarian carcinoma, and high coexpression of pAkt1 and hTERT indicates poor prognosis in epithelial ovarian carcinoma. Key words: Ovarian neoplasms; Phosphorylation of protein kinase B1; Human telomere reverse transcriptase

Prognostic and Predictive Values of cell Cycle Proteins Centrosomal Protein 5 (CEPP 5)

Background: Disturbances in the expressions of centrosomal proteins (CEPs) and regulatory proteins that control G1-Sphase transition, like cyclins could participate in dysregulation of cell cycle control that has been incriminated in the pathogenesis of several malignancies. Centrosomal protein 55 (CEP55) has an important role in participation in the final stage of cell division, and cell cycle progression. CEP55 and Cyclin D1 expressions were detected in several tumors but their prognostic and predictive roles in epithelial ovarian carcinoma (EOC) are still studied. Aim of the study: Explore tissue expressions of CEPP55 and Cyclin D1 in EOC correlating their expression with pathological, clinical and prognostic parameters. Methods: CEP55 and Cyclin D1 expressions were evaluated in tissue biopsies that are retrieved from 60 cases of epithelial ovarian carcinoma using immunohistochemistry, patients that were followed up for 3 years. The relationship between their level of expressions and degree of differentiation, spread of the tumor, disease recurrence, response to therapy and survival were studied. Results: CEP55 expression in EOC was positively correlated with loss of differentiation of the tumor, presence of L.N (p<0.001), and distant metastases (p=0.012) and advanced stage of the tumor (p=0.007), cyclin D1 expression in EOC was positively correlated with loss of differentiation and advanced stage of the tumor, presence of L.N (p<0.001), and distant metastases (p=0.009). CEPP 55 and Cyclin D1 were positively correlated with each other. Low CEPP 55 and Cyclin D1 expressions were strongly correlated with optimal surgical eradication of the tumor, increased 3-year overall survival (OS) and low incidence of tumor recurrence after therapy (P<0.001). Conclusion: High levels of expression of CEPP 55 and Cyclin D1and are markers of poor prognosis in EOC patients.

Malignant and borderline epithelial ovarian tumors in the pediatric and adolescent population

ObjectivesMalignant and borderline ovarian tumors of epithelial origin are rarely encountered among prepubertal girls and adolescents. The aim of this population-based study was to elucidate their clinicopathological characteristics and prognosis using a multi-institutional tumor registry. Study design and outcomesThe National Cancer Institute’s Surveillance, Epidemiology, and End Results database was accessed and a cohort of females aged <=19years old, diagnosed between 1988 and 2013 with a borderline ovarian tumor (BOT) or a malignant epithelial ovarian carcinoma (EOC) was accessed. Observed survival (OS) was assessed using the Kaplan-Meier method. Comparisons were made using the log-rank test. ResultsA total of 114 cases diagnosed with BOT between 1988 and 2000 were identified; 61/114 (53.5%) and 51/114 (44.8%) of BOT were of serous or mucinous histology respectively. Ten-year OS for those with BOT was 97.3%. A total of 140 cases of EOC were identified. Median age was 17 years and the most common histological subtypes were mucinous 79/140 (56.4%) and serous 29/140 (20.7%) adenocarcinoma. Most had stage I disease 92/131 (70.2%) and fertility-sparing surgery was commonly performed. Five-year OS for those with stage I disease was 93.6% compared to 48.3% for cases with exta-ovarian tumor spread (p<0.001). ConclusionsBOT and EOC are exceedingly rare in the pediatric and adolescent population. In this age group EOC consists mostly of low-grade mucinous and serous tumors confined to the ovary. OS survival for those with stage I disease is excellent.