Ovarian Tumor In Postmenopausal Woman Research Articles

Urinary Polyamines as Biomarkers for Ovarian Cancer.

Elevated concentrations of polyamines have been found in urine of patients with malignant tumors, including ovarian cancer. Previous research has suffered from poorly standardized detection methods. Our liquid chromatography-tandem mass spectrometry (LC-MS/MS) method is capable of simultaneous standardized analysis of most known polyamines. Liquid chromatography-tandem mass spectrometry has not previously been used in the differential diagnostics of ovarian tumors in postmenopausal women. In this prospective study, postmenopausal women (n = 71) presenting with an adnexal mass and, as controls, women with genital prolapse or urinary incontinence scheduled for surgery (n = 22) were recruited in the study. For analysis of the polyamines, a morning urine sample was obtained before surgery. Preoperative serum CA125 concentrations were determined in the study group. Twenty-three women with benign and 37 with malignant ovarian tumors were eligible. Of all analyzed polyamines, only urinary N,N-diacetylspermine showed statistically significant differences between all groups except controls versus benign tumors. N,N-diacetylspermine was elevated in malignant versus benign tumors (P < 0.001), in high-grade versus low malignant potential tumors (P < 0.001), in stage III to IV versus stage I to II cancers (P < 0.001), and even in early-stage cancer (stage I-II) versus benign tumors (P = 0.017). N,N-diacetylspermine had better sensitivity (86.5%) but lower specificity (65.2%) for distinguishing benign and malignant ovarian tumors than CA125 with a cut-off value of 35 kU/L (sensitivity, 75.7%; specificity, 69.6%). Urinary N,N-diacetylspermine seems to be able to distinguish benign and malignant ovarian tumors as well as early and advanced stage, and low malignant potential and high-grade ovarian cancers from each other, respectively.

Postmenopozal over kitlelerinde spektral doppler ultrason parametrelerinin preoperatif değerlendirmesi

Objective: The aim of this study was to evaluate the value of quantitative spectral Doppler ultrasound (DUS) flow measurements in ovarian tumors in postmenopausal women. Material and Method: This prospective study included 23 postmenopausal women with preoperative diagnosis of ovarian tumor. Patients were examined with transvaginal DUS 2 to 4 days before surgery. The resistive index (RI) and pulsatility index (PI) of the mass were evaluated by transvaginal DUS examination. Results: The histopathologic examination of the surgical specimens revealed 8 malignant, 13 benign and 1 borderline tumor. The mean RI and PI for malignant tumors were 0.37 (range 0.35-0.45) and 0.61 (range 0.43-0.85), respectively. The mean RI and PI for benign tumors were 0.61 (range 0.30-0.91) and 1.21 (range 0.36-3.02), respectively. The Mann-Whitney U test revealed a statistically significant (p

A Study on the Usefulness of Laparoscopy in the Management of Torsion of the Ovarian Tumor in Postmenopausal Woman

A Study on the Usefulness of Laparoscopy in the Management of Torsion of the Ovarian Tumor in Postmenopausal Woman

Histology and prevalence of ovarian tumours in postmenopausal women: Is follow-up required in all cases?

The objective of this study was to determine if follow-up is required for all ovarian tumours incidentally diagnosed in postmenopausal women, by studying the prevalence and histology of ovarian tumours in postmenopausal women undergoing hysterectomy. The histopathology of adnexa in 100 consecutive postmenopausal women who underwent an abdominal hysterectomy with bilateral salpingo-oophorectomy for various indications, was reviewed. A total of 200 adnexa were examined. Ovarian pathology was found in 62/200 (31%). Of these 34/62 (53%) were unilocular cystic tumours, 9/62 (15%) were multilocular tumours, 11/62 (18%) were solid tumours and 8/62 (11%) were uni or multilocular with solid elements. The prevalence of borderline tumours was 4% and that of malignant tumours was 5%. All tumours < 2 cm were found to be benign. All unilocular cysts < 5 cm were benign. In conclusion, a vast majority of ovarian tumours in this group of women were benign. It may be reasonable not to follow-up women with unilocular ovarian tumours < 5 cm who have a normal CA125.

Serum insulin-like growth factor (IGF)-I, IGF binding protein (IGFBP)-3, leptin concentrations and insulin resistance in benign and malignant epithelial ovarian tumors in postmenopausal women

Aims. The aims of the present study were to determine the serum concentrations of insulin-like growth factor-I (IGF-I), insulin-like growth factor binding protein-3 (IGFBP-3) and leptin and insulin resistance in benign and malignant epithelial ovarian tumors, and to discuss the use of these markers in benign–malignant tumor differentiation.Methods. Forty-seven postmenopausal women with ovarian tumor and 31 age-matched, postmenopausal, healthy controls were included in this study. Insulin resistance index by homeostasis model assessment (HOMA score) and fasting blood glucose (FBG), serum IGF-I, IGFBP-3, leptin and CA-125 concentrations were determined in all patients preoperatively. The results were evaluated according to postoperative histopathology results.Results. According to postoperative histopathology results, the patients were divided into malignant (n = 23), benign (n = 24) and control (n = 31) groups. There were no differences among the groups in relation to age, body mass index, FBG and HOMA score (p > 0.05). Serum concentrations of CA-125 were elevated in the malignant group compared with the benign ovarian tumor and control groups (p < 0.05). In contrast, serum IGF-I concentrations were significantly decreased in patients with malignant and benign ovarian tumors compared with controls (p < 0.05). Serum IGFBP-3 concentrations were also found to be lower in women with malignant ovarian tumors than in women with benign tumors (p < 0.05). Serum leptin did not differ among patients with malignant–benign tumors and controls (p > 0.05).Conclusion. Serum leptin and HOMA score have not been found to be valid indicators in ovarian tumors. However, the present data suggest that low concentrations of IGF-I and IGFBP-3 could be a reliable marker to differentiate benign from malignant ovarian tumors. Further experimental studies are warranted to understand the impact of the IGF-I system in ovarian carcinogenesis.

Contribution of sonographic measurement of ovarian volume to diagnosing ovarian tumors in postmenopausal women.

The purpose of this review article is to evaluate the current method of sonographic measurement of ovarian volume as a means of diagnosing ovarian tumors in postmenopausal women, in whom an ovarian volume greater than 10 ml is generally considered abnormal. After reviewing the general medical literature, we propose a nomogram of ovarian volume that may be used to determine whether an ovary is abnormal. Furthermore, on the basis of our previous results, we recommend that a cutoff point for ovarian volume that is adjusted to patient age be used to determine whether an ovary is abnormal. We recommend the use of such nomograms in routine clinical practice to assist physicians in identifying abnormality of the ovaries during sonographic examination.

Evaluation of ovarian tumors in postmenopausal women by transvaginal sonography

Objective: The aim of the present study was the evaluation of simple reproducible sonomorphological criteria for the preoperative evaluation of ovarian tumors in postmenopausal women by use of transvaginal sonography. Study design: Postmenopausal women (≥1 year of secondary amenorrhea) with ovarian tumors ( n=378; tumors ≥3 cm and <3 cm but with solid parts) were examined in a prospective study by transvaginal sonography prior to surgery between 1987 and 1993. The sonomorphological criteria were correlated with the histological findings of the tumors. Results: Of all ovarian tumors in postmenopausal women, 6.3% were functional cysts (follicular or corpus luteum cysts). Almost all of them were detected within the first 5 years of postmenopause. The other ovarian tumors were diagnosed as retention cysts (17.5%), benign neoplasms (39.4%), and malignant tumors (36.8%). Simple ovarian cysts (monolocular, smooth inner wall) represented sonomorphologically the second most frequent type of ovarian tumors in postmenopausal women (35.7%). Of these tumors, 9.6% were diagnosed as malignant. Conclusions: Simple reproducible sonomorphological criteria proved to be a useful clinical parameter in the preoperative evaluation of ovarian tumors.

PROSPECTIVE MULTICENTER STUDY ON THE CLINICAL UTILITY OF CA-72.4 IN POSTMENOPAUSAL PATIENTS WITH PELVIC MASS

The study objective was to evaluate the sensitivity and specificity as well as the positive predictive value and negative predictive value of CA 72.4 and CA 125 determination, separately and in combination, for diagnosing ovarian tumors in post-menopausal women with pelvic mass. The 299 patients recruited in this study underwent gynecological examination, plasma determination of CA 72.4 and CA 125, and laparotomy with histological definition of pelvic mass. CA 72.4 assay values were under 3.9 U/ml in 194 cases (70.8%); values ranged from 3.9 to 4.5 U/ml in 7 cases (2.5%) and were greater than 4.5 U/ml in 73 cases (26.6%). CA 72.4 assay was positive (>4.5 U/ml) in 56 cases (57.1%) of malignant ovarian pathology, in 4 cases (25%) of malignant extra-ovarian pathology as well as in 9 cases (7.1%) of benign ovarian pathology and in 4 cases (11.8%) of benign extra-ovarian pathology. With a cut-off at 3.9 U/ml, CA 72.4 showed a specificity of 91.3% and a sensitivity of 62.2%, whereas with a cut-off at 4.5 U/ml specificity was 92.9% and sensitivity 57.1%. Results of CA 125 assay for diagnosing a pelvic neoplasia (ovarian or extra-ovarian), showed a specificity of 85.3% and sensitivity of 68.8%. The agreement of the two markers (CA 125 and CA 72.4) as negative or positive shows a specificity of 77% and a sensitivity of 84.7% for ovarian cancer and a specificity of 73.5% and sensitivity of 75% for the diagnosis of pelvic neoplasias.

The Postmenopausal Adnexal Mass: Correlation Between Ultrasonic and Pathologic Findings

One hundred two postmenopausal women underwent ultrasonographic evaluation of adnexal masses before surgery. Twenty-nine (28%) had malignant tumors and 73 (72%) had benign tumors. Two of 33 patients with a "simple cyst" smaller than 5 cm in diameter by ultrasound had malignant ovarian tumors. Twenty-two of the 52 women (42%) with "complex masses" by ultrasound and five of the 17 (29%) with solid tumors had ovarian cancer. For predicting malignancy in ovarian tumors, abdominal ultrasonography had a positive predictive value of 39% and a negative predictive value of 94%. If a negative sonogram had been relied upon, 6% of malignant ovarian tumors in postmenopausal women might have been missed.

Androgen production by epithelial ovarian tumours in post-menopausal women

Peripheral serum concentrations of androstenedione (A) and testosterone (T) were measured in 31 post-menopausal women with epithelial ovarian tumours (12 cancer, 5 borderline malignant and 14 benign tumours), and in 20 post-menopausal women who were free from ovarian neoplasms. The levels of these androgens were also measured in ovarian venous blood in 17 women with ovarian tumours. No significant differences were found between the mean serum androgen levels in patients with malignant, borderline malignant or benign ovarian tumours or the control group. The measured levels of A and T in peripheral and ovarian venous blood were highest in women with mucinous ovarian tumours. Histopathological examinations of the ovarian tumours showed hyperplasia or luteinization in ovarian tumour stroma in 5 out of 17 cases (3 mucinous tumours, I endometrioid adenocarcinoma and I serous adenocarcinoma). The results indicate that of all epithelial tumours mucinous ovarian tumours most often demonstrate hormonal activity and that malignancy has no effect on hormonal activity.

Vaginosonographie als Screeningmethode zur Erkennung von Adnextumoren in der Postmenopause?

424 ovaries of 212 postmenopausal women not on hormone treatment were examined by vaginal ultrasound. 155 patients had no clinical complaints, 57 patients showed atypical uterine bleeding. 48 pathological findings could be detected sonographically (11.3%). Among the histologically clarified cases were 2 asymptomatic ovarian cancers. Altogether, the vaginosonography proved to be a very simple and effective method to detect ovarian tumors in postmenopausal women.

Peripheral and Ovarian Venous Concentrations of Estradiol and Progesterone in Postmenopausal Women with “Non‐Endocrine” Ovarian Tumors

Estradiol (E2) and progesterone (P4) levels in peripheral venous blood were measured in 45 postmenopausal (more than 5 years after menopause) women with ovarian neoplasms. The E2 and P4 concentrations in ovarian venous blood were also measured in 26 of these 45 patients. The steroid levels were compared with the values in 10 postmenopausal women without ovarian tumors. In peripheral venous blood, relatively high E2 concentrations were found in 24 of the 45 (53%) postmenopausal patients with ovarian tumors, and relatively high P4 concentrations were noted 15 of 45 (33%) of the patients. In ovarian venous blood, relatively high values of E2 were found in 18 of 26 (69%) of the postmenopausal patients, and relatively high values of P4 were noted in 11 of these 26 (42%). No differences in the E2 and P4 levels in peripheral and ovarian venous blood were noted between the patients with benign tumors and those with malignant tumors. These results suggest that some of the epithelial ovarian tumors in postmenopausal women have steroid-producing activity.

Hormonal activity of epithelial ovarian tumours in post-menopausal women

Concentrations of progesterone and oestradiol in peripheral serum and tumour cyst fluid were measured in 42 post-menopausal women with epithelial ovarian tumours (17 cancer, 6 borderline malignant, 19 benign tumours) and in 19 post-menopausal women without ovarian neoplasms. The hormonal response of the endometrium was assessed, progestogen and oestrogen receptor content in the tumour tissue case recorded, and tumour deoxyribonucleic acid (DNA) ploidy was measured by flow cytometry.No significant differences were found between the mean serum steroid levels in patients with malignant, borderline or benign tumours, but the mean serum levels of oestradiol in patients with malignant or benign ovarian tumours were higher than those in the controls. Endometrial hormonal activity was seen in 19% of the samples studied. Malignant and benign mucinous epithelial tumours were the types most frequently associated with hormonal activity. Increased levels of sex steroids were seen in the cyst fluid of serous malignant and borderline malignant tumours, while benign tumours were inactive.The steroid receptor content of the various tumour types did not vary significantly. Ten (59%) out of 17 ovarian carcinomas were found to be aneuploid and 41% diploid as measured by flow cytometry. No significant differences in serum levels of progesterone and oestradiol were found between aneuploid and diploid ovarian carcinomas.These results contribute to our knowledge of the hormonal activity of epithelial ovarian tumours in post-menopausal women.

Hormonally Active Non-Mesenchymal Ovarian Tumours in Postmenopausal Women. Correlation Between Urinary Estrogen and Pregnanediol and Hyperplastic Changes in the Tumour Stroma

Hormonally Active Non-Mesenchymal Ovarian Tumours in Postmenopausal Women. Correlation Between Urinary Estrogen and Pregnanediol and Hyperplastic Changes in the Tumour Stroma