Primary Ovarian Carcinoma Research Articles

Clinical and molecular determinants of response to maintenance olaparib for primary and recurrent epithelial ovarian carcinoma

Clinical and molecular determinants of response to maintenance olaparib for primary and recurrent epithelial ovarian carcinoma

P73-9 Primary ovarian small cell carcinoma of pulmonary type diagnosed with an ultrasound-guided cervical lymph node biopsy

P73-9 Primary ovarian small cell carcinoma of pulmonary type diagnosed with an ultrasound-guided cervical lymph node biopsy

The role of SATB2, CDX2, CK7 and CK20 in differentiating primary versus metastatic ovarian carcinoma

The role of SATB2, CDX2, CK7 and CK20 in differentiating primary versus metastatic ovarian carcinoma

Metabolism of primary high-grade serous ovarian carcinoma (HGSOC) cells under limited glutamine or glucose availability

BackgroundHigh-grade serous ovarian carcinoma (HGSOC) is the most common and aggressive subtype of epithelial ovarian carcinoma. It is primarily diagnosed at stage III or IV when the 5-year survival rate ranges between 20% and 40%. Here, we aimed to validate the hypothesis, based on HGSOC cell lines, that proposed the existence of two distinct groups of HGSOC cells with high and low oxidative phosphorylation (OXPHOS) metabolism, respectively, which are associated with their responses to glucose and glutamine withdrawal.MethodsWe isolated and cultivated primary cancer cell cultures from HGSOC and nontransformed ovarian fibroblasts from the surrounding ovarium of 45 HGSOC patients. We tested the metabolic flexibility of the primary cells, particularly in response to glucose and glutamine depletion, analyzed and modulated endoplasmic reticulum stress, and searched for indices of the existence of previously reported groups of HGSOC cells with high and low OXPHOS metabolism.ResultsThe primary HGSOC cells did not form two groups with high and low OXPHOS that responded differently to glucose and glutamine availabilities in the cell culture medium. Instead, they exhibited a continuum of OXPHOS phenotypes. In most tumor cell isolates, the responses to glucose or glutamine withdrawal were mild and surprisingly correlated with those of nontransformed ovarian fibroblasts from the same patients. The growth of tumor-derived cells in the absence of glucose was positively correlated with the lipid trafficking regulator FABP4 and was negatively correlated with the expression levels of HK2 and HK1. The correlations between the expression of electron transport chain (ETC) proteins and the oxygen consumption rates or extracellular acidification rates were weak. ER stress markers were strongly expressed in all the analyzed tumors. ER stress was further potentiated by tunicamycin but not by the recently proposed ER stress inducers based on copper(II)-phenanthroline complexes. ER stress modulation increased autophagy in tumor cell isolates but not in nontransformed ovarian fibroblasts.ConclusionsAnalysis of the metabolism of primary HGSOC cells rejects the previously proposed hypothesis that there are distinct groups of HGSOC cells with high and low OXPHOS metabolism that respond differently to glutamine or glucose withdrawal and are characterized by ETC protein levels.

A Rare Case of Primary Ovarian Mucinous Carcinoma with Signet-Ring Cells and Literature Review.

The presence of signet-ring cells in the ovary is almost always associated with metastatic mucinous carcinomas known as Krukenberg tumors. Here we report a primary ovarian mucinous carcinoma with signet-ring cells, which is scarcely encountered, and a review of the literature to summarize the clinical and morphological features of these tumors. The patient was a 26-year-old female who had a large multicystic lesion in the right ovary. Macroscopic examination of the cyst revealed a 30 cm-sized multicystic lesion filled with mucinous material. The capsule was intact, and there was no surface involvement. Microscopically, a multicystic mucinous tumor with a predominantly borderline background and three well-demarcated nodules composed of signet ring cells without desmoplastic stroma were noted in the cyst wall. There was only one invasive focus seen. Immunohistochemically, conventional mucinous areas were diffusely positive for Keratin 7 and Keratin 20, and focally positive for PAX8, while negative for CDX2. Signet ring cells were positive for Keratin 20, CDX2, and Keratin 7, while negative for PAX8. In the systemic examinations, no potential primary site was found. The patient has not received any adjuvant treatment and has been followed for six years without disease, which is the longest follow-up time among previously reported cases. Signet ring cells can be present in primary ovarian mucinous carcinomas. The distinction from the more frequently seen metastatic carcinomas needs a complete evaluation of clinicopathological findings. Early-stage primary mucinous carcinomas having localized signet-ring cell nodules seem to have favorable prognosis without adjuvant treatment.

Ovarian metastasis from pancreatic ductal carcinoma.

A clinical case is presented about a rare presentation of pancreatic cancer. Firstly, pancreatic cancer rarely metastasizes to the ovary, and when it does, it usually presents in the form of peritoneal carcinomatosis and bilateral involvement. However, the initial radiological diagnosis was primary pancreatic carcinoma with a synchronous primary ovarian carcinoma. Once analyzed pathologically, it was concluded that it was ovarian metastasis from pancreatic cancer. Given the diagnostic difficulty along with the patient's long survival, an exceptional case is presented.

Detection of Carcinoma-Associated Fibroblasts Derived from Mesothelial Cells via Mesothelial-to-Mesenchymal Transition in Primary Ovarian Carcinomas.

Carcinoma-associated fibroblasts (CAFs) are highly accumulated in the tumor-surrounding stroma of primary epithelial ovarian cancer (OC). CAFs exert important functions for the vascularization, growth, and progression of OC cells. However, the origin of CAFs in primary OC had not yet been studied, and they were assumed to arise from the activation of resident fibroblasts. Here, we compared CAFs in the ovary to CAFs found in peritoneal metastases from patients with advanced OC. Our findings show that CAFs from primary tumors and peritoneal metastases share the expression of mesothelial markers. Therefore, similar to peritoneal carcinomatosis, CAFs in primary ovarian carcinomas may originate from mesothelial cells via a mesothelial-to-mesenchymal transition. The detection of mesothelial-derived CAFs in tumors confined to the ovary and identification of biomarkers could be the key to the early detection of OC and peritoneal spread.

Primary ovarian squamous cell carcinoma arising from an epidermoid cyst of Ovary- A rare case report with review of literature

Primary ovarian squamous cell carcinoma is a rare entity that usually arises from the malignant transformation of a mature cystic teratoma, endometriosis or Brenner’s tumor. The denovo occurrence of primary squamous cell carcinoma of the ovary without prior lesion is a rare entity accounting for less than 1%. However, ovarian squamous cell carcinoma arising from an epidermoid cyst is an infrequent entity and only one case has been reported in literature. The prognosis of such cases is quite poor and there are no definite guidelines for treatment. Here we present a case of a 50-year-old female diagnosed with primary ovarian squamous cell carcinoma arising from an epidermoid cyst of the ovary who was treated with surgery followed by chemotherapy along with the review of literature.

Immunohistochemical expression of SATB2 and PAX8 in differentiating primary from metastatic ovarian mucinous neoplasms.

Accurate stratification of an ovarian mucinous neoplasm as primary or secondary is always challenging as they show overlapping histomorphological and immunohistochemical features. Immunohistochemical staining for SATB2 and PAX8 was performed on 80 cases of mucinous ovarian neoplasms subdivided into 53 primary [25 primary ovarian mucinous carcinomas (POMCs) and 28 mucinous borderline tumors (MBTs)] and 27 secondary (12 of colonic origin, 7 of appendiceal origin, and 8 of gastric origin). Expression was correlated with different clinicopathologic parameters. PAX8-positive immunostaining was detected in 38 out of 53 cases (71.69%) of primary ovarian mucinous neoplasms (POMNs) with null positivity in the secondary ovarian mucinous tumors (0/27). SATB2-positive expression was detected in 16 out of 27 cases (59.26%) of the secondary ovarian mucinous tumors. None of the studied POMNs showed any positive immunostaining for SATB2 (0/53). A profile of SATB2-/PAX8+ and SATB2+/PAX8- can be used to differentiate POMNCs from secondary ovarian mucinous tumors of GI origin, respectively, with 100% specificity. PAX8 expression is associated with some clinicopathologic parameters providing the basis for the possible usage of PAX8 as prognostic marker.

Multimodal diagnostic strategies and precision medicine in mucinous ovarian carcinoma: a comprehensive approach.

Mucinous ovarian carcinoma (MOC) represents a distinct entity within ovarian malignancies, characterized by diagnostic challenges due to its rarity and the potential overlap with other tumor types. The determination of tumor origin is important for precise postsurgical treatment. This article highlights the accurate diagnosis and management of MOC, including the use of imaging modalities, serological tumor markers, immunohistochemistry, and genomic analyses. Transabdominal and transvaginal ultrasonography, complemented by MRI and CT, plays a pivotal role in differentiating MOC from other mucinous tumors and in surgical planning, particularly for fertility preservation. Serological markers like CA19-9, CA-125, and CEA, though not definitive, provide valuable preoperative insights. Immunohistochemistry aids in distinguishing primary MOC from metastatic mucinous carcinomas, while genomic profiling offers the potential for precision medicine through the identification of specific molecular signatures and treatment susceptibilities. Despite advancements in diagnostic techniques, no single method conclusively differentiates between primary and metastatic tumors intraoperatively. The paper reviews the origins, diagnosis, and differential diagnosis of primary mucinous ovarian carcinoma highlights the need for a multimodal diagnostic approach and advocates for the inclusion of MOC patients in clinical trials for personalized therapies, recognizing the heterogeneity of the disease at the molecular level.

GATA4 is diagnostically useful for distinguishing primary ovarian mucinous carcinomas from metastatic colorectal adenocarcinomas to the ovary.

Determining the primary origin of an ovarian mucin-producing carcinoma can be challenging at times because some metastases of primary colorectal origin may exhibit gross, microscopic, and/or immunohistochemical features that overlap with those of primary ovarian mucinous carcinomas (OMCs). We hypothesized that GATA binding protein 4 (GATA4) might be a novel, useful marker for differentiating primary OMCs from metastatic colorectal adenocarcinomas to the ovary. For comparison with the usefulness of other markers (special AT-rich sequence-binding protein 2 (SATB2) and caudal type homeobox 2 (CDX2)), we elucidated the expression profiles of GATA4 in OMCs, colorectal non-mucinous adenocarcinomas (CNMACs), and colorectal mucinous adenocarcinomas (CMACs) using immunohistochemistry. We confirmed GATA4 expression (H-score ≥50 points) in 93%, SATB2 in 0%, and CDX2 in 64% of 14 OMCs. GATA4 was expressed in 13%, SATB2 in 90%, and CDX2 in 93% of 30 CNMACs. GATA4 was expressed in 20%, SATB2 in 73%, and CDX2 in 100% of 30 CMACs. The expression of GATA4 in a mucus-producing ovarian tumor strongly supports it being a primary OMC rather than a metastatic colorectal carcinoma: GATA4 expression indicates OMC and SATB2 expression indicates colorectal adenocarcinoma. However, three cases of colorectal adenocarcinoma were GATA4-positive and SATB2-negative, so the GATA4/SATB2 marker combination is not absolute for determining the primary site. Further research for more markers is necessary to find the ideal combination.

Unveiling the mille-feuille sign: a key to diagnosing ovarian carcinosarcoma in addition to ovarian metastasis from colorectal carcinoma on MRI.

To clarify the diagnostic utility and formation of the Mille-feuille sign for ovarian carcinosarcoma (OCS) on MRI, and to evaluate the other MRI findings and serum markers compared to ovarian metastases from colorectal carcinoma (OMCRC). Three blinded radiologists retrospectively reviewed MR images of 12 patients with OCS, 18 with OMCRC, and 40 with primary ovarian carcinoma (POC) identified by the electronic database of radiology reports. The interobserver agreement was analyzed using Fleiss' kappa test. Their MRI characteristics and tumor markers were compared using Fisher's exact test and Mann-Whitney's U test. Receiver operating characteristic curve analyses were used to determine the cutoff points for the ADC value. This study was approved by the institutional ethics committee. Interobserver agreement analysis was moderate or higher for all MRI characteristics. The frequency of Mille-feuille sign was comparable for both OCS and OMCRC groups, and predominantly higher than that of the POC group (p < 0.001, p < 0.001), respectively. Pathologically, the Mille-feuille sign in OCS reflected alternating layers of tumor cells with stroma and necrosis or intraluminal necrotic debris. Compared to OMCRC, intratumoral hemorrhage (p = 0.02), margin irregularity (p = 0.048), unilateral adnexal mass (p = 0.02), and low ADC values (p < 0.01) were more frequently observed and serum CEA levels was significantly lower (p = 0.007) in the OCS group. Under setting of the cutoff value of ADC at 0.871 × 10-3mm2/s, the discriminative ability for OCS showed 66.7% sensitivity, 94.4% specificity, and 81.0% accuracy, respectively. The Mille-feuille sign was seen in both OCS and OMCRC. MR findings of intratumoral hemorrhage, margin irregularity, unilateral adnexal mass, low ADC values, and low serum CEA levels can be useful in differentiating OCS from OMCRC.

A phase II study of anlotinib plus albumin-bound paclitaxel in patients with recurrent, platinum-resistant primary epithelial ovarian or peritoneal carcinomar (A-Plus trial): Updated efficacy and safety.

5557 Background: Initial results of the open-label, single-arm phase II clinical trial, we had demonstrated anlotinib plus albumin-bound paclitaxel treatment activity and favorable tolerance in patients with recurrent, platinum-resistant primary epithelial ovarian or peritoneal carcinoma (SGO 2023. Oral featured poster 549). Here we update the latest efficacy and safety data in enrolled patients. Methods: In this study, 44 patients diagnosed with platinum-resistant or platinum-refractory ovarian cancer were planned to be enrolled. Patients received ab-paclitaxel 260 mg/m2 given by intravenous infusion over 30 min every 3 weeks and anlotinib (10mg, po, qd, for 14 days, every 3 weeks) until disease progression or intolerable toxicity. For efficacy evaluation, the following were required: measurable disease defined by RECIST 1.1, or if there were no measurable lesions but an elevated CA125 with significant symptoms such as abdominal pain, bloating, or pleural effusion/ascites (Rustin criteria). The primary end point were investigator-confirmed objective response rate (ORR). Results: From January 2021 to March 2023, 44 patients were enrolled with a median age of 49 years(range, 40-66). 29 patients had measurable lesions and 15 patients had no measurable lesions but an elevated CA125 evaluated according to Rustin criteria. As of efficacy evaluation, 43 out of 44 patients can be analyzed and one without measurable lesions can not be included due to the absence of a post-treatment data. Among the 29 patients with measurable lesions, 16 (55.2%; 95% CI 0.359-0.730) achieved objective responses, including CR in two patients, PR in fourteen, stable disease in thirteen, and PD in zero. In the group of 14 patients without measurable lesions, 9 (60%; 95% CI 0.328-0.825) achieved responses, including CA 125 responses in nine patients, CA 125 no response in four, and CA125 disease progression in one. Overall responses were observed in 25 out of 44 patients (56.8%; 95% CI 0.411-0.713) in the intention-to-treat population, and in the per-protocol population, the response was seen in 25 out of 43 patients (58.1%; 95% CI 0.422-0.726). The grade 3/4 AEs encompassed leukopenia (31 patients, 70.5%), gum-pain (10 patients, 22.7%), hypertension (10 patients, 22.7%), Hand-foot syndrome (4 patients, 9.1%). Conclusions: Updated results reconfirm a favorable antitumor activity and manageable safety from anlotinib plus albumin-bound paclitaxel in the treatment of recurrent ovarian or peritoneal carcinoma. Further survival results are expected. Clinical trial information: ChiCTR2100054329.

The frequency and prognostic role of P53 and P16 immunoexpression in primary ovarian mucinous tumors

BackgroundPrimary ovarian mucinous tumors are uncommon. Factors leading to invasive progression and metastatic disease have not been fully delineated yet. The aim of this study is to determine the rates of p53 and p16 immunoexpressions in primary ovarian mucinous tumors, to investigate their relationship with clinicopathologic factors and their impact on prognosis and survival. MethodsSeventy-eight primary ovarian mucinous tumors (30 mucinous cystadenomas, 30 mucinous borderline tumors (MBOT), 18 mucinous carcinomas (MOC)) were evaluated immunohistochemically with p53 and p16 staining. The demographic, clinicopathological data, and postoperative follow-up findings of the patients were analyzed. ResultsMutation-type p53 staining was present in 1/30 (3.3 %) cystadenoma, 10/30 (33.3 %) MBOT and 9/18 (50 %) MOC (p = 0.001). p16 overexpression was detected in 3/30 (10.0 %) MBOT and 5/18 (27.8 %) MOC, but not in any cystadenoma (p = 0.04). The frequency of mutation-type p53 staining in MBOTs with microinvasion was higher (71.4 %) than in those without (28.6 %, p = 0.026). The frequencies of p16 or p53 mutations were similar in MBOTs with and without intraepithelial carcinoma, or mural nodule (p > 0.05). In MOCs with ovarian surface involvement, mutation-type p53 staining was detected in 66.7 % (6/9) and p16 overexpression in 55.6 % (5/9) of the cases. A significant difference was found between MOCs with or without ovarian surface involvement regarding the frequency of p16 overexpression (p = 0.029). Any relationship was not detected between survival and p53 and p16 expression in MOCs (p > 0.05). Conclusionp53 and p16 mutation rates were higher in MOCs compared to mucinous cystadenomas and MBOTs and suggest a relevant role in the development of primary ovarian mucinous carcinoma, however further studies are needed in this regard.

Rare Case of Metachronous Gastric Metastasis from Primary Ovarian Carcinoma.

Metastasis of ovarian cancer to the stomach is extremely rare. The tumors most commonly metastasizing to the stomach include melanoma, breast, lung, and oesophageal carcinoma, while ovarian cancer comprises only 0.013-1.6% of all gastric metastatic tumors. The aim of this study was to present a rare case of an isolated metachronous gastric metastasis from an ovarian carcinoma, in a 59-year-old lady. A 59-year-old lady presented with a right adnexal mass on MRI imaging of the abdomen and pelvis and an elevated serum CA 125 of 4240IU/ml. She underwent a primary cytoreductive surgery comprising of omentectomy, peritoneal biopsies, pelvic peritonectomy and peritoneal washing cytology, hysterectomy and bilateral salpingo-oophorectomy, and a retroperitoneal and pelvic nodal dissection. The surgical Peritoneal Carcinomatosis Index (PCI) was 5. The final histopathology showed a high-grade serous adenocarcinoma involving the right adnexa. She received six cycles of adjuvant chemotherapy. On a 3-monthly follow-up, the PET scan revealed that a gastric fundic lesion was noted. Investigations revealed a metachronous metastasis from the serous carcinoma of the ovary, confirmed by histopathological evaluation. The patient was treated with surgical resection of the metastasis and systemic chemotherapy to achieve disease control. Gastric metastasis from ovarian cancer should be considered a differential diagnosis in any patient presenting with a gastric mass and a history of ovarian cancer.

Human Epidermal Growth Factor Receptor 2 Overexpression/Amplification in Primary Ovarian Endometrioid Carcinoma.

Human epidermal growth factor receptor 2 (HER2) expression has become increasingly helpful in predicting responses to anti-HER2 agents in gynecological cancers. This study retrospectively analyzed HER2 expression in 48 primary ovarian endometrioid carcinomas. HER2 immunohistochemistry was performed using the Ventana platform (Clone 4B5 monoclonal predilute) following the manufacturer's protocol. HER2 expression was equivocal (score 2+) by image analysis in 2 cases (4.17%) based on the breast cancer criteria. Fluorescence in situ hybridization was negative for HER2 amplification in one case (International Federation of Gynecology and Obstetrics, grade 1) and positive in the other (International Federation of Gynecology and Obstetrics, grade 3). Our findings contribute to the growing evidence that HER2 is overexpressed in a small proportion of ovarian endometrioid carcinoma, and thus may serve as a potential therapeutic target in selected cases.

Abstract 2744: Exploring the role of the MSLN/MUC16 interaction in cancer progression via the in situ proximity ligation technique

Abstract Introduction: Mesothelin (MSLN) is a glycoprotein present on the surface of mesothelial cells, sometimes used as a tumor marker. Its overexpression in various cancers, including mesothelioma, ovarian, pancreatic, and lung, is linked to increased tumor aggressiveness, evasion of apoptosis, metastasis, and resistance to treatments. Mucin16 (MUC16) belongs to a family of proteins that play a crucial role in cell adhesion, signaling, and immune responses. In cancer, alterations in mucin expression and structure may contribute to tumor progression and metastasis by enhancing cell survival and immune evasion. Mesothelin is known to interact with mucins, influencing tumor cell behavior and metastatic potential. More specifically, the MSLN/MUC16 interaction facilitates tumor cell invasion and peritoneal spread in ovarian cancer. However, reliable molecular tools to study protein interactions have been scarce. Here, we relied on the Naveni® in situ proximity ligation technology to identify MSLN/MUC16 in various cancer samples. The method detects proteins located within interaction range (&amp;lt;40 nm) by means of antibodies conjugated to oligonucleotides that create amplified fluorescent signal. Since the technique does not compromise the structural integrity of tissues, communication between proteins can be studied in their native environment. Materials &amp; Methods: Human FFPE tissue microarrays (TMA) with ovarian primary carcinoma and matched metastatic cancer (80 cores) and ovarian cancer tissue with normal tissue (100 cores) were deparaffinized and subjected to standard heat-induced antigen retrieval and blocking. Staining against the MSLN/MUC16 interaction was performed with the NaveniFlex Tissue MR Atto647N kit (Navinci Diagnostics). Co-staining antibodies against pan-Cytokeratin and Ki67 were included in the detection mix. Immunofluorescence (IF), using the same MSLN and MUC1 primary antibodies, was completed on an additional slide of each TMA, and then secondary antibodies conjugated to Alexa Fluor™ 488 and 594 were used for detection. Imaging was performed on an Olympus scanner VS200. Results &amp; Discussion: In this study, we showed that the interaction is abundant in ovarian cancer, with a distinguishable difference in the signal presence between cancerous and normal adjacent tissue. Furthermore, the additional tumor marker co-stainings give insights into the tumor invasion and growth. When comparing the Naveni® signal of MSLN/MUC16 against IF staining of each, the Naveni® signal shows true interactions, as opposed to expression patterns. Understanding the roles of mesothelin and mucin in cancer, both individually and in interaction, is crucial for developing targeted therapies and diagnostic tools. Further research on their interaction and specific molecular pathways triggered by it is essential for devising effective strategies to combat cancer progression. Citation Format: Sara Bodbin, Doroteya Raykova, Agata Zieba-Wicher. Exploring the role of the MSLN/MUC16 interaction in cancer progression via the in situ proximity ligation technique [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2744.

A Complex Case: Solid Unilateral Ovarian Mucinous Carcinoma Masquerading as Leiomyosarcoma in Postmenopausal Women

Introduction:: Ovarian cancers are the third most common gynecological and 8th most common cancer in women, associated with high mortality rates globally. Case Presentation:: A 60-year-old postmenopausal woman presented to the Gynecological outpatient department with complaints of pain in the abdomen for 2-3 months and loss of appetite with weight loss for 1-2 months. She was diagnosed as a case of uterine leiomyosarcoma or left adnexal mass on ultrasound and MRI. Intra-operatively, she was diagnosed with a unilateral left ovarian malignant mass, predominantly solid in consistency with metastasis to the left fallopian tube, uterus, cervical stroma, and omentum. The right ovary and tube were healthy. On histopathological examination, the final diagnosis of primary mucinous ovarian carcinoma was made. The patient tolerated staging laparotomy (total abdominal hysterectomy with bilateral salpingo-oophorectomy and infracolic omentectomy) well and was started on six cycles of adjuvant chemotherapy with Paclitaxel and Carboplatin injections along with Bevacizumab. Conclusion:: Primary mucinous ovarian carcinomas are rare and distinct subtypes of epithelial ovarian carcinomas. Due to their strong resemblance to other ovarian tumors and leiomyosarcoma, their diagnosis becomes challenging. Hence, it is crucial to consider leiomyosarcomas in the differential diagnosis of ovarian masses, especially in postmenopausal women.

β-Galactosidase-activated near-infrared AIEgen for ovarian cancer imaging in vivo

Near-infrared (NIR) aggregation induced-emission luminogens (AIEgens) circumvent the noisome aggregation-caused quenching (ACQ) effect in physiological milieu, thus holding high promise for real-time and sensitive imaging of biomarkers in vivo. β-Galactosidase (β-Gal) is a biomarker for primary ovarian carcinoma, but current AIEgens for β-Gal sensing display emissions in the visible region and have not been applied in vivo. We herein propose an NIR AIEgen QM-TPA-Gal and applied it for imaging β-Gal activity in vitro and in ovarian tumor model. After being internalized by ovarian cancer cells (e.g., SKOV3), the hydrophilic nonfluorescent QM-TPA-Gal undergoes hydrolyzation by β-Gal to yield hydrophobic QM-TPA-OH, which subsequently aggregates into nanoparticles to turn NIR fluorescence “on” through the AIE mechanism. In vitro experimental results indicate that QM-TPA-Gal has a sensitive and selective response to β-Gal with a limit of detection (LOD) of 0.21 U/mL. Molecular docking simulation confirms that QM-TPA-Gal has a good binding ability with β-Gal to allow efficient hydrolysis. Furthermore, QM-TPA-Gal is successfully applied for β-Gal imaging in SKOV3 cell and SKOV3-bearing living mouse models. It is anticipated that QM-TPA-Gal could be applied for early diagnosis of ovarian cancers or other β-Gal-associated diseases in near future.

Mucin-producing tumors of the ovary——preoperative differentiation between metastatic ovarian mucinous carcinoma and primary mucinous malignant tumors

ObjectiveTo investigate the clinical and magnetic resonance imaging (MRI) features for preoperatively discriminating primary ovarian mucinous malignant tumors (POMTs) and metastatic mucinous carcinomas involving the ovary (MOMCs).MethodsThis retrospective multicenter study enrolled 61 patients with 22 POMTs and 49 MOMCs, which were pathologically proved between November 2014 to Jane 2023. The clinical and MRI features were evaluated and compared between POMTs and MOMCs. Univariate and multivariate analyses were performed to identify the significant variables between the two groups, which were then incorporated into a predictive nomogram, and ROC curve analysis was subsequently carried out to evaluate diagnostic performance.Results35.9% patients with MOMCs were discovered synchronously with the primary carcinomas; 25.6% patients with MOMCs were bilateral, and all of the patients with POMTs were unilateral. The biomarker CEA was significantly different between the two groups (p = 0.002). There were significant differences in the following MRI features: tumor size, configuration, enhanced pattern, the number of cysts, honeycomb sign, stained-glass appearance, ascites, size diversity ratio, signal diversity ratio. The locular size diversity ratio (p = 0.005, OR = 1.31), and signal intensity diversity ratio (p = 0.10, OR = 4.01) were independent predictors for MOMCs. The combination of above independent criteria yielded the largest area under curve of 0.922 with a sensitivity of 82.3% and specificity of 88.9%.ConclusionsPatients with MOMCs were more commonly bilaterally and having higher levels of CEA, but did not always had a malignant tumor history. For ovarian mucin-producing tumors, the uniform locular sizes and signal intensities were more predict MOMCs.