Ovarian Cancer as Random Finding in Laparoscopy

2021 ◽  
pp. 259-273
Author(s):  
Kimon Chatzistamatiou ◽  
Leonidas Zepiridis ◽  
Grigorios Grimbizis
Keyword(s):  
Ovarian Cancer ◽  
Cystic Tumor ◽  
Port Site Metastasis ◽  
Adnexal Masses ◽  
Adnexal Surgery ◽  
Benign Ovarian Tumors ◽  
Almost All ◽  
Intraoperative Rupture ◽  
Peritoneal Spread ◽  
Preoperative Patient

Laparoscopy can be used for almost all gynecological procedures and is considered as the indicated method for specific procedures. This is especially true for adnexal surgery. Of course, while it is considered a method of choice for the treatment of benign ovarian tumors, the same does not apply to malignant ones, although treatment of ovarian cancer either at an early or even at a more advanced stage is feasible with laparoscopy. Finding malignancy, when not suspected, during laparoscopic treatment of an ovarian cyst is a situation raising several issues, depending on whether the identification of malignancy is intra- or post-operative, which involve inadequate surgical staging, peritoneal spread of cancer cells, intraoperative rupture of a malignant ovarian cystic tumor, and port site metastasis. This chapter analyzes the possible adverse events related to the use of laparoscopy in the treatment of adnexal masses considered as benign but turn out to be malignant, and how they can be mitigated with careful preoperative patient selection and with adequate surgical experience.

Stem-like tumor cells and proinflammatory cytokines in the ascitic fluid of ovarian cancer patients

2021 ◽  
Vol 66 (5) ◽  
pp. 297-303
Author(s):  
S. O. Gening ◽  
T. V. Abakumova ◽  
I. I. Antoneeva ◽  
A. A. Rizvanov ◽  
T. P. Gening ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Blood Serum ◽  
Tumor Cells ◽  
Ascitic Fluid ◽  
Early Stage ◽  
Abdominal Cavity ◽  
Disease Stage ◽  
Cell Populations ◽  
Benign Ovarian Tumors ◽  
Number Of Cells

Ovarian cancer (OC) is able to develop implantation metastases in the abdominal cavity. Ascites is potentially useful for evaluating cancer features. The aim of the study was to assess the content of stem-like tumor cells and inflammatory mediators in ascites of OC. The prospective study included 11 patients with primary OC having ascites, 8 patients with benign ovarian tumors having ascites and 22 healthy women. In ascitic fluid obtained by laparocentesis, the populations of tumor stem-like cells were determined on a Cytoflex S` flow cytometer (Beckman Coulter, USA) and CytExpert Software using monoclonal antibodies to CD45, CD44 and CD133. The cytokine profiles of ascitic fluid and blood serum (IL-1β, IL-18, IL-4, IL-10 and VEGF) were assessed by ELISA. Stem-like cells were found in all samples. 5 cell populations were evaluated. The number of cells expressing both markers: CD44 + and CD133+, was the lowest. The highest, about 32%, was the number of CD44+ cells. The number of cells CD45-CD44+CD133- in ascites strongly positively correlated with the content of IL-10 in ascites, and the numbers of CD45-CD133+ and CD45-CD44-CD133+ - with the level of VEGF in blood serum. No correlations were found between the numbers of stem-like cells and the disease stage or the level of CA125 in blood. The combination of IL-4 and IL-10 in ascites had the greatest significance in predicting the disease stage. These results suggest a relationship between the levels of VEGF, IL-10, and cancer stem cells in the OC ascites. Stem-like cells in OC ascites are heterogeneous and are present even at an early stage of the disease. It seems promising to study cell populations and cytokine profile of ascites together, to assess the biomarker potential of their combination.

scholarly journals Metagenomic Analysis of Serum Microbe-Derived Extracellular Vesicles and Diagnostic Models to Differentiate Ovarian Cancer and Benign Ovarian Tumor

Cancers ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1309 ◽  
Author(s):  
Se Ik Kim ◽  
Nayeon Kang ◽  
Sangseob Leem ◽  
Jinho Yang ◽  
HyunA Jo ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Extracellular Vesicles ◽  
Ovarian Tumor ◽  
Ovarian Tumors ◽  
Metagenomic Analysis ◽  
Serum Samples ◽  
Benign Ovarian Tumor ◽  
Diagnostic Models ◽  
Test Sets ◽  
Benign Ovarian Tumors

We aimed to develop a diagnostic model identifying ovarian cancer (OC) from benign ovarian tumors using metagenomic data from serum microbe-derived extracellular vesicles (EVs). We obtained serum samples from 166 patients with pathologically confirmed OC and 76 patients with benign ovarian tumors. For model construction and validation, samples were randomly divided into training and test sets in the ratio 2:1. Isolation of microbial EVs from serum samples of the patients and 16S rDNA amplicon sequencing were carried out. Metagenomic and clinicopathologic data-based OC diagnostic models were constructed in the training set and then validated in the test set. There were significant differences in the metagenomic profiles between the OC and benign ovarian tumor groups; specifically, genus Acinetobacter was significantly more abundant in the OC group. More importantly, Acinetobacter was the only common genus identified by seven different statistical analysis methods. Among the various metagenomic and clinicopathologic data-based OC diagnostic models, the model consisting of age, serum CA-125 levels, and relative abundance of Acinetobacter showed the best diagnostic performance with the area under the receiver operating characteristic curve of 0.898 and 0.846 in the training and test sets, respectively. Thus, our findings establish a metagenomic analysis of serum microbe-derived EVs as a potential tool for the diagnosis of OC.

scholarly journals Diagnostic accuracy of the risk of malignancy index 1 compared to the more recent IOTA ADNEX model in discriminating benign from malignant adnexal masses: a multi-centric study

2019 ◽  
Vol 8 (3) ◽  
pp. 1001
Author(s):  
Amita Ray ◽  
Divya S. ◽  
B. N. Kumar Guru ◽  
A. S. Ramaswamy ◽  
Bharat Kumar
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Predictive Value ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Adnexal Masses ◽  
Medical College ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
Almost All

Background: Identification of the nature of an adnexal mass can ensure optimum management. Single parameters as well as diagnostic models using a combination of several parameters are in use. The International Ovarian Tumor Analysis (IOTA) consortium has developed and published the Assessment of Different NEoplasias in the adneXa (ADNEX) model, which differentiates between benign and malignant masses. Authors conducted this study with the aim of finding a cut off value for this model in the study population and comparing the diagnostic accuracy of this model to that of the risk of malignancy (RMI).Methods: Women with adnexal masses admitted to the 3 medical college affiliated hospitals for surgical management were included in this study. Appropriate investigations were done to calculate the RMI-I and ADNEX score for each participant. A cut off score for the ADNEX model was determined and diagnostic accuracy tests were done for comparison.Results: At a cut-off of 29 for the ADNEX model and 200 for RMI model the sensitivity was 75% and 77.8, specificity 100% and 80.6%; Positive Predictive Value (PPV) 100%and 60%; Negative Predictive Value (NPV) 91% and 90.6%; Positive Likelihood ratio of infinity and 4 and a negative Likelihood Ratio of 2.8 and 2.5 respectively.Conclusions: The ADNEX model rates higher than the RMI in almost all tests of diagnostic accuracy and can be used for triaging, framing a referral policy and prioritizing surgery.

scholarly journals Urachal Mucinous Cystic Tumor of Low Malignant Potential with Concurrent Sigmoid Colon Adenocarcinoma

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Kelly Brennan ◽  
Paul Johnson ◽  
Heather Curtis ◽  
Thomas Arnason
Keyword(s):  
Sigmoid Colon ◽  
Incidental Finding ◽  
Colon Adenocarcinoma ◽  
Malignant Potential ◽  
Cystic Tumor ◽  
Mucinous Cystic Tumor ◽  
Therapeutic Implications ◽  
Diagnostic Pitfall ◽  
Low Malignant Potential ◽  
Peritoneal Spread

Urachal mucinous tumors are rare neoplasms with behaviour that can range from relatively benign to malignancy that can spread distantly or throughout the peritoneum as pseudomyxoma peritonei or peritoneal carcinomatosis. Here we describe a unique case of urachal mucinous cystic tumor of low malignant potential confined to an intact cyst at the dome of the urinary bladder, without rupture or peritoneal spread. The urachal mucinous tumor was an incidental finding on a staging CT scan performed for sigmoid colon adenocarcinoma. We believe that this case illustrates a potential diagnostic pitfall which could have prognostic and therapeutic implications. Due to the intestinal phenotype of these neoplasms, a urachal tumor of low malignant potential could be mistaken for metastatic spread from a colonic adenocarcinoma in the rare situation such as this case, where the two neoplasms occur concurrently.

Risk of epithelial ovarian cancer among women with benign ovarian tumors: a follow-up study

2019 ◽  
Vol 31 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Sonia Guleria ◽  
Allan Jensen ◽  
Anita Toender ◽  
Susanne K. Kjaer
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Ovarian Tumors ◽  
Follow Up Study ◽  
Benign Ovarian Tumors

scholarly journals Th17 Cells and IL-17 As Novel Immune Targets in Ovarian Cancer Therapy

2020 ◽  
Vol 2020 ◽  
pp. 1-15 ◽  
Author(s):  
Monika Bilska ◽  
Anna Pawłowska ◽  
Ewelina Zakrzewska ◽  
Agata Chudzik ◽  
Dorota Suszczyk ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Th17 Cells ◽  
Prognostic Significance ◽  
Clinicopathological Characteristics ◽  
Lower Percentage ◽  
Benign Tumors ◽  
Control Group ◽  
Intracellular Expression ◽  
Benign Ovarian Tumors

Ovarian cancer (OC) is usually diagnosed at an advanced stage and is related with poor prognosis. Despite numerous studies, the pathogenesis of OC is still unknown. Recent studies indicate the role of the immune system in the development and spread of OC. The identification of factors and mechanisms involved in that process and their modulation is crucial for creating effective antitumor therapy. We investigated the potential role of Th17 cells in OC patients (n = 71) by analyzing the frequencies of Th17 cells in three different environments, i.e., peripheral blood (PB), peritoneal fluid (PF), and tissue (Th17 infiltrating cells), and the concentration of IL-17A in plasma and PF of patients in terms of their clinical and prognostic significance. Th17 cells were analyzed by flow cytometry as a percentage of CD4+ lymphocytes that expressed intracellular expression of IL-17A. The level of IL-17A in plasma and PF were determined by ELISA. Our results showed accumulation of Th17 cells among tumor-infiltrating CD4+ lymphocytes (p<0.001 in relation to PB). Moreover, the percentage of Th17 cells in both PB and PF of OC patients was significantly lower than that in benign tumors group (n = 35). There were no significant differences in the percentage of Th17 cells in PB, PF, and tissue in relation to clinicopathological characteristics of OC patients and survival. The lower percentage of Th17 cells in the PB and PF of OC patients may promote evasion of host immune response by cancer cells. The concentration of IL-17A in plasma of OC patients was higher (p<0.0001) than that in both benign tumors and control group (n = 10). The PF IL-17A level in OC patients was higher (p<0.0001) than that in women with benign ovarian tumors, indicating its synthesis in OC microenvironment. Higher IL-17A level in PF is correlated with longer (median: 36.5 vs. 27 months) survival of OC patients.

scholarly journals Challenges and Inconsistencies in Using Lysophosphatidic Acid as a Biomarker for Ovarian Cancer

Cancers ◽  
2019 ◽  
Vol 11 (4) ◽  
pp. 520 ◽  
Author(s):  
Tsukasa Yagi ◽  
Muhammad Shoaib ◽  
Cyrus Kuschner ◽  
Mitsuaki Nishikimi ◽  
Lance Becker ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Research ◽  
Lysophosphatidic Acid ◽  
Room Temperature ◽  
Storage Time ◽  
Ethylenediaminetetraacetic Acid ◽  
Future Studies ◽  
Blood Drawing ◽  
Benign Ovarian Tumors ◽  
Artificial Changes

Increased detection of plasma lysophosphatidic acid (LPA) has been proposed as a potential diagnostic biomarker in ovarian cancer, but inconsistency exists in these reports. It has been shown that LPA can undergo an artificial increase during sample processing and analysis, which has not been accounted for in ovarian cancer research. The aim of this study is to provide a potential explanation about how the artificial increase in LPA may have interfered with previous LPA analysis in ovarian cancer research. Using an established LC-MS method, we measured LPA and other lysophospholipid levels in plasma obtained from three cohorts of patients: non-cancer controls, patients with benign ovarian tumors, and those with ovarian cancer. We did not find the LPA level to be higher in cancer samples. To understand this inconsistency, we observed that LPA content changed more significantly than other lysophospholipids as a function of plasma storage time while frozen. Additionally, only LPA was found to be adversely impacted by incubation time depending on the Ethylenediaminetetraacetic acid (EDTA) concentration used during blood drawing. We also show that the inhibition of autotaxin effectively prevented artificial LPA generation during incubation at room temperature. Our data suggests that the artificial changes in LPA content may contribute to the discrepancies reported in literature. Any future studies planning to measure plasma LPA should carefully design the study protocol to consider these confounding factors.

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