[Assessment of the influence of chemotherapy on the nucleolar organizer regions (AgNORs) count in serous ovarian cancer cells]. / Ocena wplywu chemioterapii na parametry oceny ilosciowej stref organizatorów jaderkowych (AgNORs) w komórkach raka jajnika.

OBJECTIVE: When planning treatment of ovarian cancer, the prognostic factors should be considered. One of them is the amount of nucleolar organizer regions (AgNORs) in cancer cells, which reflects proliferative activity of the tumor. DESIGN: To estimate the influence of chemotherapy on the AgNORs count in serous ovarian cancer cells. MATERIAL AND METHODS: 26 women who underwent surgical procedure and then chemotherapy between 1998-2002 due to serous ovarian cancer were included into the study. During the initial surgery the cancer stage I was detected in 1 case, stage II in 2 cases, stage III in 12 cases, and stage IV in 11 cases. In all cases during second-look laparotomy, which was performed after 6 courses of chemotherapy (paclitaxel, cisplatinum), the persistent disease was found. In 17 out of 26 cases it was disseminated neoplasmatic disease. In all cases the specimens were prepared according to one-step AgNORs method described by Howell and Ploton. In cancer cells the mean number of AgNORs per nucleus (mAgNOR) and the mean percentage of nuclei with five or more AgNORs per nucleus (pAgNOR) were counted. RESULTS: The mAgNOR and pAgNOR mean number before chemotherapy were respectively: 4, 22 +/- 0.94 and 35.62 +/- 19.90. After treatment the mAgNOR and pAgNOR were significantly lower, and the data were respectively: 3.67 +/- 0.91 and 24.15 +/- 19.53. In 4 cases (15.4%) the mAgNOR increased, in 7 cases (26.9%) the change was not significant, and in 15 cases (57.7%) the mAgNOR decreased. In 6 cases (23.1%) the pAgNOR increased, in 5 cases (19.2%) the change was not significant, and in 15 cases (57.7%) the pAgNOR decreased. We did not found any correlation between the tendency to change the number of AgNORs and staging, the amount of persistent neoplasmatic tissue, the range of primary surgery, as well as grading. CONCLUSIONS: The number of AgNORs per nucleus in most cases of ovarian cancer after chemotherapy was lower. The tendency to change the number of AgNORs was not connected with staging as well as grading.

Preoperative assessment of unilocular adnexal cysts by transvaginal ultrasonography: a comparison between ultrasonographic morphologic imaging and histopathologic diagnosis.

OBJECTIVE: Our purpose was to evaluate the risk of malignancy in surgically removed ovarian cysts that were characterized before the operation as unilocular according to transvaginal ultrasonography. STUDY DESIGN: This prospective analysis included 927 premenopausal women and 377 postmenopausal women operated on at 2 European university hospitals between January 1992 and December 1997. On the basis of ultrasonographic findings the cysts were characterized either as echo-free, without solid parts or papillary formations (group 1), or as having echogenic cyst content, with solid parts or papillary formations (group 2). Ultrasonographic and macroscopic appearances of the cysts were compared with histopathologic diagnosis. RESULTS: In group 1, in premenopausal women 3 of 413 cysts (0.73%) proved to be borderline or malignant, and in postmenopausal women 4 of 247 cysts (1.6%) proved to be borderline or malignant. The figures for cysts in group 2 were 11 of 514 cysts (2.1%) and 13 of 130 cysts (10.0%), respectively. It was not possible to differentiate by transvaginal ultrasonography between benign, borderline, and malignant cysts when solid parts or papillary formations were visualized. CONCLUSIONS: This study confirmed that the risk of malignancy associated with unilocular echo-free cysts (group 1) was low. Serial ultrasonographic follow-up should therefore be the standard procedure with unilocular echo-free cysts <50 mm in diameter. In cysts with a mean diameter of >50 mm, papillary formations or solid parts may be missed by transvaginal ultrasonography. The risk for malignancy in cysts containing papillary formations or solid parts (group 2) was 3 to 6 times higher than that in unilocular echo-free cysts.