[Can be considered the primary fallopian tube cancer an enigma at the beginning of the third millenium?]. / Lze povazovat i na zacátku tretího tisíciletí primární karcinom vejcovodu za enigma?

OBJECTIVE: To analyze differences between primary fallopian tube cancer and ovarian cancer. DESIGN: Overview study. SETTING: Department of Obstetrics and Gynecology, The Fingerland Department of Pathology, Department of Oncology and Radiotherapy, Faculty of Medicine and University Hospital Hradec Kralove. METHODS: Overview study focused on analysis of data of primary fallopian tube cancer. CONCLUSION: The incidence of primary fallopian tube cancer was thought to be very low in the past but it is very difficult to assess the primary origin in the case of advanced disease (ovary versus fallopian tube). Tumorogenic potential of endosalpinx in relation to epithelial tumours is much more bigger. According to the current knowledge, the vast majority of high-grade serous carcinomas of the "ovary" in fact arise in the mucosa of fimbrial portion of fallopian tube.

[Hypersensitivity reactions to carboplatin and paclitaxel - our five-years experiences]. / Hypersenzitivní reakce po podání karboplatiny a paklitaxelu - nase petileté zkusenosti.

OBJECTIVE: To analyze hypersensitivity reactions to carboplatin and paclitaxel in patients treated with systemic administration of chemotherapy (carboplatin and/or paclitaxel). DESIGN: Retrospective study. SETTING: Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine and University Hospital Hradec Kralove. METHODS: One hundred-forty patients treated with systemic administration of chemotherapy were enrolled to our study between years 2008 and 2012. The presence and the grade [grade (G) 1-5; 1 = moderate, 5 = death] of hypersensitivity reactions (HSRs) were evaluated, as well as the influence of some clinical parameters on development of HSR. RESULTS: In total 29 HSRs in 21 patients were analyzed. To carboplatin were reported 19 (66%) HSRs: 13 (45%) HSRs of G1-G3 and 6 (21%) HSRs of G4. To paclitaxel were reported 10 (34%) HSRs: 9 (31%) HSRs of G1-G3 and 1 (3%) HSR of G4. The number of administered cycles of carboplatin to develop G1-G4 resp. G1-G3 HSR was higher in comparison with number of cycles to develop HSR of the same grade to paclitaxel(p = 0.001, resp. p = 0.01). CONCLUSION: HSR to carboplatin is unlike paclitaxel affected by the number of administered cycles. This fact should be included in the clinical management of patients treated with intravenous chemotherapy using carboplatin.

[Vascular endothelial growth factor in ovarian cancer patients]. / Cévní endotelový rustový faktor u pacientek s karcinomem ovaria.

OBJECTIVE: To compare plasma VEGF (vascular endothelial growth factor) levels in ovarian cancer patients, in patients with benign ovarian tumors and healthy women. DESIGN: Prospective study. SETTING: Department of Gynecology and Obstetrics, Medical Faculty Charles University, Prague and University Hospital, Hradec Králové. Department of Immunology and Alergology, Medical Faculty Charles University, Prague and University Hospital, Hradec Králové. METHODS: VEGF was estimated by ELISA (R&D Systems). RESULTS: We found that plasma VEGF levels were associated with the International Federation of Gynecology and Obstetrics (FIGO) stage (FIGO I+II, n=8) Med = 425,53 pg/ml (range 142,30-982,40 pg/ml), (FIGO III+IV, n=29) Med = 941,48 pg/ml (range202,10-2857,80 pg/ml) (p=0,03). Patients with primary ovarian cancer (n=37) had a significantly higher plasma VEGF level Med = 829,93 pg/ml (range142,30-2857,80 pg/ml), compared with patients with benign ovarian tumors (n=15) Med = 426,28 pg/ml (range 32,00-922,20 pg/ml) and healthy women (n=21) Med = 283,13 pg/ml (range 80,50-735,20 pg/ml) (p=0,0003). VEGF levels were lower in plasma (n=79) Med = 575,49 pg/ml (range 55,80-2185,00 pg/ml) compared with VEGF levels in ascitic fluid (n=37) Med = 745,74 pg/ml (range 142,30-2185,00 pg/ml) (p=0,04) in ovarian cancer patients. CONCLUSION: Plasma VEGF assay before primary treatment and the changes during the other treatment should contribute to better understanding of angiogenesis in ovarian cancer patients. Plasma VEGF correlates with the stage of primary ovarian cancer.

[Proteins of resistance and drug resistance in ovarian carcinoma patients]. / Proteiny rezistence a chemorezistence u pacientek s karcinomem ovaria.

BACKGROUND: To evaluate the correlation of resistance proteins LRP (Lung Resistance Protein), Pgp (P-glycoprotein), MRP (Multidrug Resistance-Associated Protein), MRP3 a MRP5 with stage, grade and histological type. To asses correlation of these resistance proteins with drug resistance/drug sensitivity in vitro by means of the MTT assay in ovarian cancer patients. To find the clinical outcome of these data. PATIENTS AND METHODS: 64 women with epithelial ovarian cancer who underwent primary surgery in 2006-2010 had specimens stained with immunohistochemistry for LRP, MRP, MRP3, MRP5 and Pgp and MTT assay (MTT-(3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide). RESULTS: Patients with late ovarian cancer had a higher Pgp, MRP, MRP3 and MRP5 level compared to ovarian cancer patients with early stage ovarian cancer. No correlation of resistance proteins with grading was found. Patients with high Pgp and MRP expression had significantly shorter progression-free survival. Patients with drug resistance in vitro by means of the MTT assay had higher Pgp and MRP expression. CONCLUSION: P-glycoprotein and MRP may be useful predictor for outcome of primary chemotherapy in patients with ovarian cancer.

[Primary drug resistance/sensitivity in vitro and clininical outcome in ovarian cancer patients]. / Primární rezistence/senzitivita in vitro a klinický prubeh onemocnení u pacientek s karcinomem ovaria.

OBJECTIVE: To assay correlation between primary resistance/sensitivity in vitro by MTT test in solid tumor and ascitic fluid and clininical outcome in ovarian cancer patients. DESIGN: Prospective study. SETTING: Department of Gynecology and Obstetrics, Medical Faculty Charles University, Prague and University Hospital, Hradec Králové. METHODS: MTT - (3-(4,5 - Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) chemosensitivity assay was performed in 45 samples of ovarian cancer tissue and 26 samples of ascitic fluid in ovarian cancer patients. We studied the in vitro drug resistance profiles of ovarian cancer specimens exposed to cisplatin, carboplatin, paclitaxel, topotecan, gemcitabin, etoposid. RESULTS: The highest incidence of primary drug resistance in vitro had gemcitabin and carboplatin and the lowest incidence of primary drug resistance had cisplatin and topotecan. Cisplatin had lower incidence of primary drug resistance in vitro than carboplatin. Grade and stage of epithelial ovarian cancer did not correlate to the primary drug resistance/sensitivity in vitro in ovarian cancer patients. The histological subtype of epithelial ovarian cancer correlated to the resistance and sensitivity to chemotherapeutic agents in vitro. Ovarian cancer patients with primary drug resistance to paclitaxel and carboplatin in vitro had more complications during primary chemotherapy, shorter progression free interval and worse prognosis of the disease. CONCLUSION: The lowest incidence of primary drug resistance in vitro had cisplatin. Ovarian cancer patients with in vitro resistance to paclitaxel and carboplatin had significantly higher risk for progression of disease when treated with standard platinum-paclitaxel based regimens. The primary resistance/sensitivity assay would contribute to the targeted treatment and better prognosis of ovarian cancer patients.

[Resistance/sensitivity in vitro in ovarian cancer patients]. / Rezistence/senzitivita in vitro u pacientek s karcinomem ovaria.

OBJECTIVE: To assay resistance/sensitivity by MTT test in solid tumor or ascitic fluid in ovarian cancer patients. DESIGN: Prospective study. SETTING: Department of Gynecology and Obstetrics, Medical Faculty Charles University, Prague and University Hospital, Hradec Králové. METHODS: MTT - (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) chemosensitivity assay was performed in 32 samples of ovarian cancer tissue and 26 samples of ascitic fluid in ovarian cancer patients. We studied the in vitro drug resistance profiles of ovarian cancer specimens exposed to cisplatin, carboplatin, paclitaxel, topotecan, gemcitabin, etoposid. RESULTS: The highest frequency of resistance in vitro occured for etoposid, gemcitabin and paclitaxel and the most effective chemotherapeutical agents in vitro were cisplatinum and topotecan. Cisplatin had the lowest incidence of drug resistance in vitro than carboplatin. CONCLUSION: Resistance/sensitivity assay would improve the treatment and prognosis of ovarian cancer patients.

[Prognostic factors of mesenchymal and mixed tumors of uterus]. / Prognostické faktory u mezenchymálních a smísených nádoru delozního tela.

OBJECTIVE: Analysis of clinical and histopathological prognostic factors with emphasis on carcinosarcomas, leiomyosarcomas and endometrial sarcomas of uterus. SUBJECT: Review. SETTING: Department of Obstetrics and Gynaecology, Medical Faculty Hradec Králové, Charles University, Prague; The Fingerland Department of Pathology, Medical Faculty Hradec Králové, Charles University, Prague; Department of Clinical Oncology, Medical Faculty Hradec Králové, Charles University, Prague; Department of Biological and Medical Sciences, Faculty of Pharmacy, Hradec Králové; Charles University, Prague. SUBJECT AND METHOD: Discussion about our experience and current evidence. CONCLUSION: Mesenchymal and mixed tumors of uterus are characterized by several prognostic factors as well. Except clinical prognostic variables, histopathological and molecular biological factors may play a role. The most important prognostic significance carry stage of disease, age and performance status of patient and sufficient therapy, especially surgery. In particular tumors some other prognostic factors are recognized. Except cases in really early stage of disease there is usually short interval between end of primary therapy and tumor recurrence. With the exception of endometrial stromal sarcoma, prognosis of these tumors remains very poor.

[Chemoresistance/Chemosensitivity of ovarian cancer--a case report]. / Chemorezistence/chemosenzitivita ovariálního karcinomu--kazuistika.

OBJECTIVE: To describe chemoresistance and chemosensitivity of two ovarian cancer patients and influence on their medical outcome. SETTINGS: Department of Obstetrics and Gynecology, Medical Faculty Charles University Prague and University Hospital, Hradec Králové. SUBJECT AND METHOD: A case report of two ovarian cancer patients with defined chemoresistance/chemosensitivity of their tumors. We used WST-MTT-1 test for the assessment of chemoresistance/chemosensitivity. CONCLUSION: The chemoresistance/chemosensitivity assay would improve the treatment and prognosis of ovarian cancer patients.