[The endocrine activity and clinical characteristics of benign ovarian fibro-epithelial tumors].

OBJECTIVE: To investigate the endocrine activity and clinical characteristics of benign ovarian fibro-epithelial tumors. METHODS: A retrospective analysis was done on 16 cases of benign fibro-epithelial tumor collected from the department of obstetrics and gynecology, Peking Union Medical College Hospital from 1981 to 2000. RESULTS: The examinations of endocrine activity was measured in 15 cases. Serum estradiol and follicle-stimulating hormone levels in 4 cases, it was (166.5 +/- 83.0) pmol/L and (39.4 +/- 12.6) IU/L respectively; low to moderate level of estrogen influence was observed in 8 cases by vaginal cytology; endometrium proliferation was observed in 10/15 cases by pathological examination. CLINICAL MANIFESTATIONS: post-menopausal vaginal bleeding in 10 cases, lower abdominal recessive pain in 3 cases, pelvic mass in all of the 16 cases with both pelvic examination and ultrasonography. CONCLUSION: Most of the benign fibro-epithelial tumor have endocrine activity and related clinical manifestations.

Thrombin-antithrombin III and D-dimer plasma levels in patients with benign or malignant ovarian tumours.

In 50 patients with benign ovarian tumours, 39 malignant ovarian carcinoma patients and 39 age-matched healthy women, plasma levels of thrombin-antithrombin III complex and D-dimer were determined as well as CA 125. The coagulation activation marker thrombin-antithrombin III complex and D-dimer levels were elevated in the malignant group compared to the benign and control groups. The results suggest that coagulation and fibrinolysis must play a prominent role in ovarian cancer. Moreover, D-dimer and thrombin-antithrombin III were equally useful as CA 125 for the discrimination of patients with benign or malignant ovarian tumours as evidenced by receiver operating and likelihood ratio calculations.

Mucinous adenofibroma of the ovary: case report of the endocrinologic findings.

Endocrine and clinicopathologic findings in a 77-year-old woman with ovarian mucinous adenofibroma of borderline malignancy are reported. The preoperative levels of testosterone, androstenedione, estrone, and estradiol in her peripheral blood were 91 ng/ml, 3.78 ng/ml, 82 pg/ml, and 35 pg/ml, respectively, abnormally high. Those of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were < 0.5 mIU/ml and 12.1 mIU/ml, respectively. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. Pathologic diagnosis of the right ovarian tumor was mucinous adenofibroma of borderline malignancy with hyperthecosis. Postoperatively, the levels of sex steroids and gonadotropin returned to the normal range of a postmenopausal woman. The patient remains well 2 years and 6 months after the operation.

Cystadenofibroma of the ovary in young women.

Cystadenofibroma of the ovary, a relatively rare benign tumor, usually appears during the fourth and fifth decades. This tumor has malignant ultrasonographic features and may also macroscopically appear as malignant during surgery. Since this tumor has a rare malignant potential, it is well-advised to be aware of the possibility of a cystadenofibroma before selecting an aggressive surgical approach in young patients. We present five cases of young patients with cystadenofibromas of the ovary.

Significant increases in serum CA125 and CA19-9 following torsion from an adenofibroma of the ovary: a case report.

Significant increases in the serum levels of cancer antigen 125 (CA125) and carbohydrate antigen 19-9 (CA19-9) were observed over one month prior to the removal of an ovarian adenofibroma. The serum levels of CA125 and CA19-9 decreased rapidly after surgery. The surface of the tumor at surgery showed marked inflammation, probably induced by the necrosis produced by torsion. Pathologically, most of the tumor was necrotic, and histoimmunochemical staining of the viable cells was weak for CA125 but intense for CA19-9. Clinicopathological observations of the case suggested that CA125 and CA19-9 might be stimulated in the cells by inflammation or that originally existing CA125 and CA19-9 were released from the tumor cells following the cell necrosis.

Serum and immunohistochemical studies of NCC-ST-439 in breast cancer.

It has been thought that NCC-ST-439 antigen (ST-439) is a tumor-related carbohydrate antigen. The authors conducted serum and immunohistochemical studies to investigate the clinical significance of ST-439 in breast cancer. The level of serum ST-439 was elevated in advanced and recurrent breast cancers. In comparison with CEA and CA15-3, ST-439 was superior in sensitivity but inferior in specificity to these markers. The level of serum ST-439 showed no correlation with the levels of CEA or CA15-3. In the combination assay of these three markers, 80.6% of recurrent cases and 33.8% of primary cases were positive. Immunohistochemically, the expression of ST-439 was observed in 28.1% of noncancerous mammary duct epithelium and in 38.1% of the cancerous portion. From the above, we concluded that ST-439 was a tumor-related antigen and could be a tumor marker with high sensitivity in breast cancer.

Mucin-like carcinoma-associated antigen (MCA) in breast cancer: clinical experience at the National Cancer Institute of Milan.

Mucin-like Carcinoma-associated Antigen (MCA) is a glycoprotein belonging to the mucin family; it is defined by the monoclonal antibody b-12. Mucins represent an interesting group of tumor markers and are widely utilized in the clinical monitoring of neoplastic patients. These molecules show a certain degree of tissue specificity and MCA is preferentially associated with breast tissue. Several studies have demonstrated that patients with breast cancer usually have high MCA serum levels. In this paper the experience of the National Cancer Institute of Milan with the clinical use of MCA in breast cancer patients is reported. The observed sensitivity of the MCA test was poor in patients with early-stage disease, while it was acceptable in patients with advanced breast cancer. MCA concentrations appeared to be directly related to disease spread. A clear relationship was seen between MCA levels and lymph-nodal status. The highest MCA plasma levels were observed in patients with metastatic disease. In this group of patients the sensitivity of the test on the basis of a cut-off of 11 U/mL was 52%.

[1H-NMR of blood lipids in malignant and benign tumors]. / 1H-IaMR lipidov krovi pri zlokachestvennykh i dobrokachestvennykh opukholiakh.

High-resolution 1H-NMR (360 MHz) combined with thin-layer chromatography was used to study profile and molecular structure changes of inverted micelles of human blood developing in patients with malignant and benign tumors of the breast and uterus. Alterations were demonstrated in relative intensities of some lipid NMR peaks in tumor, as compared to normal blood. Changes in blood lipid levels, e.g. cholesterol, in tumor affect lipid structural and dynamical status thus elucidating NMR regularities obtained.

[Relations between antioxidant activity and lipid state of blood as an indicator of the effect of tumor on the body]. / Vzaimosviaz' antiokislitel'noi aktivnosti i sostava lipidov krovi kak pokazatel' vliianiia opukholi na organizm.

Studies on antioxidant activity and lipid profile of erythrocytes and blood plasma in patients with fibroadenoma, fibrous-cystic mastopathy and neoplasia at different stages of progression showed each pathology to be associated with certain changes in the said parameters. Identification of signs of systemic effect of cancer growth was attempted. Malignant tumor was shown to involve at certain stage pronounced quantitative changes in lipid metabolism and erythrocyte membrane properties. These included changes in cholesterol/phospholipids molar ratio, presence of phosphatidylinositides and dissociation of regulatory links between antioxidant activity and cellular lipid profile in erythrocytes.

Normal serum proteins in female breast carcinomas and fibroadenomas. An immunohistochemical study.

Several serum proteins were immunohistochemically studied in benign and malignant breast lesions in 13 patients. The majority of infiltrating duct and lobular carcinomas showed albumin and IgG abundant immune reactive cells. Fewer cells contained immune reactive alpha-1-antitrypsin and transferrin. Staining was diffuse and limited to the cell cytoplasm. Immune reactive cells alternated with non reactive ones in a characteristic heterogeneous pattern. The parenchymal cells in carcinomas were non reactive to ceruloplasmin, fibrinogen and alphafetoprotein. Myoepithelial and epithelial cells in fibroadenomas were also positive for albumin and IgG, but less frequently for alpha-1-antitrypsin and transferrin. Normal breast tissue surrounding fibroadenomas as well as a lactational adenoma showed no immune reactive cells. Mechanisms that may be involved with the presence of plasma proteins in the cytoplasm of parenchymal cells in breast lesions are discussed.

Serial analysis of fibronectin concentration in plasma of patients with benign and malignant breast diseases.

The serial levels of fibronectin (FNp) in plasma from 65 patients with benign and malignant breast disease and from 74 healthy control women were assayed by the use of the rocket immunoelectrophoresis procedure. Mean FNp levels in patients with breast cancer were age-matched with control subjects, but no clear correlation was found between FNp levels and the presence of primary tumor. Mean FNp values for fibroadenoma patients did not differ either from controls or from patients with malignant disease. Patients were also categorized according to TNM classification, to the number of positive axillary nodes, to the histologic grade of malignancy, and to the presence of estrogen receptors. Although differences were not significant, a higher number of patients with levels greater than the normal 95% percentile were found only in the group with four or more positive axillary nodes and in the group with a greater number of histologic malignancies. Marked fluctuations in FNp concentrations were found in individual patients during the follow-up period, independently of the treatment received. FNp seems unsuitable as a tumor marker because, besides its apparent lack of specificity for cancer, it reflected neither the host-tumor burden nor the response to treatment.

[Changes in the form of erythrocytes in cancer patients in the dynamics of the disease]. / Izmeneniia formi éritrotsitov u onkologicheskikh bol'nykh v dinamike zabolevaniia.

The study was concerned with echinocytosis in cases of fibroadenoma and cancer of the breast as well as malignancies of the lung, stomach and cervix uteri before and after surgical and radiation treatment. A relationship between the level of echinocytosis and tumor stage was observed, the highest level being in stage IV stomach cancer. Radical surgery was followed by a decrease while palliative treatment--by an increase in echinocyte level.

[Summary insulin-like activity of the blood serum in breast cancer and in specific age-related pathology]. / Summarnaia insulinopodobnaia aktivnost' syvorotki krovi u bol'nykh rakom molochnoi zhelezy i pri spetsificheskoi vozrastnoi patologii.

Total insulin-like activity (ILA) was evaluated by biological testing blood serum on the basis of stimulation of glycogen synthesis in rat diaphragm in vivo. Glucose loading was followed by an increase in ILA and radioimmune insulin (RII) levels both in patients with breast fibroadenomatosis and healthy controls. However, the patients revealed an increased RII response matched by absence of ILA response, while the basal ILA was three times that in healthy controls. An elevated basal level of ILA was also observed in patients with coronary atherosclerosis and mental depression. Enhanced hyperinsulinism due to RII complementary factors, capable of insulin-like activity, may prove to be a factor in specific age-associated pathology (cancer, atherosclerosis, mental depression).

[Characteristics of 35S-lipoic acid absorption by the blood cells in breast cancer]. / Osobennosti pogloshcheniia 35S-lipoevoi kisloty kletkami krovi bol'nykh rakom molochnoi zhelezy.

The peculiar characteristics of 35S lipoic acid uptake by blood red cells in breast cancer patients were studied. The rate of 35S lipoic acid uptake by red cells in cancer patients was much higher than that in healthy female donors. The difference was less significant in cases of acute mastitis or benign tumors. The increased uptake of 35S lipoic acid by red cells may prove instrumental in the diagnosis and, probably, therapy of breast cancer.

[Changes in plasma phospholipid composition and lipid antioxidant activity of breast tumor patients without and following radiation therapy]. / Izmenenie fosfolipidnogo sostava i antiokislitel'noi aktivnosti plazmy krovi bol'nykh s opukholiami molochnoi zhelezy bez i posle radiatsionnogo lecheniia.

Phospholipid composition and antioxidative activity of lipids were studied in blood plasma of patients with tumoral and nonmalignant pathologies of mammary glands. In patients with mammary gland tumors relative content of various phospholipids was distinctly altered as compared with healthy persons. Specific alterations in content of the phospholipids were noted at various steps of the pathological process: an increase in content of sphingomyelin and complete absence of lysophosphatidyl choline in fibroadenoma; the same phenomenon, simultaneously with an increase in content of phosphatidyl ethanolamine and a decrease in phosphatidyl choline concentration, was observed in fibrocystic mastopathy. At the initial steps of malignization lysophosphatidyl choline was not found but the sphingomyelin contents were of opposite direction as compared with fibrocystic mastopathy. The subsequent development of neoplasm was characterized by an increase in relative content of sphingomyelin/in patients with tumors up to 4 cm in diameter (as well as of phosphatidyl ethanolamine and by a decrease in lysophosphatidyl choline content) tumors exceeding 5 cm/ as compared with the normal state. The antioxidative activity of blood plasma lipids was significantly decreased in patients with non-malignant tumors and with malignant neoplasms exceeding 6 cm in diameter. An X-ray treatment altered the lipid fraction antioxidative activity and relative content of erythrocyte phospholipids towards the states typical for early steps of malignization.

Detection of placental protein five (PP5) and pregnancy-specific glycoprotein (SP1) in benign and malignant breast disease.

Sensitive radioimmunoassays for the placental proteins PP5 and SP1 were used to investigate possible ectopic synthesis of these proteins by breast tumors. Elevated serum levels of the proteins were found in a small proportion of patients who had undergone mastectomy for malignant tumors, but little useful information on tumor spread could be gained from such measurements. In two patients with elevated pre-operative serum PP5, the levels fell to normal upon resection of the tumor, suggesting that PP5 may be a product of the tumor. PP5 and SP1 were found to be present in the majority of homogenates of malignant and benign breast lesions; the highest concentrations of SP1 were found in malignant tumors, whereas with PP5, especially high levels were found in cases of simple cystic disease.

Circadian variation of serum prolactin and TSH of women in health or with mammary carcinoma, fibroadenoma or fibrocystic mastopathy.

Prolactin and TSH were determined in serum samples obtained at 4-hourly intervals throughout a 24-hour span from healthy women and from women with fibrocystic mastopathy, fibroadenoma or carcinoma of the breast. Data were subjected to analysis by the population mean-cosinor method. Differences in circadian mesor of prolactin among the 4 groups were statistically significant (P < .01), with healthy women having the lowest value. Prolactin amplitude differences among the groups were of borderline statistical significance (P = .05), while no differences in circadian acrophase were apparent. No statistically significance differences in TSH circadian mesor, amplitude or acrophase could be demonstrated. Individual values from subjects with breast disease were compared with time-qualified tolerance intervals based on data from healthy subjects. If these results can be corroborated on larger populations, sampling about 3 hours after arising may best detect an abnormal serum prolactin elevation. Results from this and other studies indicate the need for multi-variable and multifrequency investigations of breast disease.