Correlation of preoperative ROMA scores with clinical stage in epithelial ovarian cancer patients

Purpose. The significance of the Risk of Ovarian Malignancy Algorithm (ROMA) in differentiating benign and malignant ovarian lesions has been evidenced. In our clinical work, we found that advanced ovarian cancer were accompanied commonly with high ROMA scores. Thus, this study aimed to clarify the performance of ROMA in different disease stage of epithelial ovarian cancer (EOC) prior to surgery. Methods. Carbohydrate antigen (CA125) and human epididymis protein 4 (HE4) levels and ROMA scores in 221 patients with FIGO stage I, II or III/IV stage EOC were analyzed. The positive rates of CA125, HE4 and ROMA at each disease stage were calculated. Their cutoff values, sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) for distinguishing patients with FIGO stage I/II from those with FIGO stage III/IV were estimated via ROC curves. Results. Serum CA125 and HE4 levels and ROMA scores rose significantly with advancing stage. ROMA and CA125 were significantly elevated more frequently in comparing with HE4 in EOC patients at with the same stage. Based on ROC curves, the cutoff values for FIGO stage III/IV EOC were 110 IU/mL, 126 pmol/L, 78 and 68% for CA125, HE4, premenopausal and postmenopausal ROMA, respectively. ROMA was the strongest predictor of FIGO stage, with the highest specificity, accuracy, and PPV, which were 84.4, 82.5, and 87.0% for postmenopausal patients, 89.3, 85.6, and 74.3% for premenopausal patients. Conclusions. Our data suggest high ROMA scores correlated with advanced ovarian cancer prior to surgery. These observations suggest potential utility of ROMA in the comprehensively preoperative evaluation of EOC patients (AU)

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CA125-related tumor cell kinetics variables after chemotherapy in advanced ovarian cancer: a systematic review

Various kinetic parameters, based on a minimum of two time points, have been built with CA125 determinations. The aim of this study is to review studies about the clinical application of CA125-related tumor cell kinetics variables in patients with advanced ovarian cancer (AOC) receiving chemotherapy. A literature search for studies about CA125-related variables in patients with AOC was undertaken on three databases, by predefined search criteria, and a selection of studies was performed. Sixty-two studies were selected. CA125-related variables were summarized in three groups: response-related, timeto- event, and other CA125-related tumor cell kinetics variables. Even though CA125 changes and half-life after chemotherapy were the most studied, other variables and two models have been well defined, and often showed an interesting power to predict survival. These kinetics variables are related to the CA125 regression curve, pre- and post-chemotherapy kinetics, or are variables inferred from a population model of CA125 kinetics (AU)

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In vitro assessment of antibody-conjugated gold nanorods for systemic injections.

BACKGROUND: The interest for gold nanorods in biomedical optics is driven by their intense absorbance of near infrared light, their biocompatibility and their potential to reach tumors after systemic administration. Examples of applications include the photoacoustic imaging and the photothermal ablation of cancer. In spite of great current efforts, the selective delivery of gold nanorods to tumors through the bloodstream remains a formidable challenge. Their bio-conjugation with targeting units, and in particular with antibodies, is perceived as a hopeful solution, but the complexity of living organisms complicates the identification of possible obstacles along the way to tumors. RESULTS: Here, we present a new model of gold nanorods conjugated with anti-cancer antigen 125 (CA125) antibodies, which exhibit high specificity for ovarian cancer cells. We implement a battery of tests in vitro, in order to simulate major nuisances and predict the feasibility of these particles for intravenous injections. We show that parameters like the competition of free CA125 in the bloodstream, which could saturate the probe before arriving at the tumors, the matrix effect and the interference with erythrocytes and phagocytes are uncritical. CONCLUSIONS: Although some deterioration is detectable, anti-CA125-conjugated gold nanorods retain their functional features after interaction with blood tissue and so represent a powerful candidate to hit ovarian cancer cells.

The value of FDG-PET/CT in the post-treatment evaluation of endometrial carcinoma: A comparison of PET/CT findings with conventional imaging and CA 125 as a tumour marker

Objetivos. Este estudio retrospectivo fue diseñado para evaluar el valor de la tomografía por emisión de positrones/tomografía axial computerizada (PET/TAC) en la evaluación pos-tratamiento de pacientes con cáncer de endometrio y comparar el estudio de PET/TAC con imágenes convencionales (IC), incluyendo la tomografía axial computerizada (TAC), ecografía (echo) y resonancia magnética (RM) y CA 125 con valores de corte de 20U/Ml y 35ml. Materiales y métodos. Se realizó un estudio de PET/TAC en 31 pacientes tratados por adenocáncer endometrio comprobado histopatologicamente para obtener reestadiaje y en la presencia de sospecha de recaída. Se realizaron 35 estudios de PET/TAC en 31 pacientes. El estado de la lesión fue determinado a partir del seguimiento clínico, incluyendo imágenes radiológicas (seguimiento del estudio de TAC) después de al menos 6 meses y respuesta a tratamiento. Resultados. Trece (37%) de los 35 estudios PET/TAC fueron positivos y 22 (63%) negativos. El análisis basado en el estudio demostró sensibilidad, especificidad, precisión para las imágenes de PET/TAC de 100%, 96% y 97%, respectivamente. Los datos correspondientes para la IC fueron 46%, 87% y 74% y para CA 125 (punto de corte=20U/ml), las mediciones fueron 27%, 100% y 78%, respectivamente. Basado en el análisis de la lesión, la PET/TAC sólo demostró un caso de falso positivo. No fueron observadas recaídas clínicas o radiológicas con un seguimiento de al menos 6 meses en los 21 pacientes con 22 estudios negativos de PET/TAC. Conclusiones. La FDG-PET/TAC es una modalidad más útil que la IC y CA 125 en la evaluación post-tratamiento de pacientes con cáncer de endometrio en búsqueda de sospecha de recaída(AU)

Objectives. This retrospective study was designed to assess the value of positron emission tomography/computed tomography imaging (PET/CT) in the post-treatment evaluation of the patients with endometrial carcinoma and to compare PET/CT scan with conventional imaging (CI) including computed tomography (CT), ultrasonography (US) and magnetic resonance imaging (MRI) and CA 125 with both 20U/ml and 35U/ml cut-off values. Materials and methods. A total of 31 patients who were treated for histopathologically proven endometrial adenocarcinoma, underwent PET/CT examination for restaging and suspected recurrence. Thirty five PET/CT studies were performed in 31 patients. Lesion status was determined on the basis of clinical follow-up including radiological imaging (follow-up CT scan) at least 6 months and response to therapy. Results. Of the 35 PET/CT studies, 13 (37%) studies were positive, whereas 22 (63%) of them were negative. On study-based analysis the overall sensitivity, specificity, accuracy for PET/CT imaging were 100%, 96% and 97%, respectively. The corresponding information for CI were 46%, 87% and 74%, for CA 125 (cut off=20U/ml) measurement were 45%, 88% and 74%, and for CA 125 (cut off=35U/ml) measurement were 27%, 100% and 78%, respectively. On lesion-based analysis, PET/CT revealed only one false positive case. In none of 21 patients with negative 22 PET/CT studies, no subsequent clinical or radiological recurrences were observed with a follow-up of at least 6 months. Conclusion. FDG-PET/CT is found more useful modality than CI and CA 125 in the evaluation of post-treatment endometrial carcinoma patients, for suspected recurrence(AU)

Heterologous immunization, a way out of the problem of monoclonal antibody production against carcinoma antigen 125.

BACKGROUND: Monoclonal antibodies (mAbs) are essential tools for many molecular immunology investigations, epitope mapping and molecular modelling, clinical laboratory diagnostic tests and immunotherapy. Humoral immune response of immunized animals largely depends on the nature of antigen and the immunization technique. Polysaccharides and heavily-glycosylated proteins are very elusive targets incapable of mounting long-lasting, high affinity antibody responses. Carcinoma antigen 125 (CA 125), a well known tumor marker of ovarian cancer, is a mucin type antigen consisting of repetitive units of heavily glycosylated moieties which render production of mAbs very difficult. OBJECTIVE: To evaluate the efficacy of heterologous antigen preparations as a way of mouse immunization in the production of anti-CA 125 mAb. METHODS: Two different protocols of immunization were used for priming of NMRI mice. In the first method, mice conventionally immunized by three intraperitoneal injections of purified CA 125 and boosted by the antigen three days before fusion. In the second approach, mice were primed by three intraperitoneal injections of living CA 125 positive cells of OVCAR-3 cell line, and boosted by intravenous injection of the purified extracellular domain of CA 125. Production of mAb was performed by standard hybridoma technology and mAbs were characterized by different immunoassays. RESULTS: The first method failed to produce stable clones despite six time fusion. A total of ten stable clones, however, were produced in the second approach. Some of the clones were characterized and found to have excellent immunoreactivity when tested by ELISA assay, western blotting, intracellular and surface immunofluorescent staining of OVCAR-3 cell line and immunohistochemical staining of ovarian cancer tissues. CONCLUSION: Altogether the results of the present study clearly showed that heterologous antigen preparation is the method of choice for immunization when production of monoclonal antibody against highly glycosylated poorly immunogenic antigens is concerned.

Tuberculosis peritoneal. Descripción de un caso / Peritoneal tuberculosis. Report of a case

Debemos pensar en el diagnóstico de tuberculosis peritoneal en cualquier paciente con dolor abdominal de etiología desconocida, ascitis y fiebre. Puede presentarse de manera insidiosa (forma clásica), o bien como infertilidad primaria o secundaria (forma actual). El diagnóstico se realiza con el estudio anatomopatológico de los granulomas caseificantes y mediante el cultivo del líquido peritoneal. Nuevas pruebas diagnósticas, como el estudio del ADA (ascitis fluid adenosine deaminasa), pueden cambiar el algoritmo diagnóstico de esta enfermedad (AU)

Síndrome de Meigs asociado a tumor paraovárico / Meigs' syndrome associated with paraovarian tumor

Se presentan dos casos de síndrome de Meigs caracterizado por la asociación de tumor ovárico (fibroma, tecoma, tumor de células de la granulosa, tumor de Brenner) con ascitis e hidrotórax. Ambos casos mostraron elevación de CA-125. Se destaca la importancia de considerar la naturaleza benigna del proceso cuando la tomografía computarizada muestra ausencia de implantes peritoneales. (AU)

Caracterización preoperatoria de las tumoraciones de ovario mediante ecografía, Doppler y determinación sérica de ca125. estudio comparativo / Preoperative characterization of ovarian tumors by Doppler ultrasonography and serum CA125 determination

Objetivo: Determinar la capacidad diagnóstica de la ecografía, el Doppler-color y pulsado, y la determinación sérica de CA125 en el diagnóstico diferencial de las tumoraciones anexiales.Material y métodos: Un total de 126 pacientes con una tumoración anexial fueron evaluadas mediante ecografía, Doppler-color y pulsado y determinación sérica de CA125 de forma previa a la cirugía. Se calcula la capacidad de cada parámetro en términos de sensibilidad, especificidad, valores predictivos positivo y negativo, precisión global y razón de riesgo.Resultados: Un total de 98 (77,7 por ciento) tumores fueron benignos y 28 (22,2 por ciento) malignos. Los tumores malignos presentaron, de forma significativa, mayor volumen, paredes y tabiques más gruesos, mayor frecuencia de partes sólidas y de ascitis, vascularización más intensa, distribución central de los vasos y valores superiores de CA125 que los tumores benignos. El tipo ecográfico más frecuentemente asociado a malignidad fue el quiste sólido multilocular, siendo la presencia de partes sólidas la variable con mayor potencia discriminatoria.Conclusiones: La información que aporta el estudio ecográfico convencional es superior a la que aporta el estudio de la vascularización del tumor y el marcador tumoral CA125. (AU)

Struma ovarii: tres presentaciones clínicas diferentes en un infrecuente tumor de ovario / Struma ovarii: three presentations of an uncommon ovarian tumor

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