Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.007
Filtrar
1.
Medicine (Baltimore) ; 100(3): e22605, 2021 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-33545921

RESUMO

BACKGROUND: Previous publications studied the correction about folate intake and ovarian cancer risk, with inconsistent results. This meta-analysis aimed to explore the association between folate intake and ovarian cancer risk using the existing published articles. METHOD: We searched for relevant studies in electronic databases of PubMed, Web of Science, Embase, Cochrane, and Wanfang databases from inception to May 31, 2020. The overall relative risk (RR) and its 95% confidence intervals (95% CI) were pooled using a random-effect model. RESULTS: A total of 12 articles with 6304 ovarian cancer cases were suitable for the inclusion criteria. The evaluated of the ovarian cancer risk with total folate intake and dietary folate intake were reported in 6 articles and 10 articles, respectively. Overall, highest category of dietary folate intake compared with lowest category had nonsignificant association on the risk of ovarian cancer (RR = 0.90, 95% CI = 0.77-1.06). The association was not significant between total folate intake and ovarian cancer risk (RR = 1.06, 95% CI = 0.89-1.27). The results in subgroup analyses by study design and geographic location were not changed either in dietary folate intake analysis or in total folate intake analysis. CONCLUSION: Our meta-analysis demonstrates that folate intake had no significant association on the risk of ovarian cancer. Study design and geographic location were not associated with ovarian cancer while some other related factors were not investigated due to the limited information provided in each included study. Therefore, further studies are needed to verify our results.


Assuntos
Carcinoma Epitelial do Ovário/epidemiologia , Suplementos Nutricionais , Ácido Fólico/administração & dosagem , Neoplasias Ovarianas/epidemiologia , Carcinoma Epitelial do Ovário/etiologia , Feminino , Humanos , Estudos Observacionais como Assunto , Neoplasias Ovarianas/etiologia , Fatores de Risco
2.
Nat Commun ; 11(1): 2660, 2020 05 27.
Artigo em Inglês | MEDLINE | ID: mdl-32461556

RESUMO

High-grade serous ovarian cancer (HG-SOC)-often referred to as a "silent killer"-is the most lethal gynecological malignancy. The fallopian tube (murine oviduct) and ovarian surface epithelium (OSE) are considered the main candidate tissues of origin of this cancer. However, the relative contribution of each tissue to HG-SOC is not yet clear. Here, we establish organoid-based tumor progression models of HG-SOC from murine oviductal and OSE tissues. We use CRISPR-Cas9 genome editing to introduce mutations into genes commonly found mutated in HG-SOC, such as Trp53, Brca1, Nf1 and Pten. Our results support the dual origin hypothesis of HG-SOC, as we demonstrate that both epithelia can give rise to ovarian tumors with high-grade pathology. However, the mutated oviductal organoids expand much faster in vitro and more readily form malignant tumors upon transplantation. Furthermore, in vitro drug testing reveals distinct lineage-dependent sensitivities to the common drugs used to treat HG-SOC in patients.


Assuntos
Sistemas CRISPR-Cas/genética , Organoides , Neoplasias Ovarianas/etiologia , Animais , Antineoplásicos/farmacologia , Proteína BRCA1/genética , Proteína 9 Associada à CRISPR , Epitélio/patologia , Tubas Uterinas/patologia , Feminino , Edição de Genes/métodos , Camundongos , Mutação , Neurofibromatose 1/genética , Técnicas de Cultura de Órgãos/métodos , Organoides/efeitos dos fármacos , Organoides/fisiopatologia , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/genética , Ovário/patologia , PTEN Fosfo-Hidrolase/genética , Proteína Supressora de Tumor p53/genética
3.
Arch Gynecol Obstet ; 301(6): 1473-1477, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32322983

RESUMO

OBJECTIVE: Data regarding the effect of post-partum bilateral tubal ligation (BTL) on future risk for ovarian cancer (OC) is lacking. In the current study, we aimed to evaluate the effect of BTL during cesarean delivery (CD) on the long-term risk for OC. STUDY DESIGN: A population-based cohort analysis of women above the age of 35 that underwent CD in their last delivery, comparing the long-term risk for OC between patients that had a Pomeroy excisional BTL and those that did not. OC diagnosis was pre-defined based on ICD-9 codes. Procedures occurred between the years 1991-2017. Kaplan-Meier survival curve was used to compare the cumulative incidence of OC over time and Cox proportional hazards model was constructed to control for confounders. RESULTS: During the study period 13,124 women met the inclusion criteria; 9438 (71.9%) of which had only CD and 3686 (28.1%) underwent CD with BTL. Despite the significantly higher incidence of maternal factors that might increase the long-term risk for OC in the BTL group (advanced maternal age, obesity, hypertensive diseases during pregnancy and diabetes mellitus), the cumulative incidence of OC cases was not significantly different between the two groups (Log-rank test p = 0.199). Likewise, when performing a Cox regression model controlling for maternal age, obesity, hypertensive diseases and diabetes, OC risk was not significantly different between the groups (adjusted HR 2.36, 95% CI 0.73-7.62; p = 0.149). CONCLUSION: Despite an increased incidence of known risk factors for OC, patients that underwent BTL during CD did not have increased long-term risk for OC.


Assuntos
Cesárea/métodos , Neoplasias Ovarianas/etiologia , Esterilização Tubária/métodos , Adulto , Estudos de Coortes , Feminino , Humanos , Incidência , Neoplasias Ovarianas/patologia , Gravidez , Estudos Retrospectivos , Fatores de Risco
4.
Cancer Epidemiol ; 65: 101700, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32146389

RESUMO

BACKGROUND: Few studies have investigated the possible association between endosalpingiosis and ovarian cancer, therefore we assessed whether there is an association between histological confirmed endosalpingiosis and ovarian cancer. METHODS: We identified all women with a histological diagnosis of endosalpingiosis between 1990 and 2015 from the Dutch nationwide registry of histopathology and cytopathology (PALGA). We used women with a benign dermal nevus as controls. Histology results for cancer of the ovaries, fallopian tubes and peritoneum between January 1990 and July 2017 were retrieved. Incidence rate ratios (IRR) were estimated for ovarian cancer and its subtypes. RESULTS: We found 2490 women with a histological diagnosis of endosalpingiosis, of which 1005 women 40.4 %) had concurrent endometriosis. The age-adjusted IRR for ovarian cancer in endosalpingiosis patients (including endometriosis) was 43.7 (95 %CI 35.1-54.3). Excluding cases with concurrent endometriosis, resulted in an age-adjusted IRR of 38.8 (95 %CI 29.3-50.4). IRRs were 2.4 (95 %CI 1.4-3.9) and 1.8 (95 %CI 0.8-4.0) respectively when excluding synchronously diagnosed cases. The increased IRRs seem to be caused by an increased risk of clear cell and endometrioid ovarian cancer subtypes. CONCLUSIONS: This study shows an association between histological diagnosed endosalpingiosis and ovarian cancer. The association with endometrioid and clear cell subtypes seems most outspoken. Additionally, this study shows that this association is independent of histological endometriosis diagnosis, making it important for pathologists to report endosalpingiosis accurately and for gynaecologists to be more aware of the increased association of ovarian cancer in women with endosalpingiosis.


Assuntos
Endometriose/epidemiologia , Neoplasias Ovarianas/epidemiologia , Adulto , Endometriose/complicações , Endometriose/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Ovarianas/etiologia , Neoplasias Ovarianas/patologia
6.
J Ovarian Res ; 13(1): 33, 2020 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-32199455

RESUMO

BACKGROUND: Primary ovarian signet-ring cell carcinoma is extremely rare, with only five recent case reports. Almost all reported cases of ovarian signet-ring cell carcinoma have been treated with TC therapy and none have reported regarding the use of S-1/CDDP therapy. We report a case of primary ovarian signet-ring cell carcinoma treated postoperatively with S-1/CDDP therapy. CASE PRESENTATION: We describe a 55-year-old woman diagnosed with stage IB primary ovarian signet-ring cell carcinoma that was treated with S-1/CDDP therapy. Preoperative transvaginal ultrasonography and contrast-enhanced computed tomography (CT) revealed a solid tumor measuring 10 cm in diameter in the pelvis. The tumor marker levels were as follows: CA125, 41.6 U/mL; CA19-9, < 2.0 U/mL; and CEA, 2.2 ng/mL. Ovarian cancer was suspected, and total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy were performed. The left ovary was enlarged to greater than fist-sized, and there was a small amount of clear yellow ascites. Histological examination of the left ovary led to the diagnosis of signet-ring cell carcinoma. Histological examination of the right ovary also showed the presence of a signet-ring cell carcinoma. After surgery, upper and lower gastrointestinal endoscopy and positron-emission tomography-CT were performed to search for a possible primary lesion, but none was found. The patient was diagnosed with primary ovarian signet-ring cell carcinoma with FIGO Stage IB (PT1b, NX, M0). As postoperative adjuvant chemotherapy, S-1/CDDP therapy (S-1120 mg/day/body × 14 days, CDDP 50 mg/m2 day 8, q 21 days) was administered for six cycles. There was no recurrence 27 months after the initial treatment. CONCLUSIONS: We considered S-1/CDDP therapy was effective for primary ovarian signet-ring cell carcinoma. This is the first case report of primary ovarian signet-ring cell carcinoma treated with S-1/CDDP therapy in the world.


Assuntos
Antimetabólitos Antineoplásicos/uso terapêutico , Carcinoma de Células em Anel de Sinete/diagnóstico , Carcinoma de Células em Anel de Sinete/tratamento farmacológico , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/tratamento farmacológico , Ácido Oxônico/uso terapêutico , Tegafur/uso terapêutico , Antimetabólitos Antineoplásicos/administração & dosagem , Antimetabólitos Antineoplásicos/efeitos adversos , Biomarcadores Tumorais , Biópsia , Carcinoma de Células em Anel de Sinete/etiologia , Combinação de Medicamentos , Feminino , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Neoplasias Ovarianas/etiologia , Ácido Oxônico/administração & dosagem , Ácido Oxônico/efeitos adversos , Tegafur/administração & dosagem , Tegafur/efeitos adversos , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Ultrassonografia/métodos
7.
J Ovarian Res ; 13(1): 27, 2020 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-32160916

RESUMO

BACKGROUND: Platinum resistance is an important cause of clinical recurrence and death for ovarian cancer. This study tries to systematically explore the molecular mechanisms for platinum resistance in ovarian cancer and identify regulatory genes and pathways via text mining and other methods. METHODS: Genes in abstracts of associated literatures were identified. Gene ontology and protein-protein interaction (PPI) network analysis were performed. Then co-occurrence between genes and ovarian cancer subtypes were carried out followed by cluster analysis. RESULTS: Genes with highest frequencies are mostly involved in DNA repair, apoptosis, metal transport and drug detoxification, which are closely related to platinum resistance. Gene ontology analysis confirms this result. Some proteins such as TP53, HSP90, ESR1, AKT1, BRCA1, EGFR and CTNNB1 work as hub nodes in PPI network. According to cluster analysis, specific genes were highlighted in each subtype of ovarian cancer, indicating that various subtypes may have different resistance mechanisms respectively. CONCLUSIONS: Platinum resistance in ovarian cancer involves complicated signaling pathways and different subtypes may have specific mechanisms. Text mining, combined with other bio-information methods, is an effective way for systematic analysis.


Assuntos
Antineoplásicos/farmacologia , Mineração de Dados , Resistencia a Medicamentos Antineoplásicos , Compostos Organoplatínicos/farmacologia , Antineoplásicos/uso terapêutico , Análise por Conglomerados , Biologia Computacional/métodos , Mineração de Dados/métodos , Resistencia a Medicamentos Antineoplásicos/genética , Feminino , Perfilação da Expressão Gênica , Regulação Neoplásica da Expressão Gênica/efeitos dos fármacos , Redes Reguladoras de Genes , Humanos , Compostos Organoplatínicos/uso terapêutico , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/etiologia , Neoplasias Ovarianas/metabolismo , Mapeamento de Interação de Proteínas , Mapas de Interação de Proteínas , Transcriptoma
8.
PLoS One ; 15(1): e0227081, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31923221

RESUMO

Chronic inflammation fundamentally influences cancer risk and development. A mechanism of chronic inflammation is the formation of inflammasome complexes which results in the sustained secretion of the pro-inflammatory cytokines IL1ß and IL18. Inflammasome expression and actions vary among cancers. There is no information on inflammasome expression in ovarian cancer (OvCa). To determine if ovarian tumors express inflammasome components, mRNA and protein expression of NLRP3 (nucleotide-binding domain, leucine-rich repeat family, pyrin domain containing 3), caspase-1, IL1ß, and IL18 expression in hen and human OvCa was assessed. Chicken (hen) OvCa a valid model of spontaneous human OvCa. Hens were selected into study groups with or without tumors using ultrasonography; tumors were confirmed by histology, increased cellular proliferation, and expression of immune cell marker mRNA. mRNA expression was higher for hallmarks of inflammasome activity (caspase-1, 5.9x increase, p = 0.04; IL1ß, 4x increase, p = 0.04; and IL18, 7.8x increase, p = 0.0003) in hen OvCa compared to normal ovary. NLRP3, caspase-8 and caspase-11 mRNA did not differ significantly between tumor and non-tumor containing ovaries. Similar results occurred for human OvCa. Protein expression by immunohistochemistry paralleled mRNA expression and was qualitatively higher in tumors. Increased protein expression of caspase-1, IL1ß, and IL18 occurred in surface epithelium, tumor cells, and immune cells. The aryl hydrocarbon receptor (AHR), a potential tumor suppressor and NLRP3 regulator, was higher in hen (2.4x increase, p = 0.002) and human tumors (1.8x increase, p = 0.038), suggesting a role in OvCa. Collectively, the results indicate that inflammasome expression is associated with hen and human OvCa, although the NLR sensor type remains to be determined.


Assuntos
Inflamassomos/metabolismo , Neoplasias Ovarianas/metabolismo , Animais , Galinhas , Citocinas/metabolismo , Feminino , Humanos , Inflamação/complicações , Mediadores da Inflamação/metabolismo , Proteína 3 que Contém Domínio de Pirina da Família NLR/genética , Neoplasias Ovarianas/etiologia , RNA Mensageiro/análise
9.
Cancer Immunol Res ; 8(3): 383-395, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31924656

RESUMO

In established tumors, tumor-associated macrophages (TAM) orchestrate nonresolving cancer-related inflammation and produce mediators favoring tumor growth, metastasis, and angiogenesis. However, the factors conferring inflammatory and protumor properties on human macrophages remain largely unknown. Most solid tumors have high lactate content. We therefore analyzed the impact of lactate on human monocyte differentiation. We report that prolonged lactic acidosis induces the differentiation of monocytes into macrophages with a phenotype including protumor and inflammatory characteristics. These cells produce tumor growth factors, inflammatory cytokines, and chemokines as well as low amounts of IL10. These effects of lactate require its metabolism and are associated with hypoxia-inducible factor-1α stabilization. The expression of some lactate-induced genes is dependent on autocrine M-CSF consumption. Finally, TAMs with protumor and inflammatory characteristics (VEGFhigh CXCL8+ IL1ß+) are found in solid ovarian tumors. These results show that tumor-derived lactate links the protumor features of TAMs with their inflammatory properties. Treatments that reduce tumor glycolysis or tumor-associated acidosis may help combat cancer.


Assuntos
Acidose Láctica/imunologia , Fator Estimulador de Colônias de Granulócitos e Macrófagos/farmacologia , Inflamação/imunologia , Inflamação/patologia , Fator Estimulador de Colônias de Macrófagos/farmacologia , Macrófagos/imunologia , Neoplasias Ovarianas/patologia , Acidose Láctica/patologia , Diferenciação Celular/efeitos dos fármacos , Diferenciação Celular/imunologia , Citocinas/metabolismo , Feminino , Humanos , Inflamação/etiologia , Macrófagos/efeitos dos fármacos , Macrófagos/metabolismo , Monócitos/efeitos dos fármacos , Monócitos/imunologia , Monócitos/metabolismo , Neoplasias Ovarianas/etiologia , Neoplasias Ovarianas/metabolismo , Fenótipo , Células Tumorais Cultivadas
10.
JAMA ; 323(1): 49-59, 2020 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-31910280

RESUMO

Importance: The relationship between use of powder in the genital area and ovarian cancer is not established. Positive associations reported in case-control studies have not been confirmed in cohort studies. Objective: To estimate the association between use of powder in the genital area and ovarian cancer using prospective observational data. Design, Setting, and Participants: Data were pooled from 4 large, US-based cohorts: Nurses' Health Study (enrollment 1976; follow-up 1982-2016; n = 81 869), Nurses' Health Study II (enrollment 1989; follow-up 2013-2017; n = 61 261), Sister Study (enrollment 2003-2009; follow-up 2003-2017; n = 40 647), and Women's Health Initiative Observational Study (enrollment 1993-1998; follow-up 1993-2017; n = 73 267). Exposures: Ever, long-term (≥20 years), and frequent (≥1/week) use of powder in the genital area. Main Outcomes and Measures: The primary analysis examined the association between ever use of powder in the genital area and self-reported incident ovarian cancer. Covariate-adjusted hazard ratios (HRs) and 95% CIs were estimated using Cox proportional hazards models. Results: The pooled sample included 252 745 women (median age at baseline, 57 years) with 38% self-reporting use of powder in the genital area. Ten percent reported long-term use, and 22% reported frequent use. During a median of 11.2 years of follow-up (3.8 million person-years at risk), 2168 women developed ovarian cancer (58 cases/100 000 person-years). Ovarian cancer incidence was 61 cases/100 000 person-years among ever users and 55 cases/100 000 person-years among never users (estimated risk difference at age 70 years, 0.09% [95% CI, -0.02% to 0.19%]; estimated HR, 1.08 [95% CI, 0.99 to 1.17]). The estimated HR for frequent vs never use was 1.09 (95% CI, 0.97 to 1.23) and for long-term vs never use, the HR was 1.01 (95% CI, 0.82 to 1.25). Subgroup analyses were conducted for 10 variables; the tests for heterogeneity were not statistically significant for any of these comparisons. While the estimated HR for the association between ever use of powder in the genital area and ovarian cancer risk among women with a patent reproductive tract was 1.13 (95% CI, 1.01 to 1.26), the P value for interaction comparing women with vs without patent reproductive tracts was .15. Conclusions and Relevance: In this analysis of pooled data from women in 4 US cohorts, there was not a statistically significant association between use of powder in the genital area and incident ovarian cancer. However, the study may have been underpowered to identify a small increase in risk.


Assuntos
Genitália Feminina , Neoplasias Ovarianas/etiologia , Pós/efeitos adversos , Talco/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Ovarianas/epidemiologia , Fatores de Risco , Estados Unidos/epidemiologia
11.
BMC Infect Dis ; 20(1): 21, 2020 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-31910823

RESUMO

BACKGROUND: Meningitis is a very rare atypical presenting feature of anti-NMDA receptor encephalitis. In our case report, we describe an unusual clinical presentation of anti-NMDA receptor encephalitis with a biphasic pattern of meningitis followed by encephalitis and discuss potential mechanisms underlying this presentation. We aim to widen the differential diagnosis to be considered in a patient presenting with clinical meningitis and pyrexia. CASE PRESENTATION: This is a case of a 33-year old Caucasian woman who initially presented with a lymphocytic meningitis attributed to a viral infection. She subsequently developed fluctuating consciousness, agitation, visual hallucinations, dyskinetic movements, a generalized tonic-clonic seizure, and autonomic instability. Investigations revealed a diagnosis of anti-NMDA receptor encephalitis secondary to a previously unidentified ovarian teratoma. She made an excellent recovery with immunotherapy and removal of the teratoma. CONCLUSION: Clinicians should consider autoimmune encephalitides in individuals with meningitis, particularly where extensive investigations fail to identify a causative pathogen and there is rapid development of an encephalitic phenotype.


Assuntos
Encefalite Antirreceptor de N-Metil-D-Aspartato/diagnóstico , Meningite Viral/diagnóstico , Neoplasias Ovarianas/patologia , Teratoma/patologia , Administração Intravenosa , Adulto , Encefalite Antirreceptor de N-Metil-D-Aspartato/complicações , Encefalite Antirreceptor de N-Metil-D-Aspartato/tratamento farmacológico , Anticorpos/sangue , Diagnóstico Diferencial , Encefalite/diagnóstico , Feminino , Febre/diagnóstico , Glucocorticoides/administração & dosagem , Glucocorticoides/uso terapêutico , Doença de Hashimoto/diagnóstico , Humanos , Imunoterapia , Metilprednisolona/administração & dosagem , Metilprednisolona/uso terapêutico , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/etiologia , Neoplasias Ovarianas/cirurgia , Troca Plasmática , Receptores de N-Metil-D-Aspartato/imunologia , Convulsões/diagnóstico , Teratoma/tratamento farmacológico , Teratoma/etiologia , Teratoma/cirurgia , Resultado do Tratamento
12.
Cancer Res Treat ; 52(1): 277-283, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31319640

RESUMO

PURPOSE: The purpose of this study was to evaluate clinical characteristics and treatment pattern of ovarian clear cell carcinoma (OCCC) in Korea and the role of adjuvant chemotherapy in early stage. Materials and Methods: Medical records of 308 cases of from 21 institutions were reviewed and data including age, performance status, endometriosis, thromboembolism, stage, cancer antigen 125, treatment, recurrence, and death were collected. RESULTS: Regarding stage of OCCC, it was stage I in 194 (63.6%), stage II in 34 (11.1%), stage III in 66 (21.6%), and stage IV in 11 (3.6%) patients. All patients underwent surgery. Optimal surgery (residual disease ≤ 1 cm) was achieved in 89.3%. Majority of patients (80.5%) received postoperative chemotherapy. The most common regimen was taxane-platinum combination (96%). Median relapse-free survival (RFS) was 138.5 months for stage I, 33.4 for stage II, 19.3 for stage III, and 9.7 for stage IV. Median overall survival (OS) were not reached, 112.4, 48.7, and 18.3 months for stage I, II, III, and IV, respectively. Early-stage (stage I), endometriosis, and optimal debulking were identified as favorable prognostic factors for RFS. Early-stage and optimal debulking were also favorable prognostic factors for OS. Majority of patients with early-stage received adjuvant chemotherapy. However, additional survival benefit was not found in terms of recurrence. CONCLUSION: Majority of patients had early-stage and received postoperative chemotherapy regardless of stage. Early-stage and optimal debulking were identified as favorable prognostic factors. In stage IA or IB, adding adjuvant chemotherapy did not show difference in survival. Further study focusing on OCCC is required.


Assuntos
Adenocarcinoma de Células Claras/diagnóstico , Neoplasias Ovarianas/diagnóstico , Adenocarcinoma de Células Claras/etiologia , Adenocarcinoma de Células Claras/mortalidade , Adenocarcinoma de Células Claras/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Gradação de Tumores , Metástase Neoplásica , Estadiamento de Neoplasias , Neoplasias Ovarianas/etiologia , Neoplasias Ovarianas/mortalidade , Neoplasias Ovarianas/terapia , Prognóstico , República da Coreia , Estudos Retrospectivos , Resultado do Tratamento
13.
Gynecol Endocrinol ; 36(2): 117-121, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31429337

RESUMO

Endometriosis is an estrogen-dependent disease that affects 5 to 15% of women of reproductive age. Data from large-cohort and case-control studies indicate an increased risk for ovarian cancers in women with endometrioma. Recently, as an ovarian cancer biomarker, human epididymal secretory protein E4 (HE4) has been increasingly investigated in the differentiating of endometrioma from ovary malignancy and in confirming the benign structure of the endometrioma. This case series study describes women who underwent surgery due to increased serum HE4 levels and higher Risk of Ovarian Malignancy Algorithm (ROMA) index, in whom the final pathology was reported as benign, although, ultrasonography and magnetic resonance imaging (MRI) findings showed features of "typical" endometrioma.


Assuntos
Endometriose/diagnóstico por imagem , Neoplasias Ovarianas/diagnóstico por imagem , Proteína 2 do Domínio Central WAP de Quatro Dissulfetos/metabolismo , Adulto , Biomarcadores Tumorais/sangue , Estudos de Casos e Controles , Endometriose/sangue , Endometriose/complicações , Feminino , Humanos , Neoplasias Ovarianas/sangue , Neoplasias Ovarianas/etiologia , Estudos Retrospectivos , Fatores de Risco , Ultrassonografia , Adulto Jovem
14.
Int J Clin Oncol ; 25(1): 51-58, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31473885

RESUMO

BACKGROUND: Endometriosis is a risk factor for ovarian cancer. Endometriosis-associated ovarian cancer (EAOC), most commonly clear cell carcinoma, is believed to develop from ovarian endometrial cysts. In this study, we reviewed published cases of EAOC considered to have developed from endometrial cysts, and focused on the observation period. METHODS: We searched for articles published since January 2000 that reported cases of ovarian cancer thought to have originated from endometrial cysts using PubMed, Web of Science, and Ichushi-Web. The period from the start of follow-up of the endometrial cyst to the diagnosis of ovarian cancer was calculated. RESULTS: Seventy-nine cases were identified from 32 articles. The median period from the diagnosis of endometrial cysts to the diagnosis of ovarian cancer was only 36 months. Approximately 75% of cases developed into cancer within 60 months and most cases developed within 120 months. CONCLUSION: Our results suggest that clinically detectable cysts subsequently diagnosed as ovarian cancer might already have contained cancer cells. Therefore, the mechanism of EAOC development needs to be re-examined and appropriate management guidelines need to be developed.


Assuntos
Carcinoma Endometrioide/etiologia , Carcinoma Epitelial do Ovário/etiologia , Endometriose/complicações , Cistos Ovarianos/complicações , Neoplasias Ovarianas/etiologia , Adulto , Carcinoma Endometrioide/diagnóstico , Carcinoma Endometrioide/patologia , Carcinoma Epitelial do Ovário/diagnóstico , Carcinoma Epitelial do Ovário/patologia , Endometriose/diagnóstico , Endometriose/patologia , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Cistos Ovarianos/diagnóstico , Cistos Ovarianos/patologia , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/patologia
15.
Annu Rev Pathol ; 15: 71-95, 2020 01 24.
Artigo em Inglês | MEDLINE | ID: mdl-31479615

RESUMO

Recent molecular genetic findings on endometriosis and normal endometrium suggest a modified model in which circulating epithelial progenitor or stem cells intended to regenerate uterine endometrium after menstruation may become overreactive and trapped outside the uterus. These trapped epithelium-committed progenitor cells form nascent glands through clonal expansion and recruit polyclonal stromal cells, leading to the establishment of deep infiltrating endometriosis. Once formed, the ectopic tissue becomes subject to immune surveillance, resulting in chronic inflammation. The inflammatory response orchestrated by nuclear factor-κB signaling is exacerbated by aberrations in the estrogen receptor-ß and progesterone receptor pathways, which are also affected by local inflammation, forming a dysregulated inflammation-hormonal loop. Glandular epithelium within endometriotic tissue harbors cancer-associated mutations that are frequently detected in endometriosis-related ovarian cancers. In this review, we summarize recent advances that have illuminated the origin and pathogenesis of endometriosis and have provided new avenues for research that promise to improve the early diagnosis and management of endometriosis.


Assuntos
Endometriose/etiologia , Endometriose/patologia , Endométrio/embriologia , Endométrio/fisiologia , Receptor beta de Estrogênio/genética , Receptor beta de Estrogênio/metabolismo , Feminino , Humanos , Menstruação/fisiologia , Neoplasias Ovarianas/etiologia , Neoplasias Ovarianas/patologia , Receptores de Progesterona/genética , Receptores de Progesterona/metabolismo , Transdução de Sinais/genética , Células Estromais/fisiologia , Útero/patologia , Útero/fisiologia
16.
J Natl Cancer Inst ; 112(2): 161-169, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31076742

RESUMO

BACKGROUND: Women with epithelial ovarian cancer (OC) have a higher chance to benefit from poly (ADP-ribose) polymerase inhibitor (PARPi) therapy if their tumor has a somatic or hereditary BRCA1/2 pathogenic variant. Current guidelines advise BRCA1/2 genetic predisposition testing for all OC patients, though this does not detect somatic variants. We assessed the feasibility of a workflow for universal tumor DNA BRCA1/2 testing of all newly diagnosed OC patients as a prescreen for PARPi treatment and cancer predisposition testing. METHODS: Formalin-fixed paraffin-embedded tissue was obtained from OC patients in seven hospitals immediately after diagnosis or primary surgery. DNA was extracted, and universal tumor BRCA1/2 testing was then performed in a single site. Diagnostic yield, uptake, referral rates for genetic predisposition testing, and experiences of patients and gynecologists were evaluated. RESULTS: Tumor BRCA1/2 testing was performed for 315 (77.6%) of the 406 eligible OC samples, of which 305 (96.8%) were successful. In 51 of these patients, pathogenic variants were detected (16.7%). Most patients (88.2%) went on to have a genetic predisposition test. BRCA1/2 pathogenic variants were shown to be hereditary in 56.8% and somatic in 43.2% of patients. Participating gynecologists and patients were overwhelmingly positive about the workflow. CONCLUSIONS: Universal tumor BRCA1/2 testing in all newly diagnosed OC patients is feasible, effective, and appreciated by patients and gynecologists. Because many variants cannot be detected in DNA from blood, testing tumor DNA as the first step can double the identification rate of patients who stand to benefit most from PARP inhibitors.


Assuntos
Proteína BRCA1/genética , Proteína BRCA2/genética , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/etiologia , Idoso , Gerenciamento Clínico , Feminino , Aconselhamento Genético , Predisposição Genética para Doença , Testes Genéticos , Humanos , Pessoa de Meia-Idade , Terapia de Alvo Molecular , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/tratamento farmacológico , Inibidores de Poli(ADP-Ribose) Polimerases/administração & dosagem , Inibidores de Poli(ADP-Ribose) Polimerases/efeitos adversos , Inibidores de Poli(ADP-Ribose) Polimerases/uso terapêutico
17.
Int J Cancer ; 146(7): 1800-1809, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-31199510

RESUMO

Results of epidemiologic studies of physical activity and ovarian cancer risk are inconsistent. Few have attempted to measure physical activity over the lifetime or in specific age windows, which may better capture etiologically relevant exposures. We examined participation in moderate-to-vigorous recreational physical activity (MVPA) in relation to ovarian cancer risk. In a population-based case-control study conducted in Montreal, Canada from 2011 to 2016 (485 cases and 887 controls), information was collected on lifetime participation in various recreational physical activities, which was used to estimate MVPA for each participant. MVPA was represented as average energy expenditure over the lifetime and in specific age-periods in units of metabolic equivalents (METs)-hours per week. Odds ratios (OR) and 95% confidence intervals (CI) for the relation between average MVPA and ovarian cancer risk were estimated using multivariable logistic regression models. Confounding was assessed using directed acyclic graphs combined with a change-in-estimate approach. The adjusted OR (95% CI) for each 28.5 MET-hr/week increment of lifetime recreational MVPA was 1.11 (0.99-1.24) for ovarian cancer overall. ORs for individual age-periods were weaker. When examined by menopausal status, the OR (95% CI) for lifetime MVPA was 1.21 (1.00-1.45) for those diagnosed before menopause and 1.04 (0.89-1.21) for those diagnosed postmenopausally. The suggestive positive associations were stronger for invasive ovarian cancers and more specifically for high-grade serous carcinomas. These results do not support a reduced ovarian cancer risk associated with MVPA.


Assuntos
Exercício Físico , Atividades de Lazer , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Pessoa de Meia-Idade , Razão de Chances , Medição de Risco , Fatores de Risco , Adulto Jovem
18.
Int J Cancer ; 146(7): 2007-2018, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-31800094

RESUMO

Ovarian cancer (OC) is the most lethal gynecological malignancy, with platinum-based chemotherapy remaining the mainstay for adjuvant treatment after surgery. The lack of indication for immunotherapy may at least in part result from the lack of suitable biomarkers allowing stratification of potentially responding patients. In this monocentric study of 141 cases with OC, we used real-time quantitative PCR to assess the expression of retinoic acid-inducible gene-I (RIG-I) in primary tumor and healthy ovarian control tissues. RIG-I expression was correlated to various clinicopathological characteristics as well as to a set of molecular and immunological markers. The prognostic significance of RIG-I expression was queried in univariate and multivariate analyses and validated in an independent cohort. RIG-I was overexpressed in the cancerous ovary and correlated with a higher tumor grade. The more aggressive Type-II cancers and cancers with inactivating p53 mutations exhibited higher RIG-I expression. RIG-I levels were also elevated in cancers that recurred after remission or were platinum-refractory. Survival analyses disclosed RIG-I as an independent marker of poor outcome in OC. Continuative analyses revealed the molecular and immunological correlates of RIG-I expression in the tumor microenvironment, including interferon production and a distinct immune-regulatory signature involving checkpoint molecules (PD-L1/PD-1), the RNA-editing enzyme ADAR1 and the regulatory T cell-specific transcription factor FoxP3. We conclude that high RIG-I expression associates with poor outcome in OC, which is explainable by local immunosuppression in the tumor bed. RIG-I expression may inform checkpoint blockade and/or RIG-I agonistic targeting in a subset of high-risk OC patients.


Assuntos
Biomarcadores Tumorais , Proteína DEAD-box 58/genética , Neoplasias Ovarianas/etiologia , Neoplasias Ovarianas/mortalidade , Evasão Tumoral/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Estimativa de Kaplan-Meier , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Neoplasias Ovarianas/diagnóstico , Prognóstico , Modelos de Riscos Proporcionais , Microambiente Tumoral/genética , Microambiente Tumoral/imunologia , Adulto Jovem
19.
Arch Gynecol Obstet ; 301(1): 1-10, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31745637

RESUMO

PURPOSE: Despite long and intensive research, endometriosis remains one of the leading causes of morbidity among premenopausal women. The majority of endometriosis-related ovarian carcinomas occur in the presence of atypical ovarian endometriosis. Nevertheless, despite the increased incidence of ovarian cancer in patients with endometriosis, our knowledge of the risk factors and mechanisms is still incomplete. METHOD: Narrative overview, synthesizing the recent findings of literature retrieved from databases. RESULTS: Herein, we reviewed and summarized the most recent knowledge regarding endometriosis and ovarian cancer. CONCLUSION: The evidence showing that patients with endometriosis have a higher risk of developing ovarian cancer is compelling. However, the question of how much higher the absolute risk is, is not fully clear.


Assuntos
Endometriose/complicações , Neoplasias Ovarianas/etiologia , Adulto , Endometriose/patologia , Feminino , Humanos , Neoplasias Ovarianas/patologia , Estudos Retrospectivos , Fatores de Risco
20.
Am J Med ; 133(6): 723-732, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31862335

RESUMO

PURPOSE: Acceptability and uptake of cancer preventive interventions is associated with physician recommendation, which is dependent on physician familiarity with available preventive options. The goal of this study is to evaluate cancer prevention perceptions, understanding of breast and ovarian cancer risk factors, and prescribing behaviors of primary care physicians. METHODS: We conducted cross-sectional. Web-based survey of 750 primary care physicians (250 each for obstetrics/gynecology, internal medicine, and family medicine) in the United States. Survey respondents were recruited from an opt-in health care provider panel. RESULTS: Perception of importance and the practice of recommending general and cancer-specific preventive screenings and interventions significantly differed by provider type. These perceptions and behaviors reflected the demographics of the population that the primary care physicians see within their respective practices. The majority of respondents recognized genetic/hereditary risk factors for breast or ovarian cancer, while epidemiologic or clinical risk factors were less frequently recognized. Prescribing behaviors were related to familiarity with the interventions, with physicians indicating that they more frequently reinforced a specialist's recommendation rather than prescribed a preventive intervention. CONCLUSIONS: Cancer prevention perceptions, recognition of cancer risk factors, and prescribing behaviors differ among practice types and were related to familiarity with preventive options. Cancer prevention education and risk assessment resources should be more widely available to primary care physicians.


Assuntos
Neoplasias da Mama/prevenção & controle , Neoplasias Ovarianas/prevenção & controle , Padrões de Prática Médica/estatística & dados numéricos , Atenção Primária à Saúde/métodos , Medição de Risco , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/etiologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Ovarianas/etiologia , Atenção Primária à Saúde/estatística & dados numéricos , Medição de Risco/métodos , Fatores de Risco , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA