• Title/Summary/Keyword: Ovarian diseases

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Serous tubal intraepithelial carcinoma detected during benign gynecologic surgery: a case report

  • Eun Seo Shin;Sung Yob Kim
    • Journal of Medicine and Life Science
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    • v.20 no.1
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    • pp.48-52
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    • 2023
  • High-grade serous carcinoma (HGSC) is the most common type of pelvic cancer among women. Serous tubal intraepithelial carcinoma (STIC) is a precursor lesion of HGSC. Herein, we report a rare occurrence of STIC in patients undergoing surgery for benign indications without a family history of ovarian cancer. A 77-year-old woman underwent total laparoscopic hysterectomy and bilateral salpingo-oophorectomy for uterine prolapse. Pathological examination revealed bilateral STIC without ovarian abnormalities, and no other abnormal findings were noted. Another patient, a 49-year-old woman, underwent laparoscopic total hysterectomy and bilateral salpingectomy for uterine fibroids. STIC lesions were observed in both fallopian tubes. Subsequently, a staging was performed. No additional lesions were found, and the patient was followedup through imaging and blood tests. As reports of STIC lesions are rare, data on their clinical outcomes and management strategies are limited. In this report, we present cases of incidental STIC in benign surgery and discuss its proper interpretation and management. Through the early detection of STIC lesions, patients with risk factors can be identified in advance, which will allow prevention and early detection of ovarian cancer. Opportunistic salpingectomy was also actively discussed in this regard.

Immunoglobulin G4-Related Disease of the Ovary Mimicking Bilateral Ovarian Malignancies (양측 난소의 악성 종양으로 오인한 난소의 면역글로불린 G4 관련 질환)

  • Yongsik Sim;Taek Chung;Dae Chul Jung;Hyun-Soo Kim;Young Taik Oh
    • Journal of the Korean Society of Radiology
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    • v.81 no.4
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    • pp.996-1002
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    • 2020
  • Immunoglobulin G4-related disease (IgG4-RD) is a fibro-inflammatory condition characterized by several pathological features that can theoretically involve all organs. Ovarian involvement in IgG4-RD has been reported by two studies only. Herein, we report a pathologically confirmed case of ovarian involvement of IgG4-RD, which mimicked bilateral ovarian malignancies on computed tomography and magnetic resonance imaging.

Novel Anti-Angiogenic and Anti-Tumour Activities of the N-Terminal Domain of NOEY2 via Binding to VEGFR-2 in Ovarian Cancer

  • Rho, Seung Bae;Lee, Keun Woo;Lee, Seung-Hoon;Byun, Hyun Jung;Kim, Boh-Ram;Lee, Chang Hoon
    • Biomolecules & Therapeutics
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    • v.29 no.5
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    • pp.506-518
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    • 2021
  • The imprinted tumour suppressor NOEY2 is downregulated in various cancer types, including ovarian cancers. Recent data suggest that NOEY2 plays an essential role in regulating the cell cycle, angiogenesis and autophagy in tumorigenesis. However, its detailed molecular function and mechanisms in ovarian tumours remain unclear. In this report, we initially demonstrated the inhibitory effect of NOEY2 on tumour growth by utilising a xenograft tumour model. NOEY2 attenuated the cell growth approximately fourfold and significantly reduced tumour vascularity. NOEY2 inhibited the phosphorylation of the signalling components downstream of phosphatidylinositol-3'-kinase (PI3K), including phosphoinositide-dependent protein kinase 1 (PDK-1), tuberous sclerosis complex 2 (TSC-2) and p70 ribosomal protein S6 kinase (p70S6K), during ovarian tumour progression via direct binding to vascular endothelial growth factor receptor-2 (VEGFR-2). Particularly, the N-terminal domain of NOEY2 (NOEY2-N) had a potent anti-angiogenic activity and dramatically downregulated VEGF and hypoxia-inducible factor-1α (HIF-1α), key regulators of angiogenesis. Since no X-ray or nuclear magnetic resonance structures is available for NOEY2, we constructed the three-dimensional structure of this protein via molecular modelling methods, such as homology modelling and molecular dynamic simulations. Thereby, Lys15 and Arg16 appeared as key residues in the N-terminal domain. We also found that NOEY2-N acts as a potent inhibitor of tumorigenesis and angiogenesis. These findings provide convincing evidence that NOEY2-N regulates endothelial cell function and angiogenesis by interrupting the VEGFR-2/PDK-1/GSK-3β signal transduction and thus strongly suggest that NOEY2-N might serve as a novel anti-tumour and anti-angiogenic agent against many diseases, including ovarian cancer.

Diagnostic Value of Human Epididymis Protein 4 Compared with Mesothelin for Ovarian Cancer: a Systematic Review and Meta-analysis

  • Lin, Jia-Ying;Qin, Jin-Bao;Li, Xiao-Yan;Dong, Ping;Yin, Bing-De
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.11
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    • pp.5427-5432
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    • 2012
  • Background and Purpose: Ovarian cancer is the leading cause of death among gynecologic cancers because of the lack of effective early detection methods. Accuracies of the human epididymis protein 4 (HE4) and mesothelin in detecting ovarian cancer have never been systematically assessed. The current systematic review aimed to tackle this issue. Methods: MEDLINE, EMBASE, and Cochrane databases were searched (September 1995-November 2011) for studies on the diagnostic performances of HE4 and mesothelin in differentiating ovarian cancer from other benign gynecologic diseases. QUADAS items were used to evaluate the qualities of the studies. Meta-DiSc software was used to handle data from the included studies and to examine heterogeneity. All included studies for diagnostic performance were combined with sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratios (DORs) with 95% confidence intervals (CIs), summary receiver operating characteristic (SROC) curves, and areas under the SROC curves (AUC). Results: A total of 18 studies and 3,865 patients were eligible for the final analysis. The pooled sensitivity estimates for HE4 (74.4%) were significantly higher than those for mesothelin (49.3%). The pooled specificity estimates for mesothelin (94.5%) were higher than those for HE4 (85.8%). The pooled DOR estimates for HE4 (26.22) were higher than those for mesothelin (24.01). The SROC curve for HE4 showed better diagnostic accuracy than that for mesothelin. The PLR and NLR of HE4 were 6.33 (95% CI: 3.58 to 11.18) and 0.27 (95% CI: 0.21 to 0.34), respectively. The PLR and NLR for mesothelin were 11.0 (95% CI: 6.21 to 19.59) and 0.51 (95% CI: 0.42 to 0.62), respectively. The combination of the two tumor markers or their combination with CA-125 increased sensitivity and specificity to different extents. Conclusion: The diagnostic accuracy of HE4 in differentiating ovarian cancer from other benign gynecologic diseases is better than that of soluble mesothelin-related protein. Combinations of two or more tumor markers show more sensitivity and specificity.

Quality Control Usage in High-Density Microarrays Reveals Differential Gene Expression Profiles in Ovarian Cancer

  • Villegas-Ruiz, Vanessa;Moreno, Jose;Jacome-Lopez, Karina;Zentella-Dehesa, Alejandro;Juarez-Mendez, Sergio
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2519-2525
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    • 2016
  • There are several existing reports of microarray chip use for assessment of altered gene expression in different diseases. In fact, there have been over 1.5 million assays of this kind performed over the last twenty years, which have influenced clinical and translational research studies. The most commonly used DNA microarray platforms are Affymetrix GeneChip and Quality Control Software along with their GeneChip Probe Arrays. These chips are created using several quality controls to confirm the success of each assay, but their actual impact on gene expression profiles had not been previously analyzed until the appearance of several bioinformatics tools for this purpose. We here performed a data mining analysis, in this case specifically focused on ovarian cancer, as well as healthy ovarian tissue and ovarian cell lines, in order to confirm quality control results and associated variation in gene expression profiles. The microarray data used in our research were downloaded from ArrayExpress and Gene Expression Omnibus (GEO) and analyzed with Expression Console Software using RMA, MAS5 and Plier algorithms. The gene expression profiles were obtained using Partek Genomics Suite v6.6 and data were visualized using principal component analysis, heat map, and Venn diagrams. Microarray quality control analysis showed that roughly 40% of the microarray files were false negative, demonstrating over- and under-estimation of expressed genes. Additionally, we confirmed the results performing second analysis using independent samples. About 70% of the significant expressed genes were correlated in both analyses. These results demonstrate the importance of appropriate microarray processing to obtain a reliable gene expression profile.

Association with Autoimmune Disease in Patients with Premature Ovarian Failure (조기 난소기능 부전증 환자에서 자가면역 질환과의 상관관계)

  • Park, Joon-Cheol;Kim, Jong-In;Rhee, Jeong-Ho
    • Clinical and Experimental Reproductive Medicine
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    • v.31 no.3
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    • pp.149-154
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    • 2004
  • Objective: To assess the association with autoimmune endocrine diseases and detection rate of autoimmune antibodies and its clinical significance in patients with premature ovarian failure. Methods: Twenty eight patients with primary or secondary amenorrhea manifesting hormonal and clinical features of premature ovarian failure (primary POF: 7, secondary POF: 21) were investigated. We tested them TFT, 75 g OGTT, ACTH and S-cortisol for thyroiditis, IDDM, Addison's disease, and antithyoglobulin antibody, antimicrosomal antibody, antinuclear antibody, rheumatic factor, anti-smooth muscle antibody, anti-acetylcholine receptor antibody for non-organ specific autoimmune disorders. Results: Only one patient was diagnosed as IDDM and no patients had abnormal TFT or adrenal function test. More than one kind of autoantibody was detected in 11 patients of all (39.2%): 5 patients (71.4%) of primary POF group and 6 patients (21.4%) of secondary POF group. Eleven patients (39.3%) had antithyroglobulin antibody, 4 (14.3%) had antimicrosomal antibody, 2 (7.1%) had antinuclear antibody, 2 (7.1%) had rheumatic factor, 1 (3.6%) had anti-smooth muscle antibody, 1 (3.6%) had anti-acetylcholine receptor antibody. Conclusions: Premature ovarian failure may occur as a component of an autoimmune polyglandular syndrome, so patients should be measured with free thyroxine, thyroid-stimulating hormone, fasting glucose and electrolytes. Measurement of thyroid autoantibodies in POF patients may be important in identifying patients at risk of developing overt hypothyoidism, but other autoantibodies may not be suitable for screening test.

A Case of Meigs' Syndrome (Meigs 증후군)

  • Jung, Jong Hoon;Kim, Hak Ryul;Yang, Sei Hoon;Moon, Hyung Bae;Jeong, Eun Taik
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.4
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    • pp.415-419
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    • 2004
  • Meigs' syndrome is defined as presence of pleural effusion, with ovarian tumor associated ascites, which spontaneously resolve soon after the removal of the tumor. The pathogenesis of the pleural effusion, in patients with Meigs' syndrome, is thought to be the passage of fluid from the peritoneal cavity into the pleural cavity, through small holes in the diaphragm. A case of Meigs' syndrome, in a 63-year-old woman, who had been referred for control of pleural effusion is reported.

A Case of Bilateral Pleural Effusion due to Ovarian Hyperstimulation Syndrome (양측 흉수를 동반한 난소과자극증후군(Ovarian Hyperstimulation Syndrome : OHSS) 1례)

  • Kim, Ki-Up;Han, Sang-Hoon;Kim, Do-Jin;Yoon, Bo-Ra;Yoon, Hyun-Soo;Lee, Young-Kyung;Na, Mun-Jun;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.50 no.5
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    • pp.636-640
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    • 2001
  • Ovarin hyperstimulation syndrome (OHSS), an iatrogenic complication of ovarian stimulation, shows varying degrees of clinical manifestations. The pathogenesis of OHSS is an increase of vascular permeability resulting in hypovolemia, thromboembolism, ARDS, and death in sometimes. Pleural effusion is also a result of an increase of vascular permeability in the pleura. Thoracentesis is sometimes required to relieve dyspnea. We report a case of OHSS with bilateral exudative pleural effusion in a 23 year-old female with resting dyspnea. She was received clomiphen, FSH, and LH for the treatment of irregular menstruation twenty days previously. The ultrasonogram showed severe ascites and bilaterally huge ovary, and chest radiography showed bilateral effusion. Therapeutic thoracentesis and paracentesis were done for relief of the dyspnea. Two weeks later the bilataral effusion and symptoms disappeared spontaneously.

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Incidence and Clinical Characteristic of Venous Thromboembolism in Gynecologic Oncology Patients attending King Chulalongkorn Memorial Hospital over a 10 Year Period

  • Oranratanaphan, S;Termrungruanglert, W;Khemapech, N
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.15
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    • pp.6705-6709
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    • 2015
  • Background: Venous thromboembolisms (VTEs) constitute a group of diseases including deep vein thrombosis (DVT) and pulmonary embolism (PE). They regarded as the second leading cause of death in cancer patients and several studies have confirmed that VTEs have a negative impact on survival and recurrent rate in both ovarian and endometrial cancer cases. The incidence of VTEs differs worldwide and depends on several risk factors including race, underlying disease, lifestyle, body weight, BMI and genetic risk factors. There is heterogeneity of DVT rates between Asian and Western countries. This study was conducted in order to evaluate the character and incidence of VTEs in gynecologic oncology patients in King Chulalongkorn Memorial Hospital over a 10 year period. Materials and Methods: A retrospective chart review was performed with VTEs defined as objective diagnosis of acute DVT or PE with typical symptoms and signs. Diagnoses were approved byan internist and/or confirmed with imaging studies. Data from both outpatient and inpatient sessions of the affected cases from January 2004 to December 2013 were extracted. General characteristics of the patients were collected with details of the diseases, types of cancer, stage, date of diagnosis of cancer, operative data, treatment outcome, progression free survival and overall survival. Results: Thirty cases of VTEs were identified in a total 2,316 gynecologic oncology cases. The incidence of symptomatic VTEs in total gynecologic oncology patients in our institution is 1.295%. The incidence of VTEs in ovarian cancer patients in our institution was 5.9%. Duration for VTE detection ranged from 13 months before diagnosis of cancer to 33 months after diagnosis of cancer. Most of the VTE cases were detected in ovarian cancer patients (60%). The most common cell type was adenocarcinoma (moderately to poorly differentiated) which accounted for 26.7% of the cases. The second most common cell type was clear cell carcinoma with 23.3% of the cases. Thirty percent of VTE cases developed before cancer was diagnosed, 20% were diagnosed at the same time as cancer detection and fifty percent developed after cancer was diagnosed. Median disease free survival of the gynecologic oncology patients with VTE was 7.5 months. Median overall survival (OS) was 12 months. Median progession free survivals of DVT and PE groups were 11.5 and 5.5 months, respectively. OS of DVT and PE was 12.0 and 11.5 months respectively. Conclusions: The incidence of VTE in Asian countries is believed to be lower than in European or Western countries. From our retrospective review, the incidence of VTEs in all types of gynecologic oncology was 1.295%, much lower than reported in the West. The reason for the lower incidence may genetic differences. Another factor is that VTE in this review was symptomatic, which is less than asymptomatic VTE. More than half of VTEs in this study developed in ovarian cancer patients. The results are compatible with earlier reports that among gynecologic malignancies, the incidence of VTE is highest in ovarian cancer.

The 5th revision of the Korean Standard Classification of Diseases (한국표준질병사인분류의 개정에 관하여)

  • OH, Hyun-Ju
    • The Journal of the Korean life insurance medical association
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    • v.27 no.1
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    • pp.21-23
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    • 2008
  • The 5th revision of Korean Classification of Diseases(KCD) became effective on January 1, 2008. It has reflected the changes made to the tenth revision of International Classification of Diseases (ICD-10) between 1998 and 2005 and the suggestions of academic and related societies in Korea. Two important alterations seem to have a major implication in the insurance industry. One would be the official introduction of a Korean version of International Classification of Diseases for Oncology, third edition(ICD-O-3). The borderline ovarian tumor is classified as a borderline neoplasm, which was classified as a malignant neoplasm in the previous edition of International Classification of Diseases for Oncology. The other would be the appearance of non-C-code malignant neoplasm for the diseases, such as polycythemia vera, newly classified as a malignant neoplasm by the current edition of International Classification of Diseases for Oncology. The National Office of Statistics(NSO) adopted the way of implementation used in the Australian Modification of International Classification of Diseases(ICD-10-AM), instead of assigning them into corresponding C code. Overall, the changes made in this revision doesn't seem to have a serious impact on the insurance industry since it has only reflected updates made to ICD-10.

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