Ploidy disturbances in endometrial and ovarian carcinomas. A review

A survey of DNA and chromosome aberrations in human endometrial and ovarian carcinomas is presented, including data obtained by chromosome analysis, absorption cytophotometry and flow cytometry. Nearly all of the cancers showed some structural or numerical chromosomal abnormalities. Endometrial carcinomas were reported to have a near-diploid DNA content in two-thirds of the cases, as opposed to ovarian carcinomas, in which only one-third of the tumors were near diploid. DNA aberrations in tumors of both origins seemed to be associated with an unfavorable prognosis, indicating that DNA measurements may supply a valuable additional criterion for biologic malignancy. Evaluable data on ploidy correlated to histologic subtypes was not available; in general, the number of patients in each study was small. Tumors of low differentiation tended more often to be aneuploid, but this was not a consistent finding. Further research comparing disease stage, tumor grade and tumor type in larger series of patients is therefore mandatory.

Spontaneous malignant granulosa cell tumors in ovaries of young SWR mice

Granulosa cell tumors (GCT) of the ovary appear spontaneously at 4-6 weeks of age in SWR/J and in SWR/Bm inbred strain mice, with a maximum incidence reached by 10 weeks. Cancer was confirmed by metastasis to abdominal organs and by transplantability of primary tumors to histocompatible hosts. Results of genetic crosses showed that GCT appear in SWR X SJL F1 but not in SJL X SWR F1 nor in other F1 females derived from matings of SWR mice with A/HeJ, C57BL/6By, CBA/J, or DBA/2J mice. These findings suggest the maternal transmission of GCT susceptibility. Recombinant inbred strains SWXJ were produced from a progenitor mating of a SWR female to a SJL male. At F20, females in 3 of 14 SWXJ strains developed GCT, with one strain displaying a 5-fold increase in incidence. Embryo transfer studies with SWXJ-6 and -9 mice suggested that maternal transmission was most likely via the fertilized egg rather than through milk or placenta-uterine contact. Analysis of metaphase chromosomes indicated that the modal number in tumors and bone marrow was 40 (2n = 40) with 2 X chromosomes present. Gross chromosomal aberrations were not detected. A working hypothesis proposes that interaction of a unique SWR factor, perhaps cytoplasmic, with nuclear genomic material common to Swiss mouse stocks results in occurrence of GCT in young SWR and SWR-derived mice.

The association of ovarian malignancy in children with maternal carcinogenesis

The occurrence of malignancy in three mothers out of six girls presenting with malignant ovarian tumors is reported. The significance of this finding is discussed.

Peritoneal carcinomatosis after prophylactic oophorectomy in familial ovarian cancer syndrome

A woman who was at high risk for ovarian cancer because of a strongly positive family history underwent prophylactic oophorectomy, but subsequently developed and died of intraabdominal carcinomatosis. One small focus of adenocarcinoma was found on the ovarian surface in serial sections performed retrospectively on the resected ovaries. This case study emphasizes the importance of thorough histologic examination for familial ovarian cancer syndrome, including serial sectioning of the specimens removed in prophylactic oophorectomy.

Stability of c-K-ras amplification during progression in a patient with adenocarcinoma of the ovary

We have identified a case of serous cystadenocarcinoma of the ovary in which the tumor cells display an amplification (from 10- to 20-fold) of the cellular oncogene K-ras. Normal cells purified from the malignant ascites did not show such amplification. Five consecutive samples were obtained by paracentesis over a 9-month period during which the patient received chemotherapy and underwent clinical progression. The level of c-K-ras amplification in the tumor cells did not change during this period. In studies of the tumors of 6 additional patients with adenocarcinoma of the ovary and 5 cell lines of the same histology, we have detected no other example of significant c-K-ras amplification.

C-band heteromorphism in breast cancer patients

The pattern of heteromorphism in the C-band-positive constitutive heterochromatin of human chromosomes #1, #9, and #16 was studied in peripheral lymphocytes of 54 breast cancer patients and 78 control individuals. The parameters of the heterochromatic regions analyzed were relative size, symmetry-asymmetry within homologous pairs, and prevalence of inversions. Significant differences between the two groups were found in C-band size of chromosomes #1, #9, and #16 and in incidence of inversions on chromosomes #1 and #9. Significant differences were noted between premenopausal and postmenopausal cancer patients in regard to inversions on chromosome #9 and between familial and sporadic patients in regard to C-band size on chromosome #16.

Familial occurrence of mature ovarian teratomas

It has been suggested that genetic predisposing factors play a role in the development of ovarian teratomas. Familial occurrence of these tumors would support this view. Reported herein are identical twins, both of whom had a right ovarian mature teratoma. In both cases the presenting symptoms were acute torsion. The diagnosis was confirmed at laparotomy and subsequent histopathologic examination. The origin of ovarian teratomas seems to be linked to the process of parthenogenesis. This process probably involves a germ cell after its first meiotic division.

Comparative properties of five human ovarian adenocarcinoma cell lines

We describe the derivation of three human ovarian carcinoma cell lines and the comparison of their properties with two previously described cell lines of like histology (SKOV-3 and CAOV-3). Two of the new lines (HOC-1 and HOC-7) were derived from separate ascites tumors (at 9-month intervals) of a patient with well-differentiated serous adenocarcinoma of the ovary. The third new line, HEY, was derived from a human ovarian cancer xenograft (HX-62) originally grown from a peritoneal deposit of a patient with moderately differentiated papillary cystadenocarcinoma of the ovary. The cell lines demonstrated differential ability to grow in semisolid culture and as xenografts in immunologically deprived CBA/CJ mice. Dose-response curves were generated for clonogenic cell survival of cells exposed to common chemotherapeutic agents; one of the lines (HEY) shows a degree of resistance to the alkylating agent cis-diamminedichloroplatinum(II) (cis-platinum). Common karyological features included structural abnormalities of chromosomes 3 and 11. Heterogeneity of expression of ovarian tumor-associated antigens was documented.

Origin of immature teratoma of the ovary

Six cases of immature teratoma of the ovary were karyotyped and analyzed for chromosomal heteromorphisms, enzyme polymorphisms, and HLA specificities to determine their mechanism of origin. Three cases were chromosomally abnormal, with karyotypes of 48,XX, +14, +21; 47,XX, +20; and 47,XXX, respectively. The tumors with 48,XX, +14, +21 and 47,XX, +20 karyotypes were heterozygous for chromosomal heteromorphisms which were identical to those of their host and therefore originated from a premeiotic cell or failure of meiosis I. Both had a poor prognosis. The 47,XXX tumor and the three cases with normal karyotypes were homozygous for chromosome heteromorphisms and either homozygous or heterozygous for enzyme and HLA markers and therefore originated from a failure of meiosis II or duplication of a mature haploid ovum. All four had an uneventful postoperative course. These observations show that immature teratomas are like cystic teratomas in having at least three separate mechanisms of origin. However, they are unlike cystic teratomas in having a high proportion with chromosome abnormalities and a high rate of malignant transformation.

Epidemiology and etiology of ovarian cancer: a review

Ovarian cancer is the most frequent cause of death from gynecologic malignancies in the western world. Much effort has been put into attempts to correlate differences in incidence rates with environmental, endocrinologic, and genetic factors. A review of the literature reveals that there is currently no evidence to incriminate any single etiologic factor for this group of tumors. There is growing evidence of familial predisposition in a small group of patients and of a relationship with reproductive history. If current knowledge of the epidemiology of ovarian cancer is to be translated into disease prevention, more attention should be paid to women at risk because of their family history, and more awareness should be made of the protective effect of oral contraceptives.

Application of DNA flow cytometry to paraffin-embedded archival material for the study of aneuploidy and its clinical significance

By using a recently developed flow cytometric method we have analyzed cellular DNA content of paraffin-embedded histological material from cancer patients. This method allows the retrospective study of tumors from patients whose clinical outcome is already known, and we have applied it to ovarian cancers, stage II breast cancers, and to metastatic adenocarcinoma of unknown primary site. In addition to knowledge of patient survival, comprehensive information was available about other prognostic determinants and treatment received, and we have used multivariate analysis in an attempt to determine the prognostic significance of cellular DNA content. In ovarian cancer, it is a major prognostic variable except in stage IV disease, whereas in metastatic adenocarcinoma of unknown primary site cellular DNA content has no influence on survival. For stage II breast cancer the situation is more complex and requires larger numbers to be studied. However, aneuploid tumors tend to have more extensive involvement of axillary lymph nodes and a poorer overall disease-free survival. This influence of DNA content on disease-free survival appears to be confined to premenopausal patients, and has no effect on patient survival following disease recurrence. Although we need to study more patients and more tumor types, taken together the results so far show a generally more favorable prognosis for patients with diploid tumors, except in the presence of recurrent or metastatic disease. The better prognosis associated with diploid tumors could be due to the fact that they are more commonly found in earlier clinical stages rather than to their being inherently less aggressive than aneuploid tumors.

[Epidemiologic factors in ovarian cancer]

Ovarian carcinoma is the most severe gynecological cancer with an overall incidence of 12 per 1000 Americans or Europeans developing it over 40 years of age. Only 3 of the 12 cases will receive efficient care because the diagnosis will be made too late. This study reveals the principal risk factors i.e. upper socioeconomic echelon, ovarian function uninterrupted by a pregnancy or usage of oral contraceptives, anamnestic evidence of ovarian carcinoma in the family, some hereditary disorders, external insults (talcum powder). The synthesis of these various risk factors permits a comprehensive review of the hypotheses of pathogenesis concerning recurrence of tumors. But corollary epidemiologic studies are still needed to try to define better the high risk groups whose follow-up systematic detection and testing is a priority.

Polymorphism of Ag-stained nucleolus organizer regions in lymphocytes of patients with ovarian or breast adenocarcinoma

The Ag-stainability of nucleolus organizer regions (NORs) in the acrocentric chromosomes identified by Q-banding was studied in 45 female patients with adenocarcinoma of the ovary or breast and in 45 healthy females. Significantly higher frequencies of Ag(+)NORs per individual (8.8 and 8.3; P less than 0.05), in the G group chromosomes (3.6 and 3.2; P less than 0.05), and in chromosome 21 (1.9 and 1.7; P less than 0.02) were found in patients, compared with controls. Despite the lack of significant differences in NORs between the groups of patients with ovarian and breast adenocarcinoma, the main difference between the patients and controls was due to the patients with adenocarcinoma of the ovary, where a significantly higher frequency of Ag(+)NORs was found in chromosomes 21 (P less than 0.01) and 13 (P less than 0.05).

Common marker chromosomes in ovarian cancer

Cytogenetic analysis of six cases of ovarian adenocarcinoma revealed the presence of common marker chromosomes. The chromosomes involved in rearrangements, were #1 (four cases), #3 (six cases), #6 (two cases), and #17 (three cases). Our data support the presence of previously reported common aberrations of certain chromosomes in ovarian cancer. The presence in all six cases of a 3p- marker chromosome, previously reported as a specific abnormality in small cell lung cancer, indicates that it can also be found in other types of cancer.

Hereditary ovarian carcinoma. Biomarker studies

Three ovarian-cancer-prone kindreds were studied, two of which contained identical twin sisters concordant for ovarian carcinoma. In one kindred, both identical twin sisters had daughters with ovarian carcinoma. In another kindred, one of the identical twin sisters had an ovarian-cancer-affected daughter. Ovarian carcinoma showed vertical transmission in all three families in a pattern consonant with an autosomal dominant mode of inheritance. Medical-genetic survey of each family included detailed questionnaires with retrieval of primary medical and pathology documents on cancer of all anatomic sites. Putative biomarker determinations included: (1) in vitro hyperdiploidy in dermal monolayer cultures; and (2) lower serum levels of alpha-L-fucosidase (less than or equal to 275 IU/ml) in all cancer-affected patients and statistically significant lower levels in 50% risk individuals when compared to spouse and published controls (P = 0.04 and P = 0.0002, respectively). These findings are discussed in context with the eventual development of a risk factor profile which, given acceptable sensitivity and specificity, would enable identification of individuals who would be prime candidates for intensive surveillance/management programs.

Chromosomal changes in an ovarian granulosa cell tumor: similarity with carcinoma

The chromosomal changes in an ovarian granulosa cell tumor were studied after short-term culture in defined medium. The abnormalities found included X monosomy, structural rearrangements of chromosome #1, and an interstitial deletion of the long arm of chromosome #6. This pattern is closely related to that found in ovarian carcinoma and argues for the malignant nature of such tumors at the cellular level.

Generation of clonal variants in a human ovarian carcinoma studied by chromosome banding analysis

We have utilized detailed chromosome banding analysis to document the selection of variant genetic clones existing in cell populations obtained from a patient with ovarian adenocarcinoma. Cytogenetic analysis was performed on two samples from the patient's malignant ascites obtained over a 9-month interval. Tumor cell lines were also established in monolayer culture from each ascites sample, analyzed by chromosome banding techniques, and compared to the clonogenic population grown from each ascites specimen. Appearance of karyotypically distinct populations were identified from both the in vivo tumor and the tumor cell lines. Tumor colony-forming units (TCFU) evidenced minimal karyotypic change between the original ascites tumor and the ascites sample obtained after a 9-month period in vivo. In contrast, the cell lines derived from these two ascites samples demonstrated markedly different karyotypic populations between samples and progressive chromosome change within each sample following prolonged in vitro growth.

46,XY gonadal dysgenesis: is oncogenesis related to H-Y phenotype or breast development?

Among women with 46,XY gonadal dysgenesis, there is a high incidence of gonadal tumors. Because of evidence of a connection between occurrence of those tumors, H-Y phenotype, and breast development, we surveyed 55 cases of 46,XY gonadal dysgenesis and 12 related cases involving chromosomal and/or skeletal abnormalities. Our survey, including three new cases presented here, indicates that H-Y phenotype but not breast development may be related to the development of the gonadoblastoma-dysgerminoma. Thus among women with 46,XY gonadal dysgenesis, there are H-Y- and H-Y+ classes, but gonadal tumors are found almost exclusively in the H-Y+ class. Yet one of our patients may represent an exception to the association of H-Y+ phenotype and gonadal tumors in this syndrome.

Histologic grade and karyotype of immature teratoma of the ovary

Seven cases of ovarian "pure" immature teratoma were encountered in patients 10 to 38 years of age, six cases being in Stage Ia and one case in Stage IIc. The primary tumors and recurrent growth observed in one case were histologically graded from 0 to 3 according to the criteria of Norris et al. Karyotypes of the tumors and the patients were determined using culture and banding techniques. The only nonsurviving case was in Stage IIc. Four primary tumors belonging to grades 0, 1, and 2 showed a normal 46,XX female karyotype and the patients are alive and healthy. Three grade 3 tumors showed various types of karyotype abnormalities (48,XX,+14,+21; 47,XX,+20; 47,XXX). One patient died, one is alive after experiencing a recurrent tumor, and one has only been followed for 22 months. All seven patients had a normal 46,XX female chromosome constitution. Evidence to date indicates that karyotype of ovarian immature teratoma is either normal female 46,XX or a slight deviation from normal. It is postulated that in ovarian immature teratoma normal 46,XX karyotype is an indicator of favorable prognosis, whereas deviations in karyotype suggest a possibility of poor prognosis.

Chromosomal complements in primary gonadal failure

Twenty-nine patients underwent clinical, hormonal, endoscopic, and cytogenetic studies to determine the cause of primary amenorrhea or delayed sexual development. In 19 of them (mean age 17.6 years), the X chromosome was either missing or anomalous. In ten patients (mean age 25.5 years), the chromosomal complement was normal, 46 XX in six patients and 46 XY in four patients. Those with abnormal chromosomal complements were shorter (mean height, 141.9 cm) than patients with normal complements (158.7 cm). Somatic stigmas were observed more frequently in patients with chromosomally abnormal primary gonadal failure. In 23 patients (79.3%), the gonads were streaks, with fibrous stroma devoid of either follicles or tubules containing germ cells. In three patients the ovaries were hypoplastic, with few primordial follicles. Gonadoblastoma was present in two patients with XY and mixed XX/X/XY gonadal dysgenesis. In every patient with streak gonads and lack of germ cells, serum gonadotropin levels were elevated. Karyotype, follicle-stimulating hormone (FSH) and luteinizing hormone (LH) assays, and eventually laparoscopy and gonadal biopsy are important in the management of patients with primary gonadal failure.

Turner syndrome resulting from partial deletion of Y chromosome short arm: localization of male determinants

Chromosome studies performed because of the possibility of Turner syndrome in an infant girl with pedal edema and mild neck webbing revealed an XY karyotype. Subsequent exploratory laparotomy showed dysplastic ovaries with nests of germ cells with the morphologic features of gonadoblastoma. Repeat chromosome studies from peripheral blood using high-resolution techniques, and also from skin and ovarian fibroblasts, showed an XY karyotype but with a partial deletion of the Y short arm, which was not detected with standard techniques. These findings indicate that testis determining factors are located in this deleted region of the Y chromosome but that other gene(s) remain that induce gonadoblastoma.

Incidence of double minutes, cytogenetic equivalents of gene amplification, in human carcinoma cells

Screening of the occurrence of double minutes (DM) was performed in more than 1,000 metaphases obtained from a total of 22 solid human breast tumours and more than 3,600 metaphases from a total of 55 malignant effusions (45 patients with different types of carcinomas). DM were observed in 15 of these breast tumor cases and in 34 of the effusions (obtained from 29 cancer patients). The percentage of cells exhibiting DM as well as the number of DM per respective cell varied widely. It could be seen that metastatic cells from malignant effusions exhibited on the average more DM per cell than did cells of primary breast carcinomas. Differences in the incidence of DM could be observed between different carcinomas as well as between different age groups. In addition, it did not appear that DM could be induced by mutagenic tumor therapy. DM are thus not a rare finding in human solid tumors but, as cytogenetic equivalents of gene amplification, they rather represent a fundamental biological characteristic of tumor development.

The epidemiology of ovarian cancer

Although no unequivocally effective ovarian cancer prevention strategies have emerged, epidemiologic studies have identified high-risk populations. The striking international variation (apparently a fivefold difference) can probably be explained on the basis of differential parity, differing classification measures, and differences in the underlying population age distribution. United States age-adjusted mortality has increased slightly in the past 30 years, and the cancer remains predominantly a disease of older adult white women of northern European extraction. The increases in age-specific mortality and age-adjusted mortality over time may be related to a decrease in average family size. Pregnancy, especially pregnancy before age 25 years, and use of oral contraceptives are protective; the risk of ovarian cancer increases with increasing years of ovulation. A positive family history is also associated with a substantial increase in ovarian cancer risk. Survivors of ovarian cancer are more susceptible to cancers of the breast, endometrium, and colon than are similarly-aged normal women, most probably because all four cancers share some common risk factor(s). Various alkylating agents are clearly leukemogenic in survivors of ovarian cancer, an observation that suggests caution in the use of adjuvant chemotherapy in women at relatively low risk of relapse.

Translocation 1;7 in dyshematopoiesis: possibly induced with a nonrandom geographic distribution

Eight patients with various hematologic disorders had an identical chromosomal aberration in their bone marrow or unstimulated peripheral blood, a translocation t(1;7) interpreted as t(1;7)(p11;p11). The translocation chromosome replaced one normal chromosome #7; therefore, the karyotype of the abnormal cells was trisomic for 1q and monosomic for 7q. Including four cases from the literature, a total of 12 patients (4 women, 8 men) with this translocation are known at the moment. The translocation does not seem to be associated with a specific disorder, but almost all patients had a preleukemic syndrome during some stage of their disease. It is very remarkable that 11 of the 12 patients lived in the Netherlands, and 7 patients had a history of iatrogenic exposure to alkylating agents or irradiation; one patient was a radiation worker and another one had a history of toxic exposure to chloramphenicol. It is suggested, therefore, that the t(1;7) is a possibly induced chromosomal aberration with a clearly nonrandom geographic distribution.

Cytogenetics of a cell line derived from an ovarian papillary serous cystadenocarcinoma

The cell line OAW 42 was established from the ascites of a patient with papillary serous cystadenocarcinoma of the ovary. Cytogenetic analysis at three different passages showed that the line was hypotetraploid, with no distinct mode, and was characterized by 14 stable markers, involving chromosomes #1, #3, #4, #5, #12, #17, #18, #20, and #21. Neither component of the translocation t(6;14)(q21;q24), previously reported to characterize ovarian papillary serous cystadenocarcinoma, was found.

Familial Ovarian Cancer Registry

Ninety-four families totaling 201 cases are reported in this first report of the Familial Ovarian Cancer Registry. The results of the Registry and future studies are presented.

Ovarian dysplasia. A study of identical twins

The normal, identical twin sisters of patients who had been the subjects of ovarian cancer were subjected to prophylactic oophorectomy after the menopause. The finding of epithelial abnormality suggests a precancerous change similar to other genital epithelial dysplasia.

Persistence of chromosome rearrangements in peripheral lymphocytes from patients treated with melphalan for ovarian carcinoma

Chromosome aberrations were studied in peripheral lymphocytes from 50 patients treated with melphalan against ovarian carcinoma. The chromosome analyses were carried out 4-132 months (mean 57 months) after the end of melphalan therapy. Most of the patients were studied several times during four years. The mean frequency of cells with chromosome and chromatid aberrations was 5.4% in the patients and 2.3% in an untreated control group. The highest aberration frequency (average 18%) was found in a patient who later developed gastric carcinoma. The dominating types of aberrations in the patients were chromosome exchanges occurring as single marker chromosomes or as multiple chromosome rearrangements. These types of aberrations were found in only 0.3% of the control cells as compared to 3.8% of the patient cells. Patients with a high total dose of melphalan (above 420 mg) and a long duration of the therapy (average 22.5 months) had a higher frequency of cells with aberrations (6.3%) than patients with a lower total dose (below 420 mg) and a shorter therapy (12 months) (4.2%). No additive effect of radiation therapy was observed on the aberration frequency.

[Genetic epidemiology study of ovarian cancer. I. A comparison of familial and population frequencies]

The frequency of several kinds of cancer among relatives of 200 patients with ovarian cancer was analysed. The annual population incidence was used as a control. Nonrandom familial clustering of ovarian cancer (p less than 0.01) was observed. The frequency of breast cancer in women and that of eosophagal cancer in man was higher than the expected value (p less than 0.05). The risk of ovarian cancer occurrence amounted 9% in women of the first degree of relationship, whereas cumulative risk in a population only reached 1.57% to the age of 90. The patterns of distribution of patients in the pedigrees satisfied the requirements of the multifactorial model. Heritability coefficient was 54.12 +/- 2.49%. Thus, women of the first degree of relationship compose the high risk group.

An ultrastructural study of ovarian development in the otu7 mutant of Drosophila melanogaster

Females homozygous for the otu7 allele produce ovarian tumours, as well as egg chambers that reach a relatively late stage of development. Mutant ovarian nurse cells contain giant polytene chromosomes. These are transcriptionally active, and RNA is transported to the oocyte through ring canals, although at reduced rate. Vitellogenic oocytes are endocytotically active. Protein (alpha yolk) spheres are formed, but glycogen (beta yolk) spheres were never seen in the ooplasm. Follicle cells migrate normally and secrete more vitelline membrane and chorion than is required to cover the slowly growing oocyte. Specialized follicle cells also secrete relatively normal dorsal appendages. The micropylar cone is secreted by another cluster of specialized follicle cells called border cells. These are out of phase with the oocyte, and the forming micropylar cone prevents the nurse cells from passing the remainder of their cytoplasm to the oocyte. The result is a morphologically abnormal chamber blocked at the p-12 stage. Sections through the micropylar cone of a p-12 chamber demonstrated that one of the border cells formed a projection containing a bundle of microtubules. Secretions of the border cells were deposited against this tube, which later degenerates or is withdrawn. Normally this results in a canal, the micropyle, through which the sperm enters the egg. The slowed growth of the mutant oocyte presumably results from a defect in the transport of fluids or charged molecules to it, and the otu+ gene is therefore believed to play a vital role in this process.

Somatic activation of rasK gene in a human ovarian carcinoma

A tumor isolate from a patient with serous cystadenocarcinoma of the ovary contained an activated rasK gene detected hy transfection of NIH/3T3 cells. In contrast, DNA from normal cells of the same patient lacked transforming activity, indicating that activation of this transforming gene was the consequence of somatic mutation in the neoplastic cells. The transforming gene product displayed an electrophoretic mobility in sodium dodecyl sulfate-polyacrylamide gels that differed from the mobilities of rasK transforming proteins in other tumors, indicating that a previously undescribed mutation was responsible for activation of rasK in this ovarian carcinoma.

The origin of ovarian teratomas

Chromosome and enzyme markers have been studied in 21 benign ovarian teratomas from 14 patients. Markers heterozygous in the patient were completely homozygous in 52% of the teratomas and completely heterozygous in 19%. The remainder showed a mixture of the two, 10% having homozygous centromeres with some heterozygous enzyme markers and 19% having heterozygous centromeres and some homozygous enzyme markers. These results suggest that benign ovarian teratomas in the present series arise from germ cells in a number of different ways. Those with heterozygous centromeres probably arise by failure of meiosis I. Some tumours with homozygous centromeres must arise by failure of meiosis II, but because of the low level of heterozygous enzyme markers in this group a substantial number are thought to arise by duplication of a mature ovum to give an entirely homozygous genotype, genetically the female equivalent of the complete hydatidiform mole.

Cellular DNA content--a stable feature in epithelial ovarian cancer

Detailed flow cytometric analysis of cellular DNA content was performed on neoplastic tissue from 33 patients with malignant common epithelial ovarian tumours in order to investigate the intratumoral stability of ploidy and proliferative fraction. There was a remarkable stability, both spatial and temporal, in the DNA pattern for any particular tumour. Of 24 tumours that were analysed in multiple areas tumour ploidy was found to be a stable marker in all but 3 cases where regional variations were evident. In 9 patients serial analyses were performed on tumour obtained either at initial diagnosis (6 patients) or second look laparotomy (3 patients) and then some time later (7-17 months) at relapse or death and in all cases the tumour ploidy remained unchanged. In addition, 10 ovarian carcinomas established in nude mice have maintained a DNA content during serial passage similar to that of the original implanted tumour. In contrast in 50% of tumours that were evaluable for S-phase analysis we demonstrated a considerable intratumoral variability in the S-phase fraction. We conclude that cellular DNA content is a stable feature of ovarian carcinoma while S-phase fraction is commonly subject to intratumoral variation.

Cytologic evidence for gene amplification in methotrexate-resistant cells obtained from a patient with ovarian adenocarcinoma

To analyze if methotrexate (MTX) resistance arises from gene amplification in a patient treated clinically with MTX, the cytogenetic and drug sensitivity profile of the tumor colony forming units (TCFUs) from a 58-year-old woman with stage III well-differentiated ovarian serous adenocarcinoma was studied. This patient had not received treatment directed against her tumor for nine months before this study, but had received oral-dose MTX (2.5 mg, twice weekly) for three years for the treatment of psoriasis. Analysis of TCFUs grown in nucleoside-free media demonstrated MTX resistance at concentrations of up to 100 micrograms/mL (2.2 X 10(-4)M). Cytologic evidence for dihydrofolate reductase (DHFR) gene amplification in TCFUs was determined by in situ hybridization, using radiolabeled cDNA to DHFR mRNA. Results localized the DHFR sequences to an abnormally staining region present on chromosome 4q. This study supports the notion that alterations in gene dosage (that is, gene amplification) play a role in the development of drug resistance in spontaneous human cancers.

Cytogenetic studies in ovarian cancer

Cytogenetic studies of ovarian cancer have been conducted in the Medicine Branch, NCI, National Institutes of Health for 5 years. A total of 72 patients were studied by direct preparation and/or 1- to 3-day short-term culture of ascites (86 samples), pleural fluid (4 samples), and tumor (2 samples). Repeat examinations (1-24 months later) were performed in 7 of the 72 patients. Forty-four patients (62%) were successfully analyzed with banding techniques: 6 patients had adenocarcinoma, 7 had serous adenocarcinoma, 13 had serous papillary adenocarcinoma, 7 had serous papillary cystadenocarcinoma, 2 had mucinous adenocarcinoma, 6 had undifferentiated or poorly differentiated adenocarcinoma, 1 had clear cell adenocarcinoma, and 2 were not classified. Of these 44 patients, 29 had received prior chemotherapy, 14 were untreated, and in 1 patient the treatment status was unknown. Aneuploidy was observed in all patients and there was considerable variation in the chromosome numbers (even within single samples), often ranging from diploidy to triploidy to tetraploidy. All 44 patients had numerical abnormalities and 39 had structural abnormalities. The chromosomes most frequently involved in structural abnormalities (in decreasing order according to the number of patients involved) were #1, #3, #2, #4, #9, #10, #15, #19, #6, and #11; the least involved chromosomes were #21 and #5. Clone formation and the number of chromosomes involved in structural abnormalities increased with duration of disease and were more extensive in patients treated with chemotherapy than in patients treated with surgery alone. Our data did not show a deletion of chromosome #6 (6q-) to be specific for ovarian cancer.

Gonadoblastoma in a patient with an isodicentric X chromosome

Although gonadoblastoma is known to be associated with the presence of a Y chromosome, this case report of a 15-year-old patient with gonadal dysgenesis, gonadoblastoma, and an idic(Xq-) chromosome provides evidence for the occurrence of gonadoblastoma even in the absence of a Y chromosome. A review of previous cases reported to have gonadoblastoma in the absence of a Y chromosome revealed that the presence of some breast development was the common denominator among those patients. Therefore, a patient who presents with gonadal dysgenesis with some breast development, but lacks a Y chromosome may observe as close scrutiny as the patient with gonadal dysgenesis in the presence of a Y chromosome.

[Cytogenetic studies of multiple ovarian dermoid cysts in a single host]

To investigate the pathogenesis of gonadal teratoma, sixteen ovarian dermoid cysts obtained from four patients were examined by using chromosomal Q and R heteromorphisms, HLA antigens and enzyme polymorphisms of phosphoglucomutase-1 and esterase-D. The results obtained were as follows: 1) Karyotypes of 16 tumors were 46,XX. 2) In thirteen tumors, chromosomal heteromorphisms were homozygous for the homologous chromosomes, being heterozygous in the hosts. In 9 of them, all gene markers analyzed were also homozygous, but in the remaining 4 tumors some gene markers showed heterozygous combination. These findings indicate that these 13 tumors arose from a germ cell after the first meiotic division by suppression of the second meiotic division or by fusion of polar body II with the oocyte. 3) In three tumors, chromosomal heteromorphisms showed heterozygous patterns as in the hosts. In 2 of them, some gene markers were homozygous, and in the remaining one tumor the gene markers were all heterozygous. These findings suggest that these three tumors arose from a germ cell before the first meiotic division. It is concluded that multiple ovarian dermoid cysts in a single host originate from different germ cells with diverse mechanisms.

Determinants of ovarian cancer risk. I. Reproductive experiences and family history

Reproductive experiences and family history were assessed in 215 white females with epithelial ovarian cancer and in 215 control women matched by age, race, and residence. Pregnancy exerted a strong protective effect against ovarian cancer, which increased with the number of live-born children. After adjustment for parity, an effect of age at first live birth and breast-feeding was not apparent. Menstrual events did not differ significantly between cases and controls, although cases were more likely to have had an earlier menopause and less likely to have had a surgical menopause. Women with ovarian cancer had more frequently used menopausal hormones in cyclic fashion compared to controls. Regarding family history, women with ovarian cancer more frequently reported consanguinity in their ancestry and a highly frequency of primary relatives with cancer of the colon, lung, ovary, and prostate gland.

An ovarian cancer family: clinical and cytogenetic data

A family with five ovarian neoplasms in three subsequent generations was studied. Four women had ovarian cancer at age 38, 40, 47, and 53, and one had cystoma ovari at 24. There were other neoplasms and preneoplastic lesions in this family. Several developmental anomalies were revealed, and one of them (a tooth anomaly) may be associated with ovarian tumors. Cytogenetic studies have been carried out on six of the living relatives, including two treated for ovarian neoplasms. The incidence of spontaneous chromosome aberrations was not significantly increased in each of these cases. Polymorphism of constitutive heterochromatin regions was observed in all six individuals. The possible type of inheritance of the ovarian cancer, the significance of the tooth anomaly, and the constitutive heterochromatin polymorphism as cancer markers in this family are discussed.

Genetic epidemiology of breast cancer and associated cancers in high-risk families. I. Segregation analysis

Genetic and environmental hypotheses that might explain the patterns of occurrence of breast cancer and associated cancers in 18 large families at high risk of the disease were tested with the use of segregation analysis. For 16 pedigrees, results were consistent with the hypothesis that breast cancer has a genetic etiology. In 2 other families, breast cancer appeared more likely to have an environmental origin. Breast cancer susceptibility is best explained by hypotheses that postulate autosomal dominant susceptibility alleles in 10 families with primarily premenopausal breast cancer and ovarian cancer, in 4 families with primarily postmenopausal breast cancer, and in 2 families with breast cancer, brain tumor, sarcoma, leukemia, and adrenocortical carcinoma in children and young adults. In an accompanying paper, genetic susceptibility in the first 2 groups of families is further explored with the use of linkage analysis.

Genetic epidemiology of breast cancer and associated cancers in high-risk families. II. Linkage analysis

Chromosomal locations of hypothetical alleles which increase susceptibility to human breast cancer in some families were investigated by genetic linkage analysis. In 7 families with primarily premenopausal breast cancer and (in 5 families) ovarian cancer, a dominant susceptibility allele may be linked to the genetic marker glutamicpyruvic transaminase or alanine aminotransferase (GPT; lod score 1.95 at zero recombination). The most positive lod score for linkage to a recessive susceptibility allele was for acid phosphatase (ACP; lod score 0.78 at 40% recombination), but ACP was informative in ony 1 family. In 3 families with primarily postmenopausal breast cancer, none of 21 genetic markers provided any evidence for linkage to either dominant or recessive susceptibility alleles. In the families with the possible GPT linkage, women who carry the hypothetical susceptibility allele would be at high risk of breast cancer, whereas their relatives who do not carry that allele would have no increased risk. GPT genotype is not associated with breast cancer risk in the general population, so GPT linkage cannot be used as a screening test for breast cancer.

The X linked recessive form of XY gonadal dysgenesis with a high incidence of gonadal germ cell tumours: clinical and genetic studies

Five phenotypic females in one family had the genotype 46,XY and all had gonadal germ cell tumours. Studies of the family pedigree suggest that this form of XY gonadal dysgenesis is inherited in an X linked recessive manner. G banding of elongated metaphase chromosomes from two subjects with XY gonadal dysgenesis and a female carrier showed no aberrations of the X chromosome. The titres of H-Y antigen in three girls with XY gonadal dysgenesis were in the male control range. Thus it appears that, in the X linked form, XY gonadal dysgenesis may be caused by a point deletion or mutation of a gene on the X chromosome, which controls the gonad specific receptor for the H-Y antigen. Studies of Xg blood groups were uninformative about linkage of Xg with the X borne gene causing the XY gonadal dysgenesis. Dermatoglyphic studies in the girls with XY gonadal dysgenesis and female carriers revealed high a-b palmar ridge counts and a tendency for the A mainline to terminate in the thenar area. Both of these features have been described in patients with Turner's syndrome.