Neoplastic cellularity is associated with clinical and molecular features of high-grade serous ovarian carcinoma

Study on the Application of Systemic Inflammation Response Index and Platelet-Lymphocyte Ratio in Ovarian Malignant Tumors

Objective

We aimed to evaluate whether the systemic inflammatory response index (SIRI) and platelet lymphocyte ratio (PLR) are associated with ovarian malignancy and their diagnostic value. Design: This retrospective study compared SIRI, PLR, cancer antigen 125 (CA125), cancer antigen 153 (CA153), cancer antigen 199 (CA199), A carcinoma embryonic antigen (CEA) and alpha fetal protein (AFP) of the two groups in Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University from January 2018 to December 2020, divided into two groups based on pathological results, including 85 with ovarian malignancy who met the study criteria and 85 patients with benign ovarian tumors were randomly selected as control group.

Results

1) SIRI and PLR in benign ovarian tumor group were lower than those in ovarian malignancy group; 2) SIRI and PLR in ovarian malignant tumor low stage group were lower than those in the high stage group; 3) In ovarian malignancies, SIRI and PLR were positively associated with CA125 (the correlation coefficient r = 0.251, p = 0.021; r = 0.251, p = 0.020;) but showed no correlation with CA153.

Conclusion

The study shows that SIRI and PLR are both convenient and associated with ovarian malignancy. SIRI and PLR can be used to help the differentiation of benign and malignant ovarian tumors and can also be used in the markers of ovarian malignant tumors roughly staging.

Sodium MRI with 3D-cones as a measure of tumour cellularity in high grade serous ovarian cancer

The aim of this study was to assess the feasibility of rapid sodium MRI (23Na-MRI) for the imaging of peritoneal cancer deposits in high grade serous ovarian cancer (HGSOC) and to evaluate the relationship of 23Na-MRI with tumour cellularity. 23Na-MRI was performed at 3 T on twelve HGSOC patients using a 3D-cones acquisition technique. Tumour biopsies specimens were collected after imaging and cellularity was measured from histology. Total 23Na-MRI scan time for each patient was approximately 11 min. At an isotropic resolution of 5.6 mm, signal-to-noise ratios (SNRs) of 82.2 ± 15.3 and 15.1 ± 7.1 (mean ± standard deviation) were achieved for imaging of tumour tissue sodium concentration (TSC) and intracellular weighted sodium concentration (IWS) respectively. Tumour TSC and IWS concentrations were: 56.8 ± 19.1 mM and 30.8 ± 9.2 mM respectively and skeletal muscle TSC and IWS concentrations were 33.2 ± 16.3 mM and 20.5 ± 9.9 mM respectively. There were significant sodium concentration differences between cancer and skeletal muscle, Wilcoxon signed-rank test, P <  0.001 for TSC and P =  0.01 for IWS imaging. Tumour cellularity displayed a strong negative correlation with TSC, Spearman's rho = -0.92, P <  0.001, but did not correlate with IWS. This study demonstrates that 23Na-MRI using 3D-cones can rapidly assess sodium concentration in peritoneal deposits of HGSOC and that TSC may serve as a biomarker of tumour cellularity.

Molecular Response to Neoadjuvant Chemotherapy in High-Grade Serous Ovarian Carcinoma

While high-grade serous ovarian carcinoma (HGSOC) is the most common histologic subtype of ovarian cancer, significant tumor heterogeneity exists. In addition, chemotherapy induces changes in gene expression and alters the mutational profile. To evaluate the notion that patients with HGSOC could be better classified for optimal treatment based on gene expression, we compared genetic variants [by DNA next-generation sequencing (NGS) using a 50 gene Ion Torrent panel] and gene expression (using the NanoString PanCancer 770 gene Panel) in the tumor from 20 patients with HGSOC before and after neoadjuvant chemotherapy (NACT). NGS was performed on plasma cell free DNA (cfDNA) on a select group of patients (n = 14) to assess the utility of using cfDNA to monitor these changes. A total of 86 genes had significant changes in RNA expression after NACT. Thirty-eight genetic variants (including SNPs) from 6 genes were identified in tumors pre-NACT, while 59 variants from 19 genes were detected in the cfDNA. The number of DNA variants were similar after NACT. Of the 59 variants in the plasma pre-NACT, only 6 persisted, whereas 33 of 38 specific variants in the tumor DNA remained unchanged. Pathway analysis showed the most significant alterations in the cell cycle and DNA damage pathways.Implications: Gene expression profiles at the time of interval debulking provide additional genetic information that could help impact treatment decisions after NACT; although, continued collection and analysis of matched tumor and cfDNA from multiple time points are needed to determine the role of cfDNA in the management of HGSOC. Mol Cancer Res; 16(5); 813-24. ©2018 AACR.