1
|
Li Y, Yu C, Li H, Feng Y, Fan P, Chen X. Relationship between human epididymal protein 4 and depth of tumor invasion, postoperative recurrence, and metastasis of epithelial epithelial ovarian cancer. Asia Pac J Clin Oncol 2024; 20:472-480. [PMID: 38615275 DOI: 10.1111/ajco.14062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 03/11/2024] [Accepted: 03/20/2024] [Indexed: 04/15/2024]
Abstract
This study aimed to analyze the relationship between human epididymal protein 4 (HE4) and infiltration depth, postoperative recurrence, and metastasis of epithelial ovarian cancer (OVCA). Immunohistochemistry was used to detect the expression level of HE4 in cancer tissues and adjacent tissues of 90 patients with epithelial OVCA admitted to our hospital from May 2017 to January 2018. Cox regression was used to analyze the factors affecting the prognosis of epithelial OVCA. The relationship between HE4 and the prognosis of epithelial OVCA was analyzed by the receiver operating characteristic curve and Kaplan-Meier survival curve. The positive expression rate of HE4 in epithelial OVCA was 85.56%, which was higher than 34.44% in adjacent tissues (p < 0.01). The International Federation of Gynecology and Obstetrics stage, infiltration depth, lymph node metastasis, postoperative recurrence and metastasis, and HE4 positivity were independent risk factors for the prognosis, and platinum-based chemotherapy sensitivity was an independent protective factor for the prognosis of patients with epithelial OVCA (p < 0.05). The area under the curve of HE4 in diagnosing epithelial OVCA and predicting recurrence was 0.863 and 0.700, the sensitivity was 91.60% and 85.60%, and the specificity was 90.20% and 65.60%. The median progression-free survival and overall survival were 26.1 and 30.2 months in HE4-positive epithelial OVCA patients, while these were 31.4 and 35.6 months in HE4-negative epithelial OVCA patients (p < 0.05). In conclusion, HE4 was highly expressed in epithelial OVCA tissues. Its expression level was related to the depth of tumor invasion, postoperative recurrence and metastasis, and other clinicopathological characteristics of patients with epithelial OVCA.
Collapse
Affiliation(s)
- Yan Li
- Department of Gynaecology, Shanxi Maternal and Child Health Hospital, Taiyuan, P. R. China
| | - Chunxiang Yu
- Department of Gynaecology, Shanxi Maternal and Child Health Hospital, Taiyuan, P. R. China
| | - Hui Li
- Department of Gynaecology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, P. R. China
| | - Yan Feng
- Department of Gynaecology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, P. R. China
| | - Panhong Fan
- Department of Pathology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, P. R. China
| | - Xiaohui Chen
- Department of Gynaecology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, P. R. China
| |
Collapse
|
2
|
Dye A, Stein R, Lewis G, Hew K. Leptomeningeal Carcinomatosis From Primary Mucinous Carcinoma of the Ovary. Cureus 2024; 16:e51556. [PMID: 38313981 PMCID: PMC10835194 DOI: 10.7759/cureus.51556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2023] [Indexed: 02/06/2024] Open
Abstract
Leptomeningeal carcinomatosis (LMC) is an extremely rare site for metastasis from a primary ovarian cancer. LMC occurs when the thin layers of tissue that surround the brain and spinal cord are infiltrated by ovarian cancer metastasis. We present a case of a 63-year-old female with recurrent metastatic mucinous adenocarcinoma of the ovary who was diagnosed with LMC. While undergoing sixth-line chemotherapy, she presented with debilitating headaches and gait instability. Brain MRI revealed subarachnoid enhancement and other findings diagnostic of LMC. Given the rarity of this disease, treatment protocols have yet to be established. In patients with primary ovarian cancer that present with new onset neurological complaints, LMC should be suspected and appropriate imaging obtained.
Collapse
Affiliation(s)
- Alexander Dye
- Obstetrics and Gynecology, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Rachel Stein
- Radiology, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Gregory Lewis
- Obstetrics and Gynecology, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| | - Karina Hew
- Gynecologic Oncology, University of Florida College of Medicine - Jacksonville, Jacksonville, USA
| |
Collapse
|
3
|
Barpujari A, Klaas E, Roberts J, Vo KA, Azizi E, Martinez M, Sung E, Lucke-Wold B. Ovarian Cancer Metastasis to the Central Nervous System: A Literature Review. JOURNAL OF GYNECOLOGY, CLINICAL OBSTETRICS AND REPRODUCTIVE MEDICINE 2022; 1:10.37191/Mapsci-JGCORM-1(1)-004. [PMID: 36326265 PMCID: PMC9625854 DOI: 10.37191/mapsci-jgcorm-1(1)-004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Ovarian cancer is one of the leading causes of cancer-related deaths among women in the United States. Metastasis to the central nervous system has become more frequent in the previous decades, however, treatment options remain limited. In this review, we discuss the pathophysiology of ovarian cancer and how metastasis to the central nervous system typically occurs. We then discuss cases of metastasis presented in the literature to evaluate current treatment regimens and protocols. Finally, we highlight emerging treatment options that are being utilized in clinics to provide personalized treatment therapy for a patient's unique diagnosis. This review aims to further the understanding of pathophysiology, stimulate further innovative treatments, and present accessible resources through tables and figures.
Collapse
Affiliation(s)
- Arnav Barpujari
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | - Elizabeth Klaas
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | - Jeffery Roberts
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | - Kim-Anh Vo
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | - Esaan Azizi
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | - Melanie Martinez
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | - Eric Sung
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | | |
Collapse
|
4
|
Stopa BM, Cuoco JA, Adhikari S, Grider DJ, Rogers CM, Marvin EA. Iatrogenic Leptomeningeal Carcinomatosis Following Craniotomy for Resection of Metastatic Serous Ovarian Carcinoma: A Systematic Literature Review and Case Report. Front Surg 2022; 9:850050. [PMID: 35548192 PMCID: PMC9082594 DOI: 10.3389/fsurg.2022.850050] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Metastasis of ovarian carcinoma to the central nervous system occurs in <2% of cases and classically localizes within the brain parenchyma. Moreover, leptomeningeal spread of these tumors is an exceedingly rare phenomenon. Here, we conduct a systematic review of the current literature on the natural history, treatment options, and proposed pathogenic mechanisms of leptomeningeal carcinomatosis in ovarian carcinoma. We also report a case of a 67-year-old female with stage IV metastatic ovarian serous carcinoma initially confined to the peritoneal cavity with a stable disease burden over the course of three years. Follow-up imaging demonstrated an intracranial lesion, which was resected via craniotomy, and pathology was consistent with the original diagnosis. Three months after surgery, she developed rapidly progressive dizziness, generalized weakness, fatigue, and ataxia. Repeat MRI demonstrated interval development of extensive and diffusely enhancing dural nodularity, numerous avidly enhancing supratentorial and infratentorial lesions, enhancement of the bilateral trigeminal nerves, internal auditory canals, and exit wound from the surgical site into the posterior aspect of the right-sided neck musculature consistent with diffuse leptomeningeal dissemination. The present case highlights that leptomeningeal dissemination of ovarian carcinoma is a potential yet rare consequence following surgical resection of an ovarian parenchymal metastasis. Progressive clinical symptomatology that develops postoperatively in this patient population should prompt urgent workup to rule out leptomeningeal disease and an expedited radiation oncology consultation if identified.
Collapse
Affiliation(s)
- Brittany M. Stopa
- Virginia Tech Carilion School of Medicine, Roanoke, VA, United States
| | - Joshua A. Cuoco
- Virginia Tech Carilion School of Medicine, Roanoke, VA, United States
- Section of Neurosurgery, Carilion Clinic, Roanoke, VA, United States
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
| | - Srijan Adhikari
- Virginia Tech Carilion School of Medicine, Roanoke, VA, United States
- Section of Neurosurgery, Carilion Clinic, Roanoke, VA, United States
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
| | - Douglas J. Grider
- Virginia Tech Carilion School of Medicine, Roanoke, VA, United States
- Dominion Pathology Associates, Roanoke, VA, United States
| | - Cara M. Rogers
- Virginia Tech Carilion School of Medicine, Roanoke, VA, United States
- Section of Neurosurgery, Carilion Clinic, Roanoke, VA, United States
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
| | - Eric A. Marvin
- Virginia Tech Carilion School of Medicine, Roanoke, VA, United States
- Section of Neurosurgery, Carilion Clinic, Roanoke, VA, United States
- School of Neuroscience, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
- *Correspondence: Eric A. Marvin
| |
Collapse
|