Heterotypic CAF-tumor spheroids promote early peritoneal metastatis of ovarian cancer

The study provides insights in HGSOC by identifying that ascitic CAFs selectively recruit ITGA5^high ascitic tumor cells to form heterotypic spheroids named metastatic units (MUs), which actively engage in peritoneal metastasis, discriminates HGSOC from LGSOC, and act as therapeutic targets in hampering OC metastasis.

High-grade serous ovarian cancer (HGSOC) is hallmarked by early onset of peritoneal dissemination, which distinguishes it from low-grade serous ovarian cancer (LGSOC). Here, we describe the aggressive nature of HGSOC ascitic tumor cells (ATCs) characterized by integrin α5^high (ITGA5^high) ATCs, which are prone to forming heterotypic spheroids with fibroblasts. We term these aggregates as metastatic units (MUs) in HGSOC for their advantageous metastatic capacity and active involvement in early peritoneal dissemination. Intriguingly, fibroblasts inside MUs support ATC survival and guide their peritoneal invasion before becoming essential components of the tumor stroma in newly formed metastases. Cancer-associated fibroblasts (CAFs) recruit ITGA5^high ATCs to form MUs, which further sustain ATC ITGA5 expression by EGF secretion. Notably, LGSOC is largely devoid of CAFs and the resultant MUs, which might explain its metastatic delay. These findings identify a specialized MU architecture that amplifies the tumor–stroma interaction and promotes transcoelomic metastasis in HGSOC, providing the basis for stromal fibroblast-oriented interventions in hampering OC peritoneal propagation.

[Primary cervical cancer screening]

Cervico-uterine cancer screening with cytology decrease incidence by more than 50%. The cause of this cancer is the human papilloma virus high risk, and requires a sensitive test to provide sufficient sensitivity and specificity for early detection and greater interval period when the results are negative. The test of the human papilloma virus high risk, is effective and safe because of its excellent sensitivity, negative predictive value and optimal reproducibility, especially when combined with liquid-based cytology or biomarkers with viral load, with higher sensitivity and specificity, by reducing false positives for the detection of cervical intraepithelial neoplasia grade 2 or greater injury, with excellent clinical benefits to cervical cancer screening and related infection of human papilloma virus diseases, is currently the best test for early detection infection of human papillomavirus and the risk of carcinogenesis.

Management of recurrent epithelial ovarian cancer

Epithelial ovarian cancer is the fifth most common cancer in women. It is usually diagnosed at an advanced stage and is the leading cause of death from gynecologic cancers in women. The overall survival rate at five years is 50% and its treatment is still poor. We need new treatments for patients with recurrent ovarian cancer who are incurable with current management. We review the effectiveness of new biological agents and morbidity and mortality of cytoreductive surgery. Since the hyperthermic increases the effectiveness of chemotherapy and the chance of survival, hyperthermic intraperitoneal chemotherapy has been proven to be a promising option, however it still requires further study to be the standard treatment.

Metabolic syndrome in breast cancer

Breast Cancer is a heterogeneous disease, progressive, currently, are classified according to in pattern of gene expression luminal A, luminal B, basal and HER-2neu + and Triple-negative, 75% to 80% have receptors positive hormonal and 15% to 20% are positive for hER-2neu and 10% to 20% are triple negative, with hormone receptor negative and HER2-neu and their diagnostic is made by exclusion, the Metabolic Syndrome is related to a higher incidence of these cancers where the insulin-leptin axis-adiponectin are implicated in carcinogenesis.

[New guidelines in regard to cervical cancer screening]

Cancer screening programs have been successful in reducing the incidence and mortality due to cervical cancer. For more than a decade, the human papillomavirus test has been recommended as part of these programs, however, Pap tests is not currently recommended for women 65 years of age who participated adequately in screening programs, continuing with these screening programs is not needed. Screening programs will be different in special populations at greatest risk where tests are frequently needed or use of alternative methods.

[Giant cystic lymphangioma breast. Report of a case with 20-year follow-up and review of the literature]

BACKGROUND

Lymphangiomas are congenital malformations or acquired (secondary to trauma, infection or neoplasia) in the mammary gland, are extremely rare. These lesions tend to infiltrate surrounding tissues and malignant degeneration is extremely rare. Clinically manifests as benign masses, slow growing; diagnosed clinically and by imaging studies. Suegery with removal of the mass is performed for aesthetic reasons and to make differential diagnosis with other common injuries.

CLINICAL CASE

Women 45 years of age with progressive increase in size of the left breast, breast trauma concerns and has no other symptoms.The histologic diagnosis was cystic lymphangioma giant left mammary gland.

DISCUSSION

Lymphangiomas are uncommon lesions and extremely rare in the mammary gland, locally aggresive behavior and are benign, where abnormal lymphatic tissue has some ability to proliferate and accumulate large amounts of liquid, representing cystic appearance, as presented in our case. Local surgical excision is the treatment.

CONCLUSION

In this first case of giant breast cystic lymphangioma reported in Mexico, which corroborates the benignity of the lesion.

[Serum hormones that regulate the reproductive axis in men with testicular germ cell cancer and its impact on fertility]

BACKGROUND

Epidemiological studies treat testicular germ cancer as a single disease, the behavior of the two histological types of cancer; seminoma and nonseminoma have differences in reproductive hormone secretion and impair fertility differently.

OBJECTIVE

To demonstrate that the serum concentration of pituitary hormones involved in fertility and spermatogenesis in the affected male is different in the two histological types.

METHODS

Were determined by radioimmunoassay or inmunoradiometric assay, luteinizing hormone, follicle stimulating hormone, total testosterone, prolactin, estradiol, human chorionic gonadotropin and alpha fetoprotein in 37 patients with germ cell cancer (15 seminoma and 22 nonseminoma) and 35 controls. We analyzed the semen of patients, and were questioned about paternity before the cancer diagnosis.

RESULTS

Age was higher in patients with seminoma cancer, showed decreased luteinizing hormone, follicle stimulating hormone, and testosterone and increased estradiol and prolactin in nonseminoma compared with seminoma. In patients with nonseminoma they had 9 children, 5 were oligozoospermic, 3 azoospermic and 6 normal concentration, 8 did not provide sample, seminoma group they had eight children, only one azoospermic, nine normal concentration, and 5 did not provide sample .

CONCLUSIONS

The hormonal behavior is different in men with nonseminoma compared with seminoma, so that the negative impact on the reproductive axis and fertility is higher in cases of non-seminoma.

[Clinic characteristics of patients with trophoblastic gestational disease complicate with hypertension]

BACKGROUND

The molar pregnancy is complicated with hypertension before 20 weeks, divided into complete mole and partial mole, and in diploid and triploid hydatidiform mola depending on the fetal chromosomes.

OBJECTIVE

To determine clinical and laboratory characteristics of patients with hydatidiform mole with and without hypertension, and choriocarcinoma, correlate serum chorionic gonadotropin (hCG) and hypertension.

MATERIAL AND METHODS

We reviewed 55 cases with histopathologically proven mole, separately analyzed clinical, laboratory and hCG.

RESULTS

The prevalence of mole with hypertension was 1:7; with the choriocarcinoma is 1:11. The age and sexual initiation of mole with hypertension was higher (p = .004 and .002 respectively), liver transaminase AST (p =. 004) and lactate dehydrogenase are higher in the group with hypertension (p =. 000). Positive correlation was obtained r = .246 p =. 044 statistically significant between mean arterial pressure and hCG. We reviewed 31 cases of 28 national and international articles, in patients with diploid hydatidiform the product is allowed to live normal and high blood pressure is showing mild preeclampsia, while partial moles are triploid, malformed products, incompatible with life and with hypertension severe like severe pre-eclampsia.

CONCLUSIONS

The molar pregnancy is partially diagnosed with hypertension in our environment, is not properly analyzed and that most of the products of curettage were not performed genetic testing. The hCG probably participate in the hypertensive disorders of pregnancy.

[Endometriosis as a risk factor for ovarian cancer]

A history of endometriosis is a risk factor for some subtypes of epithelial ovarian cancer. Endometriosis is associated with increased risk of ovarian clear cell, serous low-grade endometrioid cancer, but it is unclear what the role of endometriosis is in the development of other histopathological subtypes of ovarian cancer, such as high-grade serous borderline tumors subtypes or borderline serous and mucinous cancers. An understanding of the mechanisms leading to malignant transformation of endometriosis will be needed to identify subgroups of women at increased risk of ovarian cancer. This is important because of their high prevalence and cause of infertility in Mexico and the world. All factors must be considered during the decision-making process for the treatment of endometriosis, including the rare malignant transformation.

[Comparison of robotic surgery documentary in gynecological cancer]

Robotic surgery is a surgical technique recently introduced, with major expansion and acceptance among the medical community is currently performed in over 1,000 hospitals around the world and in the management of gynecological cancer are being developed comprehensive programs for implementation. The objectives of this paper are to review the scientific literature on robotic surgery and its application in gynecological cancer to verify its safety, feasibility and efficacy when compared with laparoscopic surgery or surgery classical major surgical complications, infections are more common in traditional radical surgery compared with laparoscopic or robotic surgery and with these new techniques surgical and staying hospital are lesser than the former however, the disadvantages are the limited number of robot systems, their high cost and applies only in specialized centers that have with equipment and skilled surgeons. In conclusion robotic surgery represents a major scientific breakthrough and surgical management of gynecological cancer with better results to other types of conventional surgery and is likely in the coming years is become its worldwide.

[Primary prevention of cervical cancer]

Cervical cancer is a global public health problem related to infection by human papilloma virus. Countries with organized programs for detection and treatment of precancerous lesions and cervical cancer prevent 80% of cases; however, prevention-based cytology, colposcopy and treatment of injuries is effective but still expensive, invasive and nonspecific, especially in developing countries. The goal of primary prevention through immunization against human papillomavirus is with the use of quadrivalent vaccine genotypes 6, 11, 16 and 18 and bivalent genotypes 16 and 18, which are produced using recombinant technology. These are effective in patients without prior exposure to viral genotypes, mainly when they have not initiated sexual activity. Recommended ages are 9 to 13 years and vaccine is administered through school health centers or community centers who promote informational campaigns and dissemination aimed at parents who request this. Screening programs for cervical cancer are limited and only oncogenic virus immunization will reduce their frequency, saving the lives of hundreds of women worldwide.

[Human Papilloma virus. Epidemiologic, carcinogenic, diagnostic and therapeutic aspects]

Human Papillomavirus (HPV) is the most common infection among women. Natural History of HPV infection has changed as well as diagnosis and treatment. Clinical picture is variable even with spontaneous remission. Molecular Biology for diagnosis and typification of HPV has changed its treatment. The disease can be treated according to clinical experience. Sometimes can not eradicated since just it is impossible make to disappear it from genital tract.