Introduction: Ovarian tumours are an actual problem of present-day medicine, being one of the most difficult sections of modern oncology. The majority of ovarian tumours are of epithelial origin. The ovarian Brenner tumour represents a rare epithelial ovarian neoplasm and accounts for 1-2% of all ovarian neoplasms. The aim of the study is to identify clinical and morphological features of ovarian Brenner tumour. Materials and methods: The material was 5 cases of Brenner ovarian tumour, diagnosed in the study of 4 cases of operational material and 1 case of autopsy observation for the period from 2007 to 2019. Histological and immunohistochemical staining methods were used. The microspecimens were examined on an Olympus BX-41 microscope (Japan). Results: Ovarian Brenner tumour is a rather rare pathology, the histogenesis of which is debatable. Morphological examination is the main method for its diagnosing. Ovarian Brenner tumours developed in women of middle and old age (the average age was 51.8 years). Women with a malignant ovarian Brenner tumour were older than women with a benign variant (the average age in women with a malignant variant was 55.8 years, with a benign variant – 49.3 years). Benign ovarian Brenner tumour occurred more frequently compared with a malignant one. Malignant and benign variants of ovarian Brenner tumour were characterized by a one-sided nature of the lesion with frequent involvement in the pathological process of the left ovary. Clinically, in patients with a benign variant of the Brenner tumour in all cases an abdominal pain syndrome was determined, combined in one case with metrorrhagia. A malignant ovarian Brenner tumour was clinically manifested by severe abdominal pain syndrome, combined in one case with complaints of an increase in the size of the abdomen, and in another case with intoxication syndrome and a clinic of small bowel obstruction. In all cases a malignant ovarian Brenner tumour metastasized to the omentum and in one case also to the small intestine wall. Macroscopically the ovarian Brenner tumour had the form of a node, the dimensions of which were significantly larger for the malignant variant compared with a benign, dense or soft consistency, on the cross section of a whitish-gray or brown color with cysts. A damaged ovary with a malignant variant of Brenner tumour significantly increased in size, while with a benign one, its size did not change or increased slightly. In all cases the malignant and benign variants of ovarian Brenner tumour were combined with various reproductive system organs pathologies (mucinous papillary cystadenoma of the ovary, serous ovarian cyst, ovarian endometriosis, endometrial hyperplasia, cervical nabothian cysts, uterine leiomyoma). Conclusions: A study conducted by the authors revealed clinical and morphological features of a rare ovarian tumour – Brenner tumour, which will contribute to a better understanding of this pathology by the doctors of various specialties, and improve the treatment and diagnostic process.
Ovarian cancer remains one of the most fatal pathologies among women around the world due to late diagnosis on the advanced stages of the tumor process. Serous ovarian carcinomas (SOC) often recur, which worsens the prognosis for patients’ recovery and survival. The identification of prognostic clinical and morphological factors that predict the appearance of recurrence remains an urgent problem. The aim of the research was studying relationships between the phenomenon of epithelial-mesenchymal transformation (EMT) and the expression of surface cancer stem cells (CSCS) markers to identify recurrence predictors among women with low grade serous ovarian carcinomas (LGSC). The material were paraffin blocks and slides of 43 patients with LGSC I-IV FIGO stage. The study included 30 cancers without recurrence and 13 tumors with it within 24 months. The expression of E-cadherin, Vimentin, CD44 and CD117 was studied using immunohistochemical (IHC) method. Results. Development of recurrence is typical for women with stage III-IV (p=0,01), the expression of Vimentin at level 51–100 % (p=0,001) and E-cadherin at 10–50 % (p=0.04). CD44 was expressed in 51.16 % of tumors and level didn`t depend on age, recurrence, but depended on disease stage (p=0.001). Recurrent LGSCs are characterized by the expression of CD117> 10 % (p=0.0001), its direct correlation with the stage (p=0.0001) and the recurrence (p=0.0001). A direct relationship was found between the CD117 and Vimentin expression. Conclusions. Prognostic markers of recurrence should be considered stage III-IV, levels of Vimentin 51–100 %, E-cadherin 10-50 % and CD117> 10 %. A correlation between CD117 and Vimentin expression indicates the commonality of EMT and CSCS in progression and recur. CD44 has no independent prognostic role.
Статтю отримано 14 грудня 2018 р.; прийнято до друку 28 січня 2019 р. Анотація. У статті наведені дані сучасної літератури щодо злоякісних епітеліальних пухлин яєчників. З моменту видання 3-го перегляду класифікації пухлин яєчників ВООЗ відбулися значні зміни в поглядах на етіологію, морфогенез та прогноз цих пухлин. Дослідження останніх років дозволили внести правки в схему градації карцином яєчників, по-новому окреслити морфологічні групи. Це, в свою чергу, дозволило висвітлити суперечливі питання і ті аспекти, на вивченні яких мають зосередитись науковці надалі. ©Вінницький національний медичний університет ім. М.І. Пирогова "Вісник Вінницького національного медичного університету", 2019, Т. 23, №1 ІSSN 1817-7883 eІSSN 2522-9354 ІSSN 1817-7883 "Вісник Вінницького національного медичного університету", eІSSN 2522-9354 2019, Т. 23, №1 179 Яковцова І.І., Олійник А.Є., Данилюк С.В., Григоренко В.Р. Сучасні уявлення про рак яєчників "Вісник Вінницького національного медичного університету", 2019, Т. 23, №1 ІSSN 1817-7883 eІSSN 2522-9354 ІSSN 1817-7883 "Вісник Вінницького національного медичного університету", eІSSN 2522-9354 2019, Т. 23, №1183 Яковцова І.І., Олійник А.Є., Данилюк С.В., Григоренко В.Р.
The problem of finding reliable clinical and morphological criteria for diagnosis and prognosis of serous borderline ovarian tumors, their relationship with the risk of developing of low-grade serous ovarian carcinomas (LGSC) in future is still relevant. This study is devoted to research and highlight of precursors that allow dividing women with serous borderline ovarian tumors (SBOT) into risk group for occurrence of LGSC within next 5 years. The study included 22 patients with FIGO stage I-II SBOT aged 24 to 46 years, 9 (39.13%) of whom were diagnosed with high-grade serous ovarian carcinoma next 5 years. Two study groups were formed: the control group (n = 13), which included patients with SBOT without further development of LGSC, and the main group (n = 9), which included women with emerging LGSCs. We studied expression of immunohistochemical markers Ki-67, MMP-9, p53, Bcl-2, E-cadherin, and also a diameter and localization of the tumor. As a result of the study, it was found that patients with diameter of the SBOT≥10 cm (χ² = 6.0, p <0.03), FIGO stage II (χ² = 4.7, p <0.03) and Ki-67 expression ≥10% (χ² = 9.03, p <0.03) have a high risk of developing LGSC within next 5 years. In the group of women who underwent LGSC development, there was a tendency to more pronounced expression of MMP-9 (χ² = 4.18, p <0.04) and moderate and pronounced expression of Bcl-2 (χ² = 9.66, p = 0.008). According to our data, markers Ki-67, MMP-9, Bcl-2 are prognostic and can be used as markers of LGSC risk in women with a history of SBOT. Tumor diameter ≥10 cm is also a predictor.
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