National Cancer Institute®
Last Modified: January 1, 2002
UI - 11248061
AU - Levy-Lahad E; Lahad A; Eisenberg S; Dagan E; Paperna T; Kasinetz L;
TI - Catane R; Kaufman B; Beller U; Renbaum P; Gershoni-Baruch R A single nucleotide polymorphism in the RAD51 gene modifies cancer risk in BRCA2 but not BRCA1 carriers.
SO - Proc Natl Acad Sci U S A 2001 Mar 13;98(6):3232-6
AD - Medical Genetics Unit, Shaare Zedek Medical Center and Hebrew University/Hadassah Medical School, P.O. Box 3235, Jerusalem 91031, Israel. firstname.lastname@example.org
BRCA1 and BRCA2 carriers are at increased risk for both breast and ovarian cancer, but estimates of lifetime risk vary widely, suggesting their penetrance is modified by other genetic and/or environmental factors. The BRCA1 and BRCA2 proteins function in DNA repair in conjunction with RAD51. A preliminary report suggested that a single nucleotide polymorphism in the 5' untranslated region of RAD51 (135C/G) increases breast cancer risk in BRCA1 and BRCA2 carriers. To investigate this effect we studied 257 female Ashkenazi Jewish carriers of one of the common BRCA1 (185delAG, 5382insC) or BRCA2 (6174delT) mutations. Of this group, 164 were affected with breast and/or ovarian cancer and 93 were unaffected. RAD51 genotyping was performed on all subjects. Among BRCA1 carriers, RAD51-135C frequency was similar in healthy and affected women [6.1% (3 of 49) and 9.9% (12 of 121), respectively], and RAD-135C did not influence age of cancer diagnosis [Hazard ratio (HR) = 1.18 for disease in RAD51-135C heterozygotes, not significant]. However, in BRCA2 carriers, RAD51-135C heterozygote frequency in affected women was 17.4% (8 of 46) compared with 4.9% (2 of 41) in unaffected women (P = 0.07). Survival analysis in BRCA2 carriers showed RAD51-135C increased risk of breast and/or ovarian cancer with an HR of 4.0 [95% confidence interval 1.6-9.8, P = 0.003]. This effect was largely due to increased breast cancer risk with an HR of 3.46 (95% confidence interval 1.3-9.2, P = 0.01) for breast cancer in BRCA2 carriers who were RAD51-135C heterozygotes. RAD51 status did not affect ovarian cancer risk. These results show RAD51-135C is a clinically significant modifier of BRCA2 penetrance, specifically in raising breast cancer risk at younger ages.
UI - 11292192
AU - Koh SC; Tham KF; Razvi K; Oei PL; Lim FK; Roy AC; Prasad RN
TI - Hemostatic and fibrinolytic status in patients with ovarian cancer and benign ovarian cysts: could D-dimer and antithrombin III levels be included as prognostic markers for survival outcome?
SO - Clin Appl Thromb Hemost 2001 Apr;7(2):141-8
AD - National University of Singapore, Department of Obstetrics and Gynaecology, National University Hospital, Singapore. email@example.com
We determined the hemostatic and fibrinolytic status in 60 patients with ovarian cancer and benign ovarian cysts. Hypercoagulation, increased platelets, and enhanced fibrinolysis were seen in patients with preoperative ovarian cancer compared to patients with benign ovarian cysts. Enhanced thrombin generation, evidenced by increased F1+2 and decreased antithrombin III (ATIII) levels with further enhanced fibrinolysis by elevated D-dimer, was seen in advanced cancer. Ten ovarian cancer patients died within 13 months after diagnosis and another died at 24 months, all from advanced stage of cancer, except one from stage IC cancer who died at 11 months. The survival rates from the disease at 13 months and 24 months were 66.7% and 45%, respectively. Most of the patients had gone through the complete course of chemotherapy, and those patients still alive have been disease free between 13 and 42 months. No statistical relationships for the hemostatic parameters studied in ovarian cancer patients could be found between those who died and those still living 13 and 24 months after diagnosis, except for ATIII and D-dimer levels. Elevated D-dimer levels were associated with those who died within 13 and 24 months from the disease, and the decreased ATIII levels only reached statistical significance by 24 months. It could be suggested that these two parameters might be useful as systemic prognostic markers in survival outcome from the disease for the first 24 months in advanced ovarian cancer, in addition to the known correlation with the International Federation of Gynecology and Obstetrics stage.
UI - 11419167
AU - Matsuoka Y; Ohtomo K; Araki T; Kojima K; Yoshikawa W; Fuwa S
TI - MR imaging of clear cell carcinoma of the ovary.
SO - Eur Radiol 2001;11(6):946-51
AD - Department of Radiology, Toshiba General Hospital, 6-3-22, Higashi Ooi, Shinagawa-ku, Tokyo 140-8522, Japan. firstname.lastname@example.org
Magnetic resonance imaging findings are reported for 12 pathologically proven lesions of clear cell carcinoma (CCC) of the ovary in 11 women (mean age 50 years). T1- and T2-weighted MR images were obtained in all patients, and gadolinium-enhanced MR images were obtained in 9. The mean diameter of the tumors was 13 cm. Seven patients presented with stage-I tumors. All 12 lesions consisted of cystic masses with solid protrusions occurring in 10 and solid masses in 2. The cysts were unilocular in 9 lesions and multilocular in 1. In four lesions, the cysts displayed with high intensity on T1-weighted images. Round solid protrusions were identified in 8 lesions. In 5 lesions, the number of protrusions was only a few. The solid portions of 5 masses had slightly high-intensity regions on T1-weighted images. The number of patients with ascites was three. Magnetic resonance imaging of CCC usually shows a unilocular large cyst with solid protrusions, which are often round and few in number. Such MR imaging findings suggest malignant tumor but are not specific.
UI - 11419910
AU - Zhao X; Wei YQ; Peng ZL
TI - Induction of T cell responses against autologous ovarian tumors with whole tumor cell lysate-pulsed dendritic cells.
SO - Immunol Invest 2001 Feb;30(1):33-45
AD - Department of Gynecology and Obstetrics, Second University Hospital, West China University of Medical Sciences (HuaXi Medical School, Sichuan University), Chengdu, Sichuan, The People's Republic of China.
The loading of dendritic cells (DCs) with whole tumor cell lysates may circumvent the facts that few tumor-specific antigens have been identified in human solid tumors. The present study was designed to investigate whether ovarian cancer cells lysate-pulsed DCs activate T cell responses against autologous ovarian tumors. Incubation of T cells with autologous tumor cell lysate-pulsed DCs stimulated proliferation of autologous T cells. T cells primed by autologous tumor cell lysate-pulsed DCs showed significant killing activity against autologous tumor cells, which could be blocked by anti-MHC-class-I and anti-CD8 mAb. By contrast, T cells primed by autologous unpulsed DCs alone or tumor lysates alone failed to exhibit significant killing activity. In addition, T cells primed by DCs pulsed with allogeneic tumor cell lysates or with autologous normal cell lysate or by these cell lysates alone did not induce the increase in the autologous tumor killing activity. As additional controls, T cells stimulated with autologous tumor lysate-pulsed DCs express no increase in the lysis of autologous monocytes, allogeneic ovarian tumor cells and other cell lines including K562, Daudi and Molt-4. Furthermore, T cells stimulated with autologous tumor lysate-pulsed DCs could produce the considerable amounts of cytokines such as GM-CSF, TNF-alpha and IFN-gamma. The data in the present study suggest that whole tumor cell lysates-pulsed DCs could activate T cell responses against autologous ovarian tumor cells, and that these pulsed DCs may be used as a new approach for the specific immunotherapy of ovarian cancer patients.
UI - 11434389
AU - Campos B; Diez O; Cortes J; Domenech M; Pericay C; Alonso C; Baiget M
TI - Conditions for single-strand conformation polymorphism (SSCP) analysis of BRCA1 gene using an automated electrophoresis unit.
SO - Clin Chem Lab Med 2001 May;39(5):401-4
AD - Servei de Genetica, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
The single-strand conformation polymorphism procedure has been applied in routine testing for hereditary diseases and cancer. However, temperature, running time, gel composition, fragment length, etc. can influence its sensitivity. Mutation detection in the clinical setting depends on the development of automated technology, especially for large genes such as the breast cancer gene BRCA1. We analysed DNA samples with BRCA1 mutations in an automated system (GenePhor System; Amersham-Pharmacia Biotech, Uppsala, Sweden). The concentrations of DNA template and PCR primers, the effect of chilling after denaturation, and the temperature and time of the electrophoresis were investigated. All band-shifts were detected by electrophoresis at 5 degrees C for 2 h 15 min. Concentrations of DNA and samples used in the PCR did not affect the SSCP pattern, but chilling the PCR product in ice after denaturation was required. The type and position of mutation in the fragments did not influence the probability of a mobility shift, although SSCP analysis was more sensitive for fragments shorter than 350 bp. This automated SSCP method meets the requirements of fast turnaround and sensitivity and can be readily adapted to the screening of large genes such as BRCA1.
UI - 11474658
AU - Mahavni V; Kim SC; Benda TA; Sanders L; Buller RE
TI - The androgen receptor and DXS15-134 markers show a high rate of discordance for germline X chromosome inactivation.
SO - J Med Genet 2001 Jul;38(7):474-8
UI - 11444200
AU - Garrett AP; Lee KR; Colitti CR; Muto MG; Berkowitz RS; Mok SC
TI - k-ras mutation may be an early event in mucinous ovarian tumorigenesis.
SO - Int J Gynecol Pathol 2001 Jul;20(3):244-51
AD - Laboratory of Gynecologic Oncology, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis Street, Boston, Massachusetts, USA.
We explored the possible pathogenetic pathway for mucinous ovarian tumorigenesis by examining the k-ras mutational patterns in ovarian mucinous tumors (OMTs) with benign, borderline, and invasive epithelium in which the different types of mucinous epithelium are in close proximity. Sixteen patients with ovarian mucinous borderline tumors (OMBTs) and 4 patients with grade 1 ovarian mucinous adenocarcinomas (OMCs) were selected for the presence of a single histologic section which contained a clear "transition" zone from benign mucinous epithelium to borderline mucinous epithelium, and in four cases, to invasive epithelium. A PixCell II Laser Capture Microscope was used to microdissect and retrieve benign, borderline, and invasive epithelium separately from the 20 OMTs. Normal ovarian stroma from the same histologic section in each case was also microdissected and retrieved for use as a control. k-ras mutations were detected in these samples by PCR-SSCP analysis followed by direct PCR cycle sequencing. k-ras mutations were found in 8/16 (50%) of the OMBTs and 2/4 (50%) of the grade 1 OMCs. In 6 of these 10 cases (4 in OMBTs, 2 in grade 1 OMCs), the same k-ras mutation was found in both the benign and borderline (and invasive) regions. In 3 cases in which k-ras mutations were identified, the mutation was found in either the benign or borderline tissue samples alone, and in one case, two distinct mutations were found. No k-ras mutations were identified in the normal ovarian stroma. The presence of a k-ras mutation in adjacent benign and borderline regions of a single OMT may suggest a progression in the development of OMTs from benign to borderline and grade 1 OMCs. k-ras mutations, when they occur, are likely early genetic changes but may not alone be sufficient for malignant transformation of ovarian epithelium.
UI - 11446472
AU - Karseladze AI
TI - On the site of origin of epithelial tumors of the ovary.
SO - Eur J Gynaecol Oncol 2001;22(2):110-5
AD - Department of Pathology, Cancer Research Centre of the Russian Academy of Medical Sciences, Moscow.
Ovaries removed at 1,050 autopsies (accidental deaths) and from 300 patients with various benign gynaecological diseases were studied in search of the incipient benign epithelial tumors. One percent of the ovaries contained incipient mucinous tumors, 1.1%--Brenner tumors, 0.5%--endometrioid tumors. The exact percentage of the serous tumors was difficult to establish because of the absence of morphological criteria that distinguish these tumors from tumor-like conditions (inclusion cysts). The mucinous and Brenner tumors, as well as some serous tumors were located deep in the medullary or hilar regions of the ovary and were not connected to the covering of the ovary. The theory of incessant ovulation that links ovulatory damage of the ovarian surface with the initiation of neoplastic growth does not explain the genesis of all epithelial tumors. It is more likely that the latter two types arise in other parts of the female gonad. The process of morphogenesis of epithelial benign tumors is closely related to stromal alterations, specific for each histogenetic entity.
UI - 11446479
AU - Sawicki W; Spiewankiewicz B; Cendrowski K; Stelmachow J
TI - Preoperative discrimination between malignant and benign adnexal masses with transvaginal ultrasonography and colour blood flow imaging.
SO - Eur J Gynaecol Oncol 2001;22(2):137-42
AD - Department of Obstetrics and Gynaecology, Medical University of Warsaw, Poland.
BACKGROUND: Ovarian cancer is one of the causes of death in women, and in about 70% of cases is recognized only in advanced stages. This study was undertaken to evaluate distinctive values of transvaginal and color Doppler ultrasonography in differentiating malignant and benign adnexal masses through analysis of ultrasonic morphological features of malignancy and estimation of location and intensification of angiogenesis as well as values of resistance of flow in examined masses. PATIENTS AND METHODS: 329 women with malignant and benign adnexal masses underwent ultrasonographic and colour Doppler examination 1-5 days before surgery (laparotomy, laparoscopy) thus allowing histological verification of diagnosis. The ultrasonographic structure was assessed using a morphological scoring system devised by Sassone, Jain and Benacerraf. Regions showing vasculature, especially within septae and solid parts of tumours were examined by means of transvaginal colour Doppler. Location and intensification of angiogenesis as well as resistance index (RI) were investigated. Sensitivity, specificity, PPV and NPV of both techniques were assessed. Statistical analysis of obtained data were based on the Student's t test; p < 0.05 level was considered significant. RESULTS: Postoperatively 255 (77.5%) benign and 74 (22.5%) malignant tumours were seen. In the group of benign masses the average age of women was 42.6+/-12.3 and in the malignant it was 53.1+/-12.6 (p<0.0001). The transverse dimension of benign lesions was 77.2+/-19, whereas for malignant it was 107.0+/-31 (p<0.0001). Benign tumours in 63.0% were cystic, in 26.0% mixed cystic-solid and in 11.0% solid echostructures while in malignant they were respectively, 6.8%, 56.8% and 36.4% (p<0.0001). Doppler flow within the tumour was 74.5% in benign and 98.6% in malignant masses (p<0.0001). In benign lesions homogenous superficial or peripheral vasculature was visualized, and in the majority of cases (82.7%) it was of medium intensification. However in malignant central, peripheral or mixed vascularisation. in the majority intensified character was found. Average value of the resistance index in all benign masses amounted to 0.77+/-0.14, however in malignant it was 0.39+/-0.07 (p<0.0001). CONCLUSIONS: We contend that complete ultrasonographic estimation of ovarian neoplasms outside the qualification of structural details should include Doppler analysis of vasculature parameters. Most important is the qualification of resistance of flow, and location and intensification of vascularisation in examined masses which permit the differentiation of malignant and benign lesions. Preoperatively recognizing malignant processes with colour Doppler ultrasonography shows higher accuracy, specificity and PPV.
UI - 11471484
AU - Noujaim AA; Schultes BC; Baum RP; Madiyalakan R
TI - Induction of CA125-specific B and T cell responses in patients injected with MAb-B43.13--evidence for antibody-mediated antigen-processing and presentation of CA125 in vivo.
SO - Cancer Biother Radiopharm 2001 Jun;16(3):187-203
AD - AltaRex Corp., 1123 Dentistry-Pharmacy, University of Alberta, Edmonton, AB, T6G 2N8, Canada. email@example.com
The murine monoclonal anti-CA125 antibody MAb-B43.13 has previously been administered as an immunoscintigraphic agent in order to monitor recurrence of ovarian cancer in patients, and a long-term follow-up demonstrated a survival benefit for these patients. The clinical benefit was initially attributed to the activation of the idiotypic network. The objective of this study was to investigate the role of CA125-MAb-B43.13 immune complex formation on the induction of CA125-specific immune responses. Analysis of patient serum samples from pharmacokinetic studies demonstrated that the antibody forms immune complexes with CA125 in circulation within 30 minutes of injection. Induction of humoral and cellular anti-CA125 responses correlated with the amount of circulating CA125 antigen present at time of antibody injection. Subsequent to the injection of MAb-B43.13, the patients generated anti-CA125 antibodies that were directed against various epitopes on the antigen and were not restricted to the specific epitope recognized by MAb-B43.13. The generation of CA125-specific B and T cell responses after MAb-B43.13 injection correlated with improved survival. The influence of circulating CA125 for the induction of CA125-specific immune responses and the multi-epitopic nature of the human anti-CA125 antibodies suggest that the majority of these antibodies were not induced via the idiotypic network but by the autologous antigen itself. Since antibody and T cell responses to CA125 were not present before injection of MAb-B43.13, it is hypothesized that complex formation of MAb-B43.13 with circulating antigen triggers the induction of CA125-specific immune responses.
UI - 11462239
AU - Jakubowska A; Gorski B; Byrski T; Huzarski T; Gronwald J; Menkiszak J;
TI - Cybulski C; Debniak T; Hadaczek P; Scott RJ; Lubinski J Detection of germline mutations in the BRCA1 gene by RNA-based sequencing.
SO - Hum Mutat 2001 Aug;18(2):149-56
AD - Department of Genetics and Pathology, Pomeranian Academy of Medicine, Polabska, Poland. firstname.lastname@example.org
BRCA1 mutation detection is expensive and has sensitivity limitations, which might at least partially be overcome by RNA-based sequencing. There are claims that RNA tests are unreliable due to differential splicing, exon skipping, or nonsense-mediated mRNA decay that results in either the absence or low expression of mRNA harboring mutations. The major aim of this study was to determine if the application of specific high temperature annealing primers can assure high sensitivity of detection of BRCA1 sequence alterations by cDNA sequencing. The study group comprised 21 Polish cancer families with aggregations of breast and/or ovarian cancer. We detected mutations in 10 out of 21 unrelated patients. These were: nucleotide substitutions (c.309T>C; c.300T>G); nucleotide insertions (c.5382insC) three cases; nucleotide deletions (c.4154delA) one case, (c. 185delAG) one case, (c.3819delGTAAA) two cases; and the deletion of the entire sequence of exon 22, one case. In addition, we identified three transcript variants resulting from alternative splice sites affecting the last six nucleotides of exon 1a (GTAAAG), and the first three nucleotides (CAG) of exon 8 and exon 14. In all cases these were cDNA heterozygous changes. Two of these splice site changes have not been previously described. Sequencing of genomic DNA "exon by exon" did not result in the detection of any additional abnormalities. The sensitivity of our analyses was sufficient to reliably detect mutations without the necessity of tissue culturing to obtain enough template cDNA for analysis. Copyright 2001 Wiley-Liss, Inc.
UI - 11462242
AU - Baudi F; Quaresima B; Grandinetti C; Cuda G; Faniello C; Tassone P;
TI - Barbieri V; Bisegna R; Ricevuto E; Conforti S; Viel A; Marchetti P; Ficorella C; Radice P; Costanzo F; Venuta S Evidence of a founder mutation of BRCA1 in a highly homogeneous population from southern Italy with breast/ovarian cancer.
SO - Hum Mutat 2001 Aug;18(2):163-4
AD - Dipartimento di Medicina Sperimentale e Clinica "G. Salvatore", Universita degli Studi di Catanzaro "Magna Graecia", Italy.
Several genes have been involved in the pathogenesis of hereditary breast/ovarian cancer (BOC), but mutations in the BRCA1 gene are by far the most recurrent. In this study, we report the identification of a founder mutation in a geographically and historically homogeneous population from Calabria, a south Italian region. A screening performed on 24 patients from unrelated families highlighted the high prevalence of a 5083del19 alteration in the BRCA1 gene, which accounts for 33% of the overall gene mutations. The same mutation was also detected in 4 patients, all of Calabrian origin, referred to us by research centres from the north of Italy. Allelotype analysis, performed on probands and unaffected family members revealed the presence a common allele, therefore suggesting a founder effect due to a common ancestor. Our findings underscore the importance of ethnic background homogeneity in patients' selection and highlight the usefulness of founder mutations as a potential tool for optimisation of preclinical diagnosis in gene carriers and therapeutic approaches in affected individuals. Copyright 2001 Wiley-Liss, Inc.
UI - 11451584
AU - Burger HG; Fuller PJ; Chu S; Mamers P; Drummond A; Susil B; Neva P;
TI - Robertson DM The inhibins and ovarian cancer.
SO - Mol Cell Endocrinol 2001 Jun 30;180(1-2):145-8
AD - Prince Henry's Institute of Medical Research, PO Box 5152, Vic. 3168, Clayton, Australia. email@example.com
Interest in inhibin as a marker of ovarian malignancy was stimulated by the description of elevated immunoreactive inhibin levels in the sera of patients with granulosa cell tumours. Several groups have confirmed the value of serum inhibin in the diagnosis and follow-up of patients with this uncommon malignancy. Immunoreactive inhibin levels are also frequently elevated in patients with mucinous cystadenocarcinoma and less frequently in other forms of ovarian tumour. Assay of sera using the specific dimeric inhibin assays has shown that ovarian tumours are able to secrete dimeric inhibin particularly inhibin B. The less specific alpha-subunit directed assays, however, most frequently show elevated concentrations. Used in combination with CA125 as a dual tumour marker, it appears in principle that inhibin can be a useful diagnostic agent. Immunohistochemistry for the inhibin subunits has been reported with increasing frequency as a helpful method to assess suspected ovarian stromal cell tumours. Its diagnostic accuracy for other types of ovarian adenocarcinoma appears less reliable. Expression of the inhibin subunit mRNAs has been demonstrated in a variety of ovarian malignancies. The observation that inhibin levels are elevated in ovarian cancer has stimulated studies of their relevance to the molecular pathogenesis of these malignancies. Findings to date have been largely negative with no evidence for activating mutations of the FSH receptor or of the post-receptor signalling pathway proteins.
UI - 11499690
AU - Srivastava A; McKinnon W; Wood ME
TI - Risk of breast and ovarian cancer in women with strong family histories.
SO - Oncology (Huntingt) 2001 Jul;15(7):889-902; discussion 902, 905-7, 911-13
AD - Division of Hematology and Oncology, University of Vermont College of Medicine, Burlington 05401, USA.
Assessing the risk of breast and ovarian cancer starts with obtaining a complete and accurate family history. This can reveal evidence of inherited cancer risk. The highest risk of cancer is associated with germ-line abnormalities in several genes, including BRCA1, BRCA2, and TP53. Moderate-risk genes associated with syndromes that are inherited in an autosomal dominant pattern (such as Cowden's disease, hereditary non-polyposis colorectal cancer, Muir-Torre syndrome, and Peutz-Jeghers syndrome) exhibit lower penetrance and thus less risk of breast and/or ovarian cancer. Low-risk genes likely require significant environmental exposure, and although they are associated with the lowest risk of cancer, they account for more cancer than high- and moderate-risk genes. Lifetime risks for breast or ovarian cancer can be estimated. The Gail and Claus models, the more widely utilized models for calculation of lifetime breast cancer risk, are discussed. Models are also available for determining the likelihood of finding a BRCA1/2 mutation (the BRCAPRO and Myriad models). Appropriate candidates for testing include affected individuals who are most likely to have a hereditary form of cancer. Testing should proceed only after a thorough discussion of the risks, benefits, and limitations of testing. Risk-reducing options are available to women with a strong family history of breast and ovarian cancer. These options include high-risk screening, chemoprevention, and prophylactic surgery.
UI - 11503919
AU - Kurjak A; Kupesic S; Sparac V; Bekavac I
TI - Preoperative evaluation of pelvic tumors by Doppler and three-dimensional sonography.
SO - J Ultrasound Med 2001 Aug;20(8):829-40
AD - Department of Obstetrics and Gynecology, Medical School, University of Zagreb, Sveti Duh Hospital, Croatia.
OBJECTIVE: To study a spectrum of systems (two-dimensional transvaginal, transvaginal color Doppler, three-dimensional, three-dimensional power Doppler, and contrast-enhanced three-dimensional power Doppler sonography) for preoperative evaluation of pelvic tumors. METHODS: Two hundred ninety-two patients were evaluated by the 5 complementary methods in preoperative sonographic assessments. We examined adnexal and endometrial morphology, thickness, and volume by two- and three-dimensional sonography and analyzed blood flow by transvaginal color, pulsed Doppler, and three-dimensional power Doppler sonography in all examined patients. In 89 patients with complex adnexal lesions of uncertain malignancy, contrast-enhanced three-dimensional power Doppler sonography was performed. RESULTS: Morphologic assessment by three-dimensional sonography yielded additional information in 58% of cases compared with two-dimensional sonography. Furthermore, this modality was superior to two-dimensional sonography in accurate depiction and diagnosis of 2 cases of fallopian tube carcinoma. Combined morphology and vascular indexing reached sensitivity of 97% and specificity of 99%. Endometrial volume in patients with malignant disease was significantly different (28.2 +/- 0.02 cm3) from that in those who had hyperplasia (7.81 +/- 0.03 cm3), polyps (3.5 +/- 0.02 cm3), or normal endometria (0.8 +/- 0.02 cm3). With combined morphologic and three-dimensional power Doppler examination of endometrial lesions, sensitivity and specificity reached 89% and 97%, respectively. CONCLUSIONS: Combined morphologic and vascular imaging improves preoperative assessment of gynecologic tumors.
UI - 11503920
AU - Alcazar JL; Errasti T; Laparte C; Jurado M; Lopez-Garcia G
TI - Assessment of a new logistic model in the preoperative evaluation of adnexal masses.
SO - J Ultrasound Med 2001 Aug;20(8):841-8
AD - Department of Obstetrics and Gynecology, Clinica Universitaria de Navarra, School of Medicine, University of Navarra, Pamplona, Spain.
OBJECTIVE: To assess a new logistic regression model developed to predict malignancy in adnexal masses. METHODS: In the first part of this study, we developed a logistic model by applying logistic regression analysis in a series of 268 adnexal masses (203 benign and 65 malignant lesions) in 248 patients (mean age, 43.6 years; SD, 14.2 years) evaluated and treated at our institution. Eleven parameters were entered in the logistic regression analysis in a forward stepwise way. In the second part of the study, we evaluated the model's diagnostic performance in a further set of 135 adnexal masses (103 benign and 32 malignant tumors) in 129 patients (mean age, 44.4 years; SD, 14.6 years). This diagnostic performance was compared with that of age, tumor volume, Sassone's and Ferrazzi's B-mode ultrasonographic morphologic scoring systems, serum cancer antigen 125 level, and the tumor's lowest resistive index. Comparison was done by calculating the area under the receiver operating characteristic curve. RESULTS: In logistic analysis, only menopausal status, the presence of papillary projections, the logarithm of the cancer antigen 125 value, tumor blood flow location, and the lowest resistive index were retained in the model. The model had the best area under the curve (0.97), significantly higher than patient age (area under the curve, 0.78; P = .001), tumor volume (area under the curve, 0.68; P < .0001), cancer antigen 125 (area under the curve, 0.88; P = .008), lowest resistive index (area under the curve, 0.85; P = .011), Ferrazzi's scoring system (area under the curve, 0.89; P = .01), and maximal peak systolic velocity (area under the curve, 0.71; P< .0001). Comparison with Sassone's scoring system (area under the curve, 0.91) did not reach statistical significance, but a clear trend was found (P = .116). CONCLUSIONS: The model had the best diagnostic performance for discriminating between benign and malignant adnexal masses. A clinical prospective evaluation is needed to confirm its actual value.
UI - 11503922
AU - Mlikotic A; McPhaul L; Hansen GC; Sinow RM
TI - Significance of the solid component in predicting malignancy in ovarian cystic teratomas: diagnostic considerations.
SO - J Ultrasound Med 2001 Aug;20(8):859-66; quiz 867
AD - Department of Radiology, Harbor-UCLA Medical Center, Torrance, California, USA.
OBJECTIVE: To determine whether gray scale characteristics of the solid components of cystic ovarian teratomas exist that could differentiate more common benign forms from malignant variants. METHODS: We retrospectively reviewed the sonographic images of 188 ovarian teratomas that contain at least a 25% cystic component and correlated the images with the final diagnosis. Features of the solid component assessed included its echo texture, overall appearance, shape, size, and internal homogeneity. RESULTS: One-hundred seventy-seven teratomas were benign, and 11 were malignant; among the malignant masses, 7 were high grade. Of the benign forms, 155 solid components (88%) were hyperechoic, 168 (95%) were focal in appearance, 105 (59%) were nodular in shape, and 123 (69%) were uniformly solid. Of the malignant types, 9 solid components (82%) were isoechoic, 6 (55%) had branching, 6 (55%) were irregular in shape, and 8 (73%) were uniformly solid. Five malignant teratomas (45% overall and 71% of high-grade subtypes) had branching isoechoic components. Only 2 benign teratomas (1%) had isoechoic components that branched. CONCLUSIONS: The presence of a branching isoechoic component in a cystic ovarian teratoma may suggest malignancy.
UI - 11503928
AU - Alcazar JL; Errasti T; Minguez JA; Galan MJ; Garcia-Manero M; Ceamanos C
TI - Sonographic features of ovarian cystadenofibromas: spectrum of findings.
SO - J Ultrasound Med 2001 Aug;20(8):915-9
AD - Department of Obstetrics and Gynecology, Clinica Universitaria de Navarra, School of Medicine, University of Navarra, Pamplona, Spain.
OBJECTIVE: To describe the sonographic characteristics of ovarian cystadenofibromas. METHODS: We conducted a retrospective study of 23 ovarian tumors histopathologically confirmed as ovarian cystadenofi