Ascites as a Predictor of Ovarian Malignancy

Shen-Gunther, Jane; Mannel, Robert S.

doi:10.1006/gyno.2002.6800

Cited by 104 publications

(79 citation statements)

References 19 publications

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“…Advanced EOC is characterized by widespread intraperitoneal dissemination and ascites formation. The morbidity and mortality of EOC are due to the failure of initial therapy to eradicate a sufficient number of tumor cells to prevent disease recurrence (Shen-Gunther and Mannel, 2002). Although the function of ascites in tumor development and progression is still not well understood, ascites constitutes a microenvironment that may promote tumor cell survival and metastasis.…”

Section: Discussionmentioning

confidence: 99%

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Ovarian cancer ascites protects from TRAIL-induced cell death through αvβ5 integrin-mediated focal adhesion kinase and Akt activation

et al. 2010

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Interactions between ovarian cancer cells and the surrounding tumor microenvironment are not well characterized. We have earlier shown that ovarian cancer ascites induces Akt activation and protect tumor cells from TRAIL-induced apoptosis. Here, we investigated the mechanism by which ascites activates Akt. The ability of ovarian cancer ascites to activate Akt and inhibit TRAILinduced cell death and caspase activity was decreased by heat inactivation, but was retained in ascites fractions 45 kDa. The survival promoting activity of ascites was not affected by inhibitors of growth factor receptor including epidermal growth factor receptor (EGFR), VEGFR, FGFR, Her2/neu, and IGF-R1. However, this activity was inhibited by an avb5 integrin-blocking antibody, but not by blocking antibodies against avb3, b1, or b3 integrins. avb5 integrin-blocking antibodies also inhibited ascites-induced Akt phosphorylation and c-FLIPs up-regulation. Ovarian cancer ascites induced a rapid phosphorylation of focal adhesion kinase (FAK), which closely correlated with the phosphorylation of Akt overtime. FAK phosphorylation was strongly inhibited by avb5 integrin-blocking antibodies. Depletion of FAK content by RNA interference was also associated with inhibition of ascites-mediated Akt activation and survival. These results suggest that ovarian cancer ascites induces FAK and Akt activation in an avb5 integrin-dependent pathway, which confers protection from TRAIL-induced cell death and caspase activation.

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Section: Discussionmentioning

confidence: 99%

“…EOC is a highly metastatic cancer characterized by widespread intraperitoneal dissemination and ascites formation (Puls et al, 1996;Shen-Gunther and Mannel, 2002). EOC ascites may contain a variety of cytokines, growth factors, bioactive lipids, hormones, and components of the extracellular matrix.…”

Section: Introductionmentioning

confidence: 99%

Ovarian cancer ascites protects from TRAIL-induced cell death through αvβ5 integrin-mediated focal adhesion kinase and Akt activation

et al. 2010

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“…Family history of ovarian and breast cancer has strong link and considers as major risk factor for ovarian cancer. [11][12][13] One theory is that ovarian carcinoma arises from endometriosis; it is the presence of endometrial tissue rather than uterus.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of ovarian tumours among ovarian mass lesions in Gajra Raja Medical College, Gwalior, India

Bindal

Bankey

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Ovarian tumor is one of the most common gynecological tumors seen in female although there are different types of ovarian tumor but epithelial ovarian cancer is the fifth most common cause of cancer death in women. It is often called the "silent killer" because the disease is not often detected until it reaches an advance stage. Methods: This observational study conducted on 130 patients from February 2015 to March 2017 in the Department of Obstetrics and Gynaecology in Gajra Raja Medical College, Gwalior. Clinical details of the patients included age, gynaecological and obstetric history, presenting symptoms, and surgery details. Histopathological reporting was done at our Pathology department. Results: Out of total 130 patients with ovarian tumours studied 49.2% were > 60 years of age group, most of them were nullipara (53.8%), 54.6% with ovarian tumours presented after one-year development of symptoms. most of the symptoms were vague and nonspecific. Benign tumours were the most prevalent (79.2%), 19.2% were malignant tumours and 1.5% were borderline. Histological pattern of distribution of ovarian tumour shows that most of ovarian tumour were surface epithelial tumour (72 patients) followed by germ cell tumour (58 patients). Age wise distribution of study population showed that most of the surface epithelial tumour were more common in 3 rd to 5 th decade while most of germ cell tumour were more frequent in 2 nd and 3 rd decade. Conclusions: For better prognosis and patient survival, early detection and treatment is mandatory, which may reduce mortality. There is need to increase awareness of population. Abdominal and pelvic bimanual examination should be carried out in every patient presenting with gynecological problem. Appropriate investigations in post-menopausal women in early period to diagnose the disease at an early stage.

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“…Similar clinical history is also obtained in subjects with benign conditions such as Endometriosis, cirrhosis, pancreatitis. 16 Other carcinomas including endomtrium, liver pancreas and colorectal carcinoma may also present with similar picture. 14 Overlapping of clinical presentation as well as CA-125 levels may blunt the diagnostic advantage.…”

Section: Discussionmentioning

confidence: 97%

CA-125 requisition pattern in a tertiary care hospital in central India and necessary modifications

et al. 2017

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Background: Utility of CA-125 is not limited to being tumour marker for only epithelial ovarian carcinoma but it has also been found to be elevated in various other benign and malignant conditions. This versatility also adds to increased prescription of CA-125 in non ovarian tumours and is also a reason for reduced specificity of CA-125 as tumor marker for epithelial ovarian cancer. Both these factors could lead to inappropriate frequent prescription and missed diagnosis.Aims and Objective: We thus carried out a case note audit aimed to assess the prescription pattern of CA-125 in daily clinical practice and its contribution to final diagnosis and management in a tertiary healthcare facility in central India.Materials and Methods: All the subjects advised estimation of CA 125 during the study period were included in the study. Data regarding sign and symptoms, provisional diagnosis was collected and serum CA-125 levels estimated.Result: Total 238 subjects were recruited for the study, out of them 221 (92.8%) were female and 17 (7.2%) were male. Mean age was found to be 43.95±13.88. S. CA-125 level were 32.30(3.24-5000) U/ml. Only 65% investigations were related to ovarian carcinoma and out of that abnormal CA125 levels were noted in 54% subjects. No oblivious indication was found in 14% subjects. Abnormal CA-125 levels were significantly low in frequency in follow up subjects as well as in subjects with no indication.Conclusion: Low specificity and versatility of CA-125 in diagnosis of various benign and malignant conditions may lead to inappropriate prescription of CA-125. This may cause additional economic burden as well as psychological stress to patients. This can be avoided by establishment of proper algorithm or guidelines to advice tumor markers and their strict implementation.Asian Journal of Medical Sciences Vol.8(5) 2017 17-21

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Ascites as a Predictor of Ovarian Malignancy

Cited by 104 publications

References 19 publications

Ovarian cancer ascites protects from TRAIL-induced cell death through αvβ5 integrin-mediated focal adhesion kinase and Akt activation

Ovarian cancer ascites protects from TRAIL-induced cell death through αvβ5 integrin-mediated focal adhesion kinase and Akt activation

Prevalence of ovarian tumours among ovarian mass lesions in Gajra Raja Medical College, Gwalior, India

CA-125 requisition pattern in a tertiary care hospital in central India and necessary modifications

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