rome and Ovarian-Neoplasms

In ovarian cancer (OC), approximately 70% will relapse within 12 months from diagnosis; inflammation plays an important role in cancer initiating and progression; thus, a combination of neutrophil-to-lymphocyte ratio (NLR) and fibrinogen (F-NLR) has been proposed as prognostic marker in several tumors. The aim of our study was to investigate the correlation between NLR, fibrinogen, and F-NLR and survival in OC population.. Patients with diagnosis of OC admitted to our institute between 2011 and 2016 were included. Data about pretreatment complete blood count were collected. Neutrophil-to-lymphocyte ratio was defined as the absolute neutrophil count divided by the absolute lymphocyte count; the F-NLR score was 0 for low NLR and fibrinogen, 1 for low NLR and high fibrinogen, or, conversely, 2 for both high markers. We correlated this index with progression-free survival.. A total of 94 patients were enrolled. Median age at diagnosis was 55 (34-83) years; more than 80% of patients presented International Federation of Gynecology and Obstetrics stage III-IV at diagnosis, and 72 (77%) presented high-grade serous histology. Primary debulking surgery was performed in 57 women (60%), whereas 37 (40%) underwent interval debulking surgery.Mean serum NLR was 5.25 ± 5.37, and mean serum fibrinogen value was 4.19 ± 0.97 g/L. The median follow-up time was 27 months (range, 8-60 months). All patients with F-NLR value of 2 presented advanced disease compared with 64% of those with F-NLR of 0 (P < 0.031); these patients more frequently required neoadjuvant chemotherapy (P < 0.003) and more often had platinum-resistant disease (P < 0.022). Patients with high F-NLR presented worse progression-free survival than did patients with low F-NLR (12 vs 42 months, respectively, P = 0.023).. Combining NLR and fibrinogen levels could be used as a factor for prediction of prognosis and response to treatment in patients affected with OC.

Topics: Adult; Aged; Aged, 80 and over; Biomarkers; Female; Fibrinogen; Humans; Lymphocyte Count; Middle Aged; Ovarian Neoplasms; Prognosis; Retrospective Studies; Rome

Most frequent causes of androgenic manifestation are Cushing's syndrome, PCO, benign and malignant androgen-secreting non adrenal tumors and iatrogenic hirsutism. Hyperplasia or neoplasms of ectopic adrenocortical gland are rare. We report a case of a 63-year old female with hirsutism and alopecia. Laboratory data highlighted increased levels of androgens. Diagnostic imaging revealed normal morphology of adrenocortical gland and ovaries. In view of the clinical picture and suspected diagnosis of extra-adrenal cause, she underwent bilateral salpingo-oophorectomy. Histologic examination showed an ectopic adrenal gland with adenoma in the ovarian and peri-ovarian tissue. At six months of follow up, the patients has no sign of hyperandrogenism. In case of hyperandrogenism in postmenopausal women and in the absence of the adrenocortical gland abnormality, ovarian origin should be considered in the differential diagnosis.

Topics: Adenoma; Alopecia; Diagnosis, Differential; Female; Hirsutism; Humans; Hyperandrogenism; Middle Aged; Ovarian Neoplasms; Ovariectomy; Rome; Salpingectomy; Treatment Outcome

To evaluate the incidence of PI3KCA, KRAS and BRAF mutations in primary ovarian clear cell carcinoma (OCCC).. 63 consecutive patients, with a proven diagnosis of OCCC, according to WHO criteria, were included into the study. Pyrosequencing analysis of all three genes hotspot regions were performed on 2.5 µm sections of formalin-fixed paraffin-embedded tissue from primary OCCC.. PI3KCA mutations were found in 20/63 (32%) cases; KRAS mutations were found in 8/63 (13%); no BRAF V600 mutations were found. In particular, 12/20 mutations (60%) of PI3KCA were found in the exon 20, whereas the remaining eight cases presented mutations in exon 9 (8/20; 40%). KRAS pyrosequencing analysis revealed higher incidence of codon 12 mutations (7/8; 90%) than codon 13 mutations (1/8; 10%). In five cases (5/66; 8%), synchronous mutations, affecting PI3KCA and KRAS genes, were found. No differences were found in the distribution of hotspot mutations, according to the stage.. The high frequency of PI3KCA mutations, the low rate of mutations in KRAS and the absence of mutations in BRAF, indicate a molecular signature of OCCCs different from other ovarian carcinomas. Detection of driver mutations, such as PI3KCA and KRAS, may be the basis for a targeted therapy, although the clinical and therapeutic implications of these findings have to be supported by further studies.

Topics: Adenocarcinoma, Clear Cell; Adult; Aged; Codon; Exons; Female; Humans; Incidence; Middle Aged; Mutation; Nuclear Proteins; Ovarian Neoplasms; Ovary; Proto-Oncogene Proteins B-raf; Proto-Oncogene Proteins p21(ras); Rome; Sequence Analysis, DNA; Transcription Factors

We conducted a case-control study to analyze risk factors for ovarian cancer.. Cases included 440 women (age range 13-80 years, median 54) with a histologically confirmed diagnosis of epithelial ovarian cancer who were admitted to the Gynecological Oncological Department of Gynecologic Oncology at the Catholic University Hospital in Rome, Italy. Controls were women admitted to the same hospital where cases were identified for acute nongynecological, nonhormonal, and nonneoplastic conditions. A total of 868 control women (age range 19-80 years, median 55) were interviewed.. In comparison with ever married women, the multivariate odds ratios (OR) of ovarian cancers was 2.0 (95% confidence interval, CI 1.3-3.2) for never married women. Cases and controls were similar as regards educational status and body mass index. No clear relation emerged between ovarian cancer and age at menarche, menopausal status, and age at menopause. In comparison with nulliparae, the estimated ORs were 0.8, 0.9, and 0.7, respectively, in women reporting one, two, or three births. Women reporting two or more induced abortions were at decreased risk of ovarian cancer (OR 0.5, 95% CI 0.3-1.0). In comparison with women reporting their first birth before 20 years of age, the multivariate ORs were 1.8, 2.0, and 2.8, respectively, for women reporting their first birth at age 20-24, 25-30, and >/=31 (chi(2) trend = 10.1). Breast-feeding for more than 1 year was associated with an OR of 0.5 (95% CI, 0.4-0.8). Forty-two (9.5%) cases and 164 (18.9%) controls reported ever oral contraceptive use: in comparison with never users, the multivariate OR was 0.4 (95% CI 0.3-0.6) for ever users, and the risk decreased with duration of use. The OR for ovarian cancer was 2.9 (95% CI, 1.5-5.8) for women with a family history of the disease.. This study, conducted on a relatively low-risk population, confirms the role of oral contraceptive on ovarian cancer risk and the direct association with family history of ovarian cancer. It also indicates that a later age at first birth is directly, and induced abortion and breast-feeding are inversely, related to the risk of the disease.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Body Mass Index; Case-Control Studies; Education; Family Health; Female; Humans; Middle Aged; Ovarian Neoplasms; Parity; Risk Factors; Rome; Smoking; Socioeconomic Factors

One hundred seven patients with epithelial ovarian cancer and one hundred fifty healthy women, categorized according to age, were evaluated for constitutional characteristics and also for dietary habits. No significant differences were observed between patients and controls in menarchal and menopausal history. Daily intake of proteins, glycides, lipids and calories was significantly higher in patients than in controls. However obesity was not confirmed as a risk factor for ovarian cancer. These conflicting data confirm that in ovarian neoplasia, although the exact mechanism is unknown (direct action or indirect effect), dietary factors may play an important role, suggesting a new mechanism in the etiology of this disease.

Topics: Case-Control Studies; Dietary Fats; Feeding Behavior; Female; Humans; Ovarian Neoplasms; Retrospective Studies; Rome

The sonographic and histologic findings observed in 11 cases of ovarian fibrothecoma were compared, and an attempt was made to find a correlation between each histologic type of the tumor (pure thecoma, predominantly fibrous fibrothecoma, mixed fibrothecoma) and its sonographic appearance. The presence of a homogeneous echogenic pattern, with marked posterior acoustic shadowing, in the absence of any calcification, was highly suggestive of a predominantly fibrous ovarian fibrothecoma; the presence of a diffusely hypoechoic ovarian mass, with no posterior echo enhancement, was strikingly correlated with pure thecomas; mixed fibrothecomas were characterized by the presence of an echogenic pattern with no posterior acoustic shadowing. Sonographic findings, even though nonspecific, can provide the clinician with useful information which permits to detect these rare neoplasms preoperatively.

Topics: Adult; Aged; Evaluation Studies as Topic; Female; Fibroma; Hospitals, University; Humans; Incidence; Middle Aged; Neoplasm Staging; Ovarian Neoplasms; Rome; Thecoma; Ultrasonography