Utilitatea imunohistochimiei în diagnosticul carcinomului ovarian, Ovarian cancer incidence by age

Ovarian cancer what age

The purpose of this paper is to quantify the in­ci­dence of different histological types of ovarian tumors and to demonstrate the clinical importance of an effective screening program, considering the paucisymptomatic na­ture of this pathology.

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The incidence of ovarian epithelial tumors varied across age groups, our study group including women aged between 34 and 64 years old. Knowing the age distribution plays an important role in the implementation of screening pro­grams. All cases presented with similar symptomatology: pelvic pain, abdominal distension and ascites. The gross appearance of these tumors was overlapping in different histological subtypes, showing variable cystic and solid components. The histological subtypes included in our study were: serous carcinoma, low grade and high grade, mucinous carcinoma, endometrioid carcinoma and clear cell carcinoma.

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A positive correct diagnosis of the his­to­lo­gical subtype is essential for therapy and follow-up, and immunohistochemial studies should be performed in difficult cases. There is a large series of antibodies used for the positive diagnosis of ovarian carcinoma, so the pathologist should know what algorithm to use in approaching a diagnosis in order to obtain a correct result.

Scopul acestei lucrări este de a cuantifica incidența diferitelor tipuri histologice de tumori ovariene și de a demonstra importanța clinică a unui program eficient de screening, având în vedere na­tura paucisimptomatică a acestei patologii.

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Incidența tumorilor epiteliale ovariene a variat în funcție de grupurile de vârstă, grupul nostru de studiu incluzând femei cu vârsta cuprinsă între 34 și 64 de ani. Cunoașterea distribuției pe vârste joacă un rol im­por­tant în implementarea tratament dirofilaria helminth de screening.

Toa­te recenzii de papilomavirus uman au prezentat simptomatologie similară: durere pelviană, distensie abdominală și ascită.

Studiu clinico-patologic al tumorilor ovariene - experienţa de un an într-un centru medical Hereditary Cancer Syndromes: "The Angelina Effect" Ovarian cancer young age TR Hereditary Cancer Syndromes: "The Angelina Effect" Angelina Jolie's announcement triggered an increase in the number of people in high risk being screened and this is a very important step so they can minimize the chances of the disease developing. Ghidul clinic pentru obstetrică şi ginecologie pe tema cancerului ovarian precizează standardele, principiile şi aspectele fundamentale ale conduitei particularizate unui caz concret clinic, care trebuie respectată de practicieni indiferent de nivelul unităţii sanitare în care activează.

Aspectul macroscopic al acestor tumori se suprapune în diferite sub­tipuri histologice, prezentând componente variabile chis­tice și ovarian cancer what age. Subtipurile histologice incluse în studiul nos­tru au fost carcinomul papiloma em caes, de grad scăzut sau crescut, carcinomul mucinos, carcinomul endometrioid și carcinomul cu celule clare.

Un diagnostic corect pozitiv al subtipului his­to­logic este esențial pentru terapie și follow-up, iar studiile imu­no­histochimice trebuie efectuate în cazuri dificile. Există o serie mare de anticorpi folosiți pentru diagnosticul pozitiv al carcinomului ovarian, astfel încât anatomopatologul ar trebui să știe ce algoritm să utilizeze în abordarea unui diagnostic pentru a obține un rezultat corect.

Ovarian cancer incidence by age

Cuvinte cheie epiteliu carcinom ovar imunohistochimie Introduction Ovarian cancer is a public health problem that affects women of reproductive age and is a major cause of morbidity and mortality. Early diagnosis is the primary method of ameliorating complications and long-term prognosis, but this is hampered by reduced symptomatology, with most patients presenting in advanced stages.

From tothe incidence rate and the mortality rate decreased by 0. The most important factor in determining the prognosis of the patient is the tumor stage. For epithelial ovarian cancer, current screening methods ultrasound and tumor markers have not been as effective as in cervical or breast ovarian cancer what age.

Ovarian epithelial tumors represent a heterogeneous class of neoplasia, classified by cell type in serous, mucinous, endometrioid and clear cell. Because there are no benign equivalent tissues in the ovary, the mechanism of carcinogenesis was attributed initially to the ovarian epithelium mesotheliumbut recent studies have proposed ovarian cancer what age serous tumors are secondary tumors, derived from lesions of the fallopian tube fimbria, while endometrioid tumor or clear cells tumors are secondary to ovarian endometriosis 4.

Ovarian epithelial tumors are classified according to the degree of nuclear atypia, tumor proliferation and the presence or absence of stromal invasion, in benign, borderline and malignant conditions. The borderline tumors are called this way because they present cytological and histological aspects that are intermediate between benign and malignant.

Materials and method The purpose of this paper is to quantify the incidence of different histological types of ovarian tumors and to demonstrate parazit de giardia în simptom clinical importance of an effective scre­ening program, considering the paucisymptomatic nature of this pathology.

Symptoms suggestive for this pathology were noted to demonstrate the silent clinical appearance of ovarian neoplasia.

Hereditary Cancer Syndromes: "The Angelina Effect"

Specimens were obtained from limited tumor excision, but also from oophorectomy and hysterectomy with bilateral anexectomy, formalin fixed and ovarian cancer what age embedded, then stained with Hematoxylin-Eosin.

In some cases, additional immunohistochemical stains were needed to clarify the diagnosis. Results This study included data from a batch of 23 ovarian carcinomas, selected from ovarian pathology patients. The incidence of ovarian epithelial tumors varies across age groups, our study group including women aged between 34 and 64 years old. Knowing the age distribution plays an important role in the implementation of screening programs.

Studiu clinico-patologic al tumorilor ovariene - experienţa de un an într-un centru medical The aim of this study is a retrospective analysis of papiloma humano plantar tratamiento spectrum of ovarian tumors: statistics, epidemiology and pathological features, based on one-year experience in our hospital. Materials and method. We analyzed 58 cases registered in the Pathology Department as oophorectomy or hysterectomy specimens diagnosed with ovarian tumors, including benign, borderline and malignant tumors of various histological types.

All cases presented with similar symptomatology: pelvic pain, abdominal distension and ascites in two cases. In the category of malignant serous tumors, we included 9 patients, 6 low-grade and 3 high-grade.

The low-grade serous carcinoma was non-invasive and showed a papillary-type development, with small nuclei, rare mitoses and a hyalinized stroma with occasional psamoma bodies. Immunohistochemical assays showed positivity to CK7 and ER.

Studiu clinico-patologic al tumorilor ovariene - experienţa de un an într-un centru medical

Figure 1. The immunohistochemical assays showed, by contrast to the previous low-grade serous cases, a mutated expression of p53 and high Ki67 index. The pattern of p53 immunosay is very important and the result should refer to the presence or absence of a mutation. A strong and diffuse immunoexpression of p53, as well as a completely negative immunostaining should be interpreted as an indicator of a TP53 gene mutation.

In our cases, all high grade showed mutated status of TP53 gene. Hormone receptor testing showed no difference from the low-grade cases and is not useful in the differential diagnosis.

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Also, all cases of both low-grade and high-grade serous carcinoma exhibited diffuse nuclear positivity with WT1. Figure 2. High-grade serous carcinoma of the ovary, HE, 40x, and p53 mutated, 40x The cases of carcinomas with glandular architecture, atypical cells and foci of squamous metaplasia were classified as endometroid carcinomas due to their resemblance to the endometrium 5 cases.

The immunohistochemical profile of endometriod carcinomas is similar to that of benign endometrial tumors, presenting a positive reaction for cytokeratins and both estrogenic and progesterone receptors and different values of Ki67, depending on the aggresive character of the tumor.

In one case, the initial intraoperative diagnosis was endometriod cyst, while extensive grossing for the final diagnosis revealed the presence of a small area of endometrioid carcinoma Figure 3.

Ovarian cancer incidence by age, Hereditary Cancer Syndromes: "The Angelina Effect"

Figure 3. Endometrioid ovarian carcinoma and associated endometrioid cyst, HE, 40x A third histopathological category of ovarian epithelial tumors were the mucinous tumors, which represented 2.

The most frequent risk factor for serous type was the ovulation lifetime over 30 years Conclusions: The ovulation lifetime over 30 years was identified as the main risk factor for both histological types, but it was significant more frequent among women with serous type. The smoking was more frequent among those who had mucinous carcinoma compared with serous type. No significant differences were identified among women with both histological types regarding the age at first menstrual bleeding and parity.

On gross examination, two cases showed cystic appearance and the rest were solid with dimensions between 6 and 14 cm. In one case, the mucinous adenocarcinoma has shown an expansive pattern of development, without any stromal invasion and complex architecture, while the rest were infiltrative. Figure 4. The year-old patient who was diagnosed with this tumor had epiploic metastasis at admission.

Clinical risk profile associated with ovarian cancer

Because all bilateral or large mucinous ovarian tumors should be considered secondary dissemination until proven otherwise, immunohistochemical tests are compulsory. In our cases, three tumors turned out to be primary tumors, two were metastasis from a colorectal adenocarcinoma and one of them was a Krukenberg tumor metastasis from a gastric carcinoma. Figure 5. Primary mucinous ovarian adenocarcinoma, HE, 40x, and CK7 positive The Krukenberg tumor showed a specific pattern, with signet ring infiltrating tumoral cells, Ck20, CDx2 and CEA positive, but the diagnosis cannot be relied solely on histological and immunohistochemical pattern and it had to be confirmed by the clinical context.

Figure 7. Krukenberg tumor, HE, x and CK20 positive, x Clear cell carcinomas are rare tumors and we only found ovarian cancer what age cases that showed very different histological pattern: one had hobnail cell that protruded into the lumina, while the other showed clear cytoplasm.

The arhitecture was heterogenous in both cases, with tubular-cystic, papillary cores with hyalinization and solid area. The immunohistochemical tests are useful mainly for the differential diagnosis with serous and mucinous carcinoma. Also, Ki67 had a high value in both cases, as these types of tumors are rather aggressive Figure 8. Figure 8. Clear cell carcinoma of the ovary - EMA positive, x, and Ki67 positive, x Discussions Malignant ovarian neoplasms are the seventh most common form of cancer diagnosed in the female population.

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Another important aspect of this pathology is the reduced symptomatology of the incipient stages. The main symptoms are abdominal pain, palpable abdominal mass, or vaginal bleeding, which are predominantly found in borderline and malignant tumors 8.

In some cases, the rapid increase in size leads to torsion of the ovary and important pain.

Utilitatea imunohistochimiei în diagnosticul carcinomului ovarian

The screening for this pathology consists in several methods, such as: transvaginal ultrasonography with or without contrast, BRCA mutation testing, or tumor marker dosing. An element of interest in this pathology is represented by risk factors still incompletely elucidated.

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The main process involved in pathogenic epithelial ovarian tumors is inflammation of the ovarian cancer what age epithelium. The inflammatory changes occurring at the time of ovulation and hyaline body formation cause alterations of epithelial cell DNA A positive ovarian cancer what age diagnosis of the histological subtype is essential for therapy and follow-up.

False negative results, that might come up intraoperatively, should be solved by extensive grossing of the surgical specimen. In our study, only one case showed false negative result. Most cases of ovarian carcinoma will need immunohistohemical confirmation, especially the mucinous subtypes.

Ovarian mucinous tumors represent a wide range of neoplasms, from benign to malignant, and are distinct from other histological and molecular ovarian epithelial tumor subtypes. The assessment of ovarian mucosal tumors requires the correlation of clinical data, imaging aspects, contralateral ovary status, the presence or absence of intraperitoneal mucin and the macroscopic aspect of the appendix.

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Although in most cases a positive diagnosis of ovarian cancer what age benign lesion does not pose diagnostic problems, the differential diagnosis between a primary ovarian tumor and a metastasis is difficult to perform intraoperatively or in the classic histological examination. The prognosis and therapeutic management are different for each histological entity, so positive diagnosis is essential.

Malignant tumors of the ovary are characterized by positivity to CK7 and P53, and negative for CK20 Conclusions In conclusion, epithelial ovarian neoplasia affects an increased number of women, mainly of reproductive age. The most affected age categories are the third and fourth decades, with a maximum incidence in the fourth decade.

Thus, ovarian epithelial tumors also have socio-economic importance, in addition to public health, affecting the active occupational categories. Reducing the morbidity and mortality of this pathology through effective screening programs becomes a priority of the health system. As therapy has progressed towards a more targeted approach, there have been changes and advances in the understanding of ovarian carcinoma. Also, the ovarian tumors of the epithelial type present a large histological variety, each exhibiting several developmental patterns and requiring additional immunohistochemical tests.

ovarian cancer what age

Bibliografie 1. Gynecologic pathology: A volume in the series foundations in diagnostic pathology.

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Edinburgh: Churchill Livingstone, Elservier. Diagnostic Gynecologic and Obstetric Pathology. The origin and pathogenesis of epithelial ovarian cancer: a proposed unifying theory.

Ovarian cancer young age,

Am J Surg Pathol ; Mutter G, Prat J. Epidemiology of ovarian cancer: a review. Cancer Biol Med, ; 14 1 Development of an ovarian cancer symptom index: possibilities for earlier detection.

Cancer, ; 2 Prediagnostic symptoms of ovarian carcinoma: A case-control study. Gynecologic oncology, ; 2 Value in Health, ; 20 4 Risk factors for epithelial ovarian cancer by histologic subtype. Am J Epidemiol, ; 1 Kriplani D, Patel MM. Immunohistochemistry: A diagnostic aid in differentiating primary epithelial ovarian tumors and tumors metastatic to the ovary.

South Asian J Cancer. Articole din ediţiile anterioare Sindromul ovarelor polichistice, cea mai frecventă cauză de infertilitate George Alexandru Filipescu, Andreea Boiangiu, Amelia Milulescu, Nicoleta Clim, Oana Solomon Sindromul ovarelor polichistice reprezintă principala cauză ovarian cancer what age infertilitate la femei.

Etiologia acestei patologii nu este complet elucidată, princ