Survivin expression in ovarian cancer

Aim: To examine the expression of survivin in benign ovarian tumors, ovarian carcinomas of different stages. Methods: We screened the expression of survivin mRNA by reverse transcription polymerase chain reaction in 114 ovarian tissue samples. Quantitative real-time PCR was used to estimate survivin mRNA levels in the samples with positive survivin expression. Results: No survivin mRNA was expressed in all normal ovarian specimens, while it appeared in 73% of ovarian carcinomas, 47% of borderline ovarian carcinomas and 19% of benign ovarian tumors. The survivin mRNA expression rate was positively associated with clinical stage (P = 0.026) and differentiation grade (P = 0.049). There was notably statistically significant difference in the survivin mRNA expression rate dependent on different histological types (serous, mucinous, endometrioid, P = 0.008), but not – dependent on lymph node metastasis (P = 0.921) and ascites (P = 0.87). In tissues with positive expression of survivin, we also found that mean survivin mRNA expression levels were higher in ovarian carcinomas than that in benign ovarian tumors and borderline ovarian carcinoma tissues (P < 0.001). Among ovarian carcinomas, the high survivin mRNA expression levels correlated with the clinical stages, differentiation grade, lymph node metastasis, but not — with ascites and histological type. Conclusion: Our study suggest that survivin is associated with progression of ovarian carcinoma.Цель: исследовать экспрессию сурвивина в доброкачественных и злокачественных новообразованиях яичника. Методы: экспрессия мРНК сурвивина исследована методом RT-PCR в 114 образах ткани яичника человека. Для установления уровня экспресии мРНК сурвивина применяли количественный PCR в режиме реального времени. Результаты: экспрессия мРНК сурвивина не выявлена в образцах нормальной ткани яичника, но зарегистрирована в 73% случаев рака яичника, 47% случаев серозных опухолей яичника серозного типа и 19% образцов доброкачественных опухолей. Установлена положительная зависимость между уровнем экспрессии мРНК сурвивина и клинической стадией заболевания (P = 0,026), и степенью дифференцировки опухоли (P = 0,049). Выявлена статистически значимая зависимость уровня экспрессии мРНК сурвивина от гистологического типа опухоли (серозного, мукозного, эндометриоидного, P = 0,008) и отсутствие таковой от наличия метастазов в лимфатических узлах (P = 0.921) или асцита (P = 0.87). Также установлено, что средние уровни экспрессии мРНК сурвивина выше при раке яичника, чем в ткани доброкачественных новобразований или серозных опухолей яичника пограничного типа (P < 0,001). При раке яичника высокий уровень экспрессии мРНК сурвивина коррелировал с клинической стадией заболевания, степенью дифференцировки опухолевых клеток, но не коррелировал с гистологическим типом новообразования. Выводы: результаты свидетельствуют о том, что экспрессия сурвивина ассоциирована с прогрессией рака яичника. Ключевые слова: сурвивин, рак яичника, опухолевая прогрессия

Global Retinoblastoma Presentation and Analysis by National Income Level

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4) were female. Most patients (n = 3685 84.7%) were from low-and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 62.8%), followed by strabismus (n = 429 10.2%) and proptosis (n = 309 7.4%). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 95% CI, 12.94-24.80, and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 95% CI, 4.30-7.68). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs. © 2020 American Medical Association. All rights reserved