Therapeutic results of patients with endometriosis and ovarian cancer

Introduction. The aim of this study is to compare the therapeutic results of patients with ovarian cancer coexisting with endometriosis with a group of patients with cancer formed in the endometriosis focus in the scar after caesarean section. Methods. We analysed the therapeutic results of patients with ovarian cancer coexisting with endometriosis with a group of patients with cancer formed in the endometriosis focus in the scar after caesarean section. They were operated in the Oncology Centre in Bydgoszcz. All the patients had endometriosis and ovarian cancer confirmed in one tissue preparation. Results. The probability of death at any time is 7.826-times higher in the group with scar cancer than in the group with endometriosis and ovarian cancer. Conclusions. Because scar cancer that arises in the background of endometriosis is an extremely rare condition and also because the prognosis for this group of patients is poor we consider it necessary to plan combination therapy by a multidisciplinary oncological team

The Possible Correlation between the Patient's Immune Tolerance Level During Cesaerean Section and the Incidence of Subsequent Emergency Peripartum Hysterectomy

Introduction. Cesarean section is an independent risk factor for peripartum hysterectomy. As a method of delivery, cesarean section may interfere with a number of molecular changes that occur at the maternal-fetal interface during the course of labor. Methods. The level of CD3, CD56, CD25, and CD69 antigen immunoreactivity was assessed by immunohistochemistry in 26 decidual tissue samples. The tissue samples were obtained from 18 women who underwent cesarean sections at term and from 8 women who underwent cesarean hysterectomies. Results. An increase in the activity and infiltration of immune cells in the decidua sampled during the spontaneous beginning of labor was observed. The further progression of labor was accompanied by a decrease in the number and activity of immune cells. The number of CD56+ and CD3+ cells in the decidua was statistically significantly lower in patients who had undergone cesarean hysterectomies than in those who had had cesarean sections at term. Conclusion. Abnormal immune response during labor may increase the risk for peripartum hysterectomy

An analysis of the influence of infection on overall survival rates, following modified posterior pelvic exenteration for advanced ovarian cancer

Objectives: The aim of our study was to determine the association between the appearance of infection after modified posterior pelvic exenteration (MPE) and the time to adjuvant chemotherapy (TTC), and to examine whether infection has any impact on clinical results by delaying the start of chemotherapy.Material and methods: Our retrospective study analyzed 77 patients who had undergone MPE followed by adjuvantchemotherapy. Postoperatively, either there was no residual tumor or, the residual tumor was less than 2.5 mm, in 76.7% of the study patients. Our study group was divided into two subgroups for comparison; the first group consisted of 41 patients with postoperative infections, and the second group of 36 patients had no infections. The infections of the first group were monitored during a 90-day postoperative period. Median TTC and overall survival rates (OS) were determined for those patients who developed an infection as well as for those who did not.Results: The expected 5-year survival rate was 0.40 (SD = 0.09) for those patients without infection and 0.17 (SD = 0.07) for those patients with infection. The survival curves of patients with infection and those without infection were significantly different statistically (p = 0.038). The median TTC differed significantly for those patients who developed infection compared with those patients who did not develop infection (37 days compared with 27.5 days respectively, p = 0.024); and patients without infection were statistically more likely to receive chemotherapy within 25 days following surgery than in the subsequent 25–42-day period compared with those patients who did develop infection (p = 0.048). No statistically significant differences were found between the two groups in relation to results following the initiation of chemotherapy during the first 42 days postoperatively (p = 0.445).Conclusions: The absence of postoperative infection was associated with better survival rates. Patients with infectionexperienced a longer time interval between surgery and the start of chemotherapy, without negative impact to theiroverall survival rates

The analysis of RCAS1 and DFF-45 expression in nasal polyps with respect to immune cells infiltration

BACKGROUND: Nasal polyp constitutes a benign growth process in the nasal and sinus mucosa. RCAS1 (receptor-binding cancer antigen expressed on SiSo cells) is a protein expressed mainly by various human cancer cells. It is not only the marker of cancer process and its expression can also be observed in physiological processes. It is responsible for the regulation of immune cells activity. DFF45 (DNA fragmenting factor) has been described as a substrate for caspase-3. DFF45 seems to play an important role in the onset of apoptotic process by acting probably through the regulation of DNA fragmentation. The aim of the study was to evaluate the ability of nasal polyps to regulate the cytotoxic immune response and to determine their resistance to apoptosis. RESULTS: The higher RCAS1 level was identified in lymphocytic nasal polyps, the medium one in eosinophilic while the lowest was identified in neutrophilic. DFF-45 expression was higher in eosinophilic than in neutrophilic and lymphocytic nasal polyps. CONCLUSION: The changes in DFF-45 level in nasal polyps might indicate a different resistance to apoptosis mediated by immune cells. The alterations in RCAS1 expression indicate that nasal polyps have the ability to regulate the cytotoxic immune response. The breaking of resistance to immune mediated apoptosis in nasal polyps might have a new therapeutic impact

Cytoplasmic and membranous receptor-binding cancer antigens expressed on SiSo cells (RCAS1) immunoreactivity in epithelial ovarian cancer cells represent differing biological function of RCAS1

Introduction. Receptor-binding cancer antigen expressed on SiSo cells (RCAS1) is a selective suppressor of the immune response that has been linked to the evasion of immune surveillance by cancer cells. However, the exact prognostic impact of RCAS1 on epithelial ovarian cancer (EOC) has not been fully elucidated. The main aim of our study was to evaluate the influence of RCAS1 immunoreactivity (RCAS1-Ir) in EOC cells and in tumor stroma cells on patient overall survival. We also focused on RCAS1-Ir and the structure of the tumor stroma. Material and methods. RCAS1-Ir was evaluated by means of immunohistochemistry in 67 patients with EOC. We distinguished cytoplasmic and membranous immunoreactivity patterns. Results. We found that high cytoplasmic RCAS1-Ir in cancer cells was associated with more than a two-time shortened period of overall survival. Membranous RCAS1-Ir in cancer cells, as well as in tumor stroma macrophages and fibroblasts, did not correlate with patient survival. RCAS1-Ir in the cytoplasm of cancer cells was positively correlated with the degree of tumor stroma infiltration by fibroblasts and macrophages, but not with RCAS1-Ir in these cells. On the other hand, membranous RCAS1-Ir in cancer cells was positively correlated with RCAS1-Ir in fibroblasts and macrophages, but not with their quantity. Conclusions. Due to their different impacts on patient prognosis and tumor stroma structure, it seems that cytoplasmic and membranous RCAS1-Ir in EOC cells may have different biological functions

The placental RCAS1 expression during stillbirth

Background: Independently of the fetal death cause the beginning and course of stillbirth is closely related with the growing cytotoxic activity at the maternal-fetal interface. RCAS1 participates in the inhibition of maternal immune response during pregnancy. The alterations of RCAS1 protein expression in placental cells seem to determine the beginning of the labor and participate in the placental abruption. The aim of the present study was to investigate RCAS1 expression in placentas obtained following stillbirths or normal term births. Methods: RCAS1 expression was evaluated by Western blot method with the use of monoclonal anti-RCAS1 antibody in 67 placental tissue samples. Pregnant women were divided into four groups according to the mode of labor onset – spontaneous or induced, and the type of labor, stillbirth or labor at term. Placental beta-Actin expression was chosen as a control protein. Relative amounts of placental RCAS1 were compared with the use of Student's t-test, whereas beta-Actin control data were compared with the use of Mann-Whitney U test. Results: The average relative amount of RCAS1 was significantly lower in women with induced stillbirths than in women with induced labor at term. Similarly, significantly lower RCAS1 placental levels were observed in patients with spontaneous stillbirths than in women with spontaneous labor at term. Significant differences in RCAS1 expression were also observed with the respect to the beginning of the stillbirth: spontaneous and induced. Lowest RCAS1 placental levels were observed in women with spontaneous stillbirth. Conclusions: These preliminary results indicate that the alterations of RCAS1 expression in the human placenta may be involved in the changes of maternal immune system that take place during stillbirth

Analysis of the treg cell population in the peripheral blood of ovarian cancer patients in relation to the long-term outcomes

Objectives: There is growing evidence that Treg cell infiltration into the cancer nest is associated with poor prognosis. How- ever, the Treg cell population in the peripheral blood may change when a different type of anticancer therapy is applied. Since Treg cells may support tumor growth by enhancing the suppressive profile of the cancer microenvironment, the assessment of Treg cells can bring to light important information regarding prognosis. Thus we decided to analyze the Treg cell population in the peripheral blood in relation to long-term outcomes in the group of patients with ovarian cancer.  Material and methods: The 80 patients included in the study were treated surgically followed by chemiotherapy for ovar- ian cancer between October 2010 through May 2011.The peripheral blood samples from the patients were collected directly prior to chemotherapy. Information on any patients who died was retrieved from the database of the Cuiavia-Pomerania Regional Office of the National Health System of Poland. CD4+CD25+FOXP3+ lymphocytes T were assed by flow cytometry. We have analyzed the long term outcomes of treatment regarding to the level of Treg cells in peripheral blood.  Results: We found that patients with serous adenocarcinomas had significantly higher Treg levels compared to those patients with non-serous types. Patients who had a higher percentage of Treg cells within the CD4+ cell population prior to the beginning of the treatment had worse long-term outcomes from the applied therapy.  Conclusions: The assessment of Treg levels prior to the start of chemotherapy is clinically useful and may predict overall survival in ovarian cancer patients.

Expression of B7–H4 in endometrial cancer and its impact on patients’ prognosis

Objectives: The aim of the study was to evaluate the B7–H4 expression in endometrial cancer cells and to investigate its relationship with patient prognosis and clinicopathological features of the disease. Material and methods: We performed a single-center, retrospective cohort study that included endometrial cancer patients treated between 2012 and 2019. B7–H4 expression in specimens obtained from 63 patients was examined by immunohistochemical staining. The evaluation of B7H4 immunoreactivity was assessed using Immunoreactivity Scoring (IRS) system. Results: B7–H4 reactivity was observed in all, except one, endometrial cancer patients (98%). Staining intensity: no reaction in one case, weak in 16 (24%) patients, moderate in 25 (37%), and strong in 22 (35%). Twenty-nine (46%) patients showed B7–H4 immunoreactivity in more than 60% of cells, while, in 18 (29%) cases and 16 (25%) patients, the percentages were 30–60% and < 30% respectively. Median IRS was 2 (range 0–6). We found a significantly worse overall survival (OS) rate for patients with high versus low B7–H4 IRS (p = 0.03), however, in multivariate analysis, the difference in patient survival was close to the significance level (p = 0.052). B7–H4 expression was not related to histopathological type of the tumor, tumor grade, lymph node metastases, or the FIGO stage of the disease. Conclusions: Our result suggests that B7–H4 expression might be a useful prognostic factor in endometrial cancer

The impact of splenectomy and diaphragmatic surgeryon perioperative morbidity and overall survival of ovarian cancer patients

Objectives: The prognosis of ovarian cancer (OC), among other factors, depends on residual disease after primary debulking surgery (PDS) and initial disease advancement. The main aim of our study was to evaluate the survival benefits of splenectomy and diaphragmatic surgery in OC patients, when the procedures result in resection to no macroscopic residual disease or minimal residual disease [tumor nodules below 2.5 mm according to Sugarbaker’s completeness of cytoreduction score (CC) = 1]. Material and methods: The study included 25 OC patients after splenectomy procedures, 28 patients after diaphragmatic surgery and 17 patients who had undergone both splenectomy and diaphragmatic surgery. Patients’ overall survival (OS) was compared with residual disease-matched controls (47 patients) who had upper abdomen involvement but no requirement for splenectomy and/or diaphragmatic surgery. Results: Overall survival of patients after splenectomy was not significantly different from OS of patients who did not required splenectomy (36.1 vs 31.6 months; p = 0.85). No differences in OS were observed between patients who did and did not require diaphragmatic surgery (31.3 vs 41.8; p = 0.33). Similarly, we found no differences in OS between patients who underwent both splenectomy and diaphragmatic surgery and those patients who did not require either procedure (20.1 vs 31.6 months; p = 0.45). Splenectomies and diaphragmatic surgeries were associated with prolonged hospitalization and length of surgery, however, no specific morbidity related to the procedures was observed. Conclusions: In the cases of advanced OC, diaphragm and spleen involvement do not hamper patient prognosis when adequately resected