Objective: To investigate the cytomorphological and immunocytochemical features of tumor cells in the ascites of ovarian plasmacytoma (SOC). Methods: Specimens of serous cavity effusions were collected from 61 tumor patients admitted to the Affiliated Wuxi People's Hospital of Nanjing Medical University from January 2015 to July 2021, including ascites from 32 SOC, 10 gastrointestinal adenocarcinomas, 5 pancreatic ductal adenocarcinomas, 6 lung adenocarcinomas, 4 benign mesothelial hyperplasia and 1 malignant mesothelioma patients, pleural effusions from 2 malignant mesothelioma patients and pericardial effusion from 1 malignant mesothelioma. Serous cavity effusion samples of all patients were collected, conventional smears were made through centrifugation, and cell paraffin blocks were made through centrifugation of remaining effusion samples. Conventional HE staining and immunocytochemical staining were applied to observe and summarize cytomorphological characteristics and immunocytochemical characteristics. The levels of serum tumor markers carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) were detected. Results: Of the 32 SOC patients, 5 had low-grade serous ovarian carcinoma (LGSOC) and 27 had high-grade serous ovarian carcinoma (HGSOC). 29 (90.6%) SOC patients had elevated serum CA125, but the difference was not statistically significant between them and patients with non-ovarian primary lesions included in the study (P>0.05); The serum CEA was positive in 9 patients with gastrointestinal adenocarcinoma and 5 patients with lung adenocarcinoma, and the positive rate was higher than that in SOC patients (P<0.001); The serum CA19-9 was positive in 5 patients with gastrointestinal adenocarcinoma and 5 patients with pancreatic ductal adenocarcinoma, and the positive rate was higher than that in SOC patients (P<0.05). The serum CA125, CEA and CA19-9 were within the normal range in 4 patients with benign mesothelial hyperplasia. LGSOC tumor cells were less heterogeneous and aggregated into small clusters or papillary pattern, and psammoma bodies could be observed in some LGSOC cases. The background cells were fewer and lymphocytes were predominant; the papillary structure was more obvious after making cell wax blocks. HGSOC tumor cells were highly heterogeneous, with significantly enlarged nuclei and varying sizes, which could be more than 3-fold different, and nucleoli and nuclear schizophrenia could be observed in some cases; tumor cells were mostly clustered into nested clusters, papillae and prune shapes; there were more background cells, mainly histiocytes. Immunocytochemical staining showed that AE1/AE3, CK7, PAX-8, CA125, and WT1 were diffusely positively expressed in 32 SOC cases. P53 was focally positive in all 5 LGSOCs, diffusely positive in 23 HGSOCs, and negative in the other 4 HGSOCs. Most of adenocarcinomas of the gastrointestinal tract and lung had a history of surgery, and tumor cells of pancreatic ductal adenocarcinoma tend to form small cell nests. Immunocytochemistry can assist in the differential diagnosis of mesothelial-derived lesions with characteristic "open window" phenomenon. Conclusion: Combining the clinical manifestations of the patient, the morphological characteristics of the cells in the smear and cell block of the ascites can provide important clues for the diagnosis of SOC, and the immunocytochemical tests can further improve the accuracy of the diagnosis.
Female ; Humans ; Carcinoembryonic Antigen ; Ascites ; CA-19-9 Antigen ; Mesothelioma, Malignant/diagnosis* ; Hyperplasia ; Adenocarcinoma/pathology* ; Cystadenocarcinoma, Serous/diagnosis* ; Biomarkers, Tumor ; Carcinoma, Ovarian Epithelial ; Diagnosis, Differential ; Ovarian Neoplasms/pathology* ; Carbohydrates

Adenocarcinoma, Clear Cell ; metabolism ; pathology ; Adenocarcinoma, Mucinous ; metabolism ; pathology ; Carcinoma, Endometrioid ; metabolism ; pathology ; Carcinoma, Transitional Cell ; metabolism ; pathology ; Cystadenocarcinoma, Serous ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Humans ; Neoplasms, Glandular and Epithelial ; classification ; metabolism ; pathology ; Ovarian Neoplasms ; classification ; metabolism ; pathology ; Tumor Suppressor Protein p53 ; metabolism ; WT1 Proteins ; metabolism

Cyclin-Dependent Kinase Inhibitor p16 ; metabolism ; Cystadenocarcinoma, Serous ; metabolism ; pathology ; Diagnosis, Differential ; Endometrial Neoplasms ; metabolism ; pathology ; Female ; Humans ; Precancerous Conditions ; metabolism ; pathology ; RNA-Binding Proteins ; metabolism ; Tumor Suppressor Protein p53 ; metabolism

Adenocarcinoma, Clear Cell ; diagnosis ; metabolism ; pathology ; Adenocarcinoma, Mucinous ; diagnosis ; metabolism ; pathology ; Biomarkers, Tumor ; metabolism ; Carcinoma, Endometrioid ; diagnosis ; metabolism ; pathology ; Cystadenocarcinoma, Serous ; diagnosis ; metabolism ; pathology ; Diagnosis, Differential ; Endometrial Neoplasms ; diagnosis ; metabolism ; pathology ; Female ; Humans ; Immunohistochemistry ; Uterine Cervical Neoplasms ; diagnosis ; metabolism ; pathology

OBJECTIVE: We wanted to evaluate the diagnostic value of serum CA-125 concentration, when used in combination with the preoperative contrast-enhanced CT results, to differentiate borderline ovarian tumors (BOTs) from stage I malignant epithelial ovarian tumors (MEOTs). MATERIALS AND METHODS: Ninety-eight masses (46 BOTs and 52 stage I MEOTs) from 87 consecutive patients (49 with BOTs and 38 with stage I MEOTs) who had undergone preoperative contrast-enhanced computed tomography (CT) and surgical staging were evaluated retrospectively and independently by two radiologists. The preoperative serum CA-125 concentration was measured in all patients. The utility of analyzing serum CA-125 concentration in combination with the CT results was evaluated by receiver operating characteristic (ROC) curve analysis. RESULTS: An irregular tumor surface and lymphadenopathy were predictive of a MEOT. ROC analysis showed that the combination of CT data and the serum CA-125 level resulted in a higher diagnostic performance than did using the CT alone for differentiating BOTs from MEOTs. The areas under the curves (AUCs) without and with the use of the serum CA-125 level data were 0.67 (95% confidence interval [CI]: 0.57-0.77) and 0.78 (95% CI: 0.68-0.85), respectively, for reader 1 (p = 0.029) and 0.71 (95% CI: 0.61-0.80) and 0.81 (95% CI: 0.72-0.89), respectively, for reader 2 (p = 0.009). CONCLUSION: The serum CA-125 concentration is of additional diagnostic value when used in conjunction with the CT imaging results for differentiating BOTs from MEOTs.
Adenocarcinoma, Mucinous/*blood/pathology/*radiography ; Adolescent ; Adult ; Aged ; Biological Markers/blood ; CA-125 Antigen/*blood ; Contrast Media/diagnostic use ; Cystadenocarcinoma, Serous/*blood/pathology/*radiography ; Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Neoplasm Staging ; Ovarian Neoplasms/*blood/pathology/*radiography ; Predictive Value of Tests ; ROC Curve ; Retrospective Studies

OBJECTIVE: To determine whether or not detailed cystic feature analysis on CT scans can assist in the differential diagnosis of pancreatic ductal adenocarcinoma (PDAC) from serous cystadenoma (SCN), mucinous cystadenoma (MCN), and a pseudocyst. MATERIALS AND METHODS: This study received Institutional Review Board approval and informed patient consent was waived. Electronic radiology and pathology databases were searched to identify patients with PDAC (n = 19), SCN (n = 26), MCN (n = 20) and a pseudocyst (n = 23) who underwent pancreatic CT imaging. The number, size, location, and contents of cysts, and the contour of the lesions were reviewed, in addition to the wall thickness, enhancement patterns, and other signs of pancreatic and peripancreatic involvement. Diagnosis was based on lesion resection (n = 82) or on a combination of cytological findings, biochemical markers, and tumor markers (n = 6). Fisher's exact test was used to analyze the results. RESULTS: A combination of the CT findings including irregular contour, multiple cysts, mural nodes, and localized thickening, had a relatively high sensitivity (74%) and specificity (75%) for differentiating PDAC from SCN, MCN, and pseudocysts (p < 0.05). Other CT findings such as location, greatest dimension, or the presence of calcification were not significantly different. CONCLUSION: The CT findings for PDAC are non-specific, but perhaps helpful for differentiation. PDAC should be included in the general differential diagnosis of pancreatic cystic neoplasms.
Adenocarcinoma/pathology/*radiography ; Adolescent ; Adult ; Aged ; Cystadenocarcinoma, Serous/pathology/*radiography ; Cystadenoma, Mucinous/pathology/*radiography ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Pancreatic Neoplasms/pathology/*radiography ; Retrospective Studies ; Sensitivity and Specificity ; *Tomography, X-Ray Computed ; Tumor Markers, Biological/analysis

12E7 Antigen ; Antigens, CD ; metabolism ; CD56 Antigen ; metabolism ; Calbindin 2 ; Carcinoma, Endometrioid ; metabolism ; pathology ; Cell Adhesion Molecules ; metabolism ; Cystadenocarcinoma, Serous ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Inhibins ; metabolism ; MART-1 Antigen ; metabolism ; Neprilysin ; metabolism ; Ovarian Neoplasms ; diagnosis ; metabolism ; S100 Calcium Binding Protein G ; metabolism ; Sertoli-Leydig Cell Tumor ; metabolism ; pathology ; Sex Cord-Gonadal Stromal Tumors ; diagnosis ; metabolism ; Steroidogenic Factor 1 ; metabolism ; WT1 Proteins ; metabolism

Adenocarcinoma, Papillary ; metabolism ; pathology ; Adult ; Calbindin 2 ; Cystadenocarcinoma, Serous ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Humans ; Keratin-5 ; metabolism ; Leiomyoma ; metabolism ; pathology ; surgery ; Mesothelioma ; metabolism ; pathology ; surgery ; Neoplasms, Multiple Primary ; metabolism ; pathology ; surgery ; Omentum ; Ovarian Neoplasms ; metabolism ; pathology ; surgery ; Peritoneal Neoplasms ; metabolism ; pathology ; surgery ; S100 Calcium Binding Protein G ; metabolism ; Teratoma ; metabolism ; pathology ; surgery ; Uterine Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

OBJECTIVEBoth (18)F-fluorodeoxyglucose (FDG) imaging and serum tumor marker measurements can be used in the post-therapy surveillance of recurrent endometrial carcinoma, but the relationship between those two methods has not been demonstrated yet. The purpose of this study was to compare the diagnostic efficiency of (18)F-FDG imaging and serum tumor marker measurements in the diagnosis of recurrent endometrial carcinoma, as well as to analyze the correlation between those two methods.

METHODSThirty-five patients with histopathologically confirmed endometrial carcinoma and suspected to have recurrent disease during post-therapy surveillance were included in this study. (18)F-FDG images from the thorax to the pelvis were obtained in all patients by using GE-Millennium VG Hawkeye system, and the abnormal FDG uptake was judged as tumor recurrence. Serum CA-125 and CP-2 were also measured for each patient by enzyme-linked immunoassay, and a cutoff value of 35 U/ml was taken as the criteria for predicting tumor recurrence. Based on the final clinical diagnosis, the efficiency of tumor markers (CA-125, CP-2) and (18)F-FDG imaging in the diagnosis of recurrent tumor was evaluated.

RESULTSAccording to the histopathological diagnosis or follow-up examinations, tumor recurrence was confirmed in 13 of the 35 patients. Elevated serum level of CA-125 was found in 7 patients, serum CP-2 was increased in 9, and (18)F-FDG imaging was positive in 15. The diagnostic sensitivity, specificity and accuracy were 53.8%, 100% and 82.9% for the serum CA-125; 38.5%, 81.0% and 65.7% for the serum CP-2, and 100%, 90.9% and 94.3% for the (18)F-FDG imaging, respectively. The diagnostic coincidence rate between the (18)F-FDG imaging and serum CA-125 was 77.1% (Kappa = 0.50, P = 0.001), but no significant correlation was found between the (18)F-FDG imaging and serum CP-2. In the patients with true positive (18)F-FDG imaging, a positive correlation between the tumor volume and the serum CA-125 value was found (r = 0.89, P < 0.001), but no correlation was found between the tumor uptake and the serum CA-125 values.

CONCLUSIONFor the post-therapy surveillance of patients with endometrial carcinoma, serum CA-125 is a high specific tumor marker for diagnosing recurrent disease and better than CP-2, but (18)F-FDG imaging is better than CA-125, and there is a positive correlation between tumor volume and serum CA-125 value.

Adenocarcinoma ; blood ; diagnosis ; diagnostic imaging ; pathology ; Adult ; Aged ; Biomarkers, Tumor ; blood ; CA-125 Antigen ; blood ; Cystadenocarcinoma, Serous ; blood ; diagnosis ; diagnostic imaging ; pathology ; DNA-Binding Proteins ; blood ; Endometrial Neoplasms ; blood ; diagnosis ; diagnostic imaging ; pathology ; Female ; Fluorodeoxyglucose F18 ; Follow-Up Studies ; Humans ; Middle Aged ; Neoplasm Recurrence, Local ; blood ; diagnosis ; diagnostic imaging ; pathology ; Positron-Emission Tomography ; Radiopharmaceuticals ; Sensitivity and Specificity ; Transcription Factors ; blood

BACKGROUND AND OBJECTIVEEpithelial ovarian cancer involves a number of factors. Recent studies have shown that osteopontin (OPN) is related to the occurrence and development of a variety of tumors, but few studies are on ovarian cancer. B7-H4 is a newly identified tumor marker in ovarian cancer. This study explored the expression of OPN and B7-H4 and their clinical significance in epithelial ovarian tumors.

METHODSThe expression of OPN and B7-H4 in 15 cases of normal ovarian tissue, 20 of benign ovarian tumor tissue, 20 of borderline ovarian tumor tissue, and 40 of ovarian cancer tissue were detected by immunohistochemistry, and the relationship of OPN and B7-H4 expression to clinical and pathologic features of ovarian cancer was analyzed.

RESULTSThe expression of OPN and B7-H4 were significantly higher in ovarian cancer than in borderline and benign tumors (P<0.05). The positive rates of OPN and B7-H4 were significantly higher in poorly differentiated ovarian cancer than in medium and highly differentiated ovarian cancer (P<0.05), and the levels of expression were significantly lower in tissue at stages I and III of ovarian cancer than in stages III and IV (P<0.05). The positive rate of OPN associated with a higher rate of lymph node metastasis (P<0.05), but did not relate to age and histologic type. The positive rate of B7-H4 were significantly higher in ovarian serous carcinoma than in the mucinous carcinoma (P<0.05), but did not relate to age and lymph node metastasis.

CONCLUSIONThe expression of OPN and B7-H4 increased in epithelial ovarian cancer, which could be referenced in the diagnosis of ovarian malignant tumors.

Adenocarcinoma, Mucinous ; diagnosis ; metabolism ; pathology ; Adolescent ; Adult ; Aged ; Cystadenocarcinoma, Serous ; diagnosis ; metabolism ; pathology ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Staging ; Neoplasms, Glandular and Epithelial ; diagnosis ; metabolism ; pathology ; Osteopontin ; metabolism ; Ovarian Neoplasms ; diagnosis ; metabolism ; pathology ; Ovary ; metabolism ; V-Set Domain-Containing T-Cell Activation Inhibitor 1 ; metabolism ; Young Adult