Objective: To investigate the mechanism of signal transducer and activator of transcription 3 (STAT3) and cancer associated fibroblasts (CAF) jointly generate chemo-resistance in epithelial-ovarian cancer and their effect on prognosis. Methods: A total of 119 patients with high-grade ovarian serous cancer who received surgery in Cancer Hospital of Chinese Academy of Medical Sciences from September 2009 to October 2017 were collected. The clinico-pathological data and follow-up data were complete. Multivariate Cox regression model was used to analyze the prognostic factors. Ovarian cancer tissue chips of patients in our hospital were prepared. EnVision two-step method immunohistochemistry was used to detect the protein expression levels of STAT3, the specific markers of CAF activation, fibroblast activating protein (FAP), and type Ⅰ collagen (COL1A1) secreted by CAF. The relationship between the expression of STAT3, FAP, COL1A1 protein and drug resistance and prognosis of ovarian cancer patients was analyzed, and the correlation between the expression of three proteins was analyzed. These results were verified through the gene expression and prognostic information of human ovarian cancer tissues collected in the GSE26712 dataset of gene expression omnibus (GEO) database. Results: (1) Multivariate Cox regression model analysis showed that chemotherapy resistance was an independent risk factor for overall survival (OS) of ovarian cancer (P<0.001). (2) The expression levels of STAT3, FAP, and COL1A1 proteins in chemotherapy resistant patients were significantly higher than those in chemotherapy sensitive patients (all P<0.05). Patients with high expression of STAT3, FAP, and COL1A1 had significantly shorter OS than those with low expression (all P<0.05). According to the human ovarian cancer GSE26712 dataset of GEO database, patients with high expression of STAT3, FAP, and COL1A1 also showed shorter OS than patients with low expression (all P<0.05), the verification results were consistent with the detection results of ovarian cancer patients in our hospital. (3) Correlation analysis showed that the protein level of STAT3 was positively correlated with FAP and COL1A1 in our hospital's ovarian cancer tissue chips (r=0.47, P<0.001; r=0.30, P=0.006), the analysis of GEO database GSE26712 dataset showed that the expression of STAT3 gene and FAP, COL1A1 gene were also significantly positively correlated (r=0.31, P<0.001; r=0.52, P<0.001). Conclusion: STAT3 and CAF could promote chemotherapy resistance of ovarian cancer and lead to poor prognosis.
Female ; Humans ; Cancer-Associated Fibroblasts/pathology* ; Carcinoma, Ovarian Epithelial ; Ovarian Neoplasms/pathology* ; Prognosis ; STAT3 Transcription Factor/metabolism* ; Drug Resistance, Neoplasm

BACKGROUND: Epithelial ovarian cancer remains to be the leading cause of death from gynecologic malignancy. Survival is influenced primarily by FIGO stage amount of residual disease and histologic type. Unfortunately, such prognostic factors still fail to account fully for the biologic behavior of ovarian carcinomas. It is of interest therefore to identify new prognostic factors which are more objective, quantifiable and reproducible. DNA ploidy has been shown to be an independent prognostic factor in epithelial ovarian malignancies.
OBJECTIVE: The general objective of the study was to determine the ploidy characteristics of epithelial tumors of ovary. The specific objectives were to determine the association of age and aneuploidy, the association of tumor size and aneuploidy and the association of stage and aneuploidy.
METHODS: Patients who underwent surgical staging and/or tumor debulking for ovarian cancer with final histopathologic results of epithelial ovarian carcinoma were included in the study. Exclusion criteria included previous treatment with chemotheraphy or radiotherapy and previous or concomitant malignant diseases. DNA ploidy was determined using flow cytometry of paraffin embedded blocks.
RESULTS: DNA ploidy was obtained in 109 paraffin-embedded blocks of epithelial cancers of the ovary. Aneuploidy was establish in 14 of the total 109 samples (12.8%) as follows: 2 from 24 mucinous cystadenocarcinoma (14.2%), 2 from 24 mucinous tumor of low malignant potential (14.2%), 5 from 29 serious cystadenocarcinoma (17%), 5 from 30 endometriod carcinoma (16%).
CONCLUSION: The prevalence of aneuploidy in epithelial ovarian cancer is 12.8% and aneuploidy is higher for serous adecarcinoma and endometriod adenocarcinoma compared to mucinous tumors of low malignant potential and mucinous cystadenocarcinoma.

Human ; Ovarian Epithelial Cancer ; Cystadenocarcinoma, Mucinous ; Flow Cytometry ; Ovarian Neoplasms ; Cystadenocarcinoma ; Adenocarcinoma ; Ploidies ; Aneuploidy

Collision tumors represent the coexistence of two or three adjacent but histologically distinct tumors, without histoiogic admixture in an organ. Collision tumors have been reported in various organs, but are rarely seen in the ovaries. Reported cases consisted of a benign mature ovarian teratoma and an ovarian cystadenoma or cystadenocarcinoma. Primary carcinoid tumors of the ovary, on the other hand, are uncommon, with a reported incidence of 0.3%. They are usually unilateral and are found in association with mature cystic teratoma, forming a solid nodule within it. Primary ovarian carcinoids rarely metastasize and are treated as ovarian tumors with low malignant potential. This is a rare case of a triple collision tumor of the ovary in a 63 year old multigravid who complained of a gradually enlarging abdominal mass. Total abdominal hysterectomy with bilateral salpingo oophorectomy and complete surgical staging was performed. Histopathology revealed coexistence of a mucinous tumor of low malignant potential, trabeculartype carcinoid tumor, and mature cystic teratoma in the right ovary. The possibility of the occurrence of such collision tumors must always be kept in mind intraoperatively and during pathologic examination to avoid misdiagnosis of these cases.

Human ; Female ; Middle Aged ; Diagnostic Errors ; Incidence ; Salpingo-oophorectomy ; Ovarian Germ Cell Cancer ; Ovarian Neoplasms ; Neoplasms, Glandular And Epithelial ; Teratoma ; Carcinoid Tumor ; Cystadenocarcinoma ; Cystadenoma ; Hysterectomy