Гранулезно-клеточные опухоли (ГКО), несмотря на свою индолентную природу, обладают высокой рецидивностью и связанной с ней смертностью. Таким образом, задача современной лабораторной диагностики по своевременному выявлению ГКО до сих пор не решена, что негативно сказывается на дальнейшей тактике лечения и прогноза. Цель: Обзор данных современной литературы диагностики гранулезных клеточных опухолей яичников. Материал и методы: Статьи, взятые из Scopus, Web of Science, Pubmed. В обзор включены только статьи на английском языке за последние пять лет и только по ГКО. Результаты: Золотой стандарт современной лабораторной диагностики ГКО это - иммуногистохимические исследования, а также жидкостная биопсия (циркулирующие опухолевые клетки и циркулирующие ДНК, исследуемые в основном посредством полимеразной цепной реакцией и секвенированием следующего поколения), молекулярно-генетический анализ FOXL2 C.402>G (C134 W) выступают в роли необходимого дополнения. Все эти методы в основном нацелены на определения риска рецидивирования ГКО взрослого типа (ГКОВТ). Обсуждение. Несмотря на сохраняющуюся актуальность улучшения эффективности лечения ГКО, в диагностике ГКО расставлены приоритетные направления, среди которых важнейшая это – определения риска рецидивирования ГКОВТ, а именно на молекулярно-генетическом уровне это – определение FOXL2 C.402>G (C134 W). А альтернативные методы в виде жидкостной биопсии (циркулирующих опухолевых клеток и циркулирующих ДНК) и молекулярно-генетический анализа имеют важное теоретико-практическое значение для своевременной диагностики ГКО. Выводы: В диагностике ГКО важнейшая задача это выявление пациентов с высоким риском рецидивирования ГКОВТ, которая до сих пор не решена. Золотой стандарт современной диагностики ГКО это – имунногистохимическое исследование, а другие методы такие как, жидкостная биопсия (циркулирующие опухолевые клетки (ЦОК) и циркулирующие ДНК (цДНК)), молекулярно-генетический анализ FOXL2 C.402>G (C134 W) выступают в роли необходимого дополнения. Необходимо продолжать проводить новаторские исследования в вопросах улучшения качества диагностики ГКО. Это должно положительно сказаться на дальнейшей тактике лечения и прогнозирования пациентов с вГКО.
Introduction . Despite that ovarian carcinosarcoma (OCS) is an extremely rare disease, it is of great medical and social importance by taking into account very high level of overall mortality, recurrence, metastasis, and economic costs. Aim : to summarize current data on various aspects of OCS. Materials and Methods . The search strategy for English written papers published in databases PubMed/MEDLINE, Scopus, Web of Science, Google Scholar was based on the following keyword queries: «ovarian carcinosarcoma», «etiology and pathogenesis», «epidemiology», «classification», «clinical picture», «diagnosis», «treatment». The search depth was limited within the years 2010–2022, by prioritizing the search depth within the last 5 years (2017–2022). Results . We found 48 articles in English, published from 2016 to 2022, of which 47 (97.9 %) articles were published within the last 5 years. Scientific data are represented by studies with a small patient sample and with low evidence base. The results of the analysis for identified publications showed a limited, fragmented and inconsistent scientific data both in terms of etiology, pathogenesis and treatment, as well as an impact of OCS stages, age and other risk factors on the likelihood of relapses. Conclusion . The lack of extensive clinical studies along with observed substantial number of controversial issues may be accounted for by OCS low prevalence and complex pathogenesis. Nevertheless, the results obtained during the generalization of scientific knowledge provide a realistic insight into the current state of global science about this medical and social disease and may be used to improve the diagnostics and treatment of OCS patients.
Objective: identification and description of clinical and morphological characteristics of rare forms of stromal cell tumors of the ovaries.Materials and methods. Retrospectively processed over 10 thousand case histories of patients with various ovarian tumors who were examined and treated at the N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia and the National Center for Oncology and Hematology of the Ministry of Health of Kyrgyz Republic. In 473 patients were diagnosed stromal cell tumors, among them 3 cases of rare forms of tumors of the stroma of the sex cord were identified: stromal tumor from Sertoli cells, malignant luteoma of the ovary, lipid‑cell tumor from Leydig cells. All patients underwent a planned morphological study of surgical material and immune-histochemical study.Results. The detailed data of clinical observations of rare types of tumors, which was presented in the literature by isolated cases, are presented, the description of which in the literature is presented by isolated cases. The possible effect of clinical and morphological characteristics on the survival of patients with rare forms of stromal cell tumors of the ovaries were analyzed.Conclusions. The necrobiotic changes in the tumor, the degree of malignancy, and the stage of the disease are potential predictors of poor prognosis in patients with rare forms stromal cell tumors of the ovaries which require confirmation in a larger sample of patients.
Ovarian stromal cell tumors are a rare group of neoplasms that characterized by an ambiguous prognosis and biological activity associated with the hypersecretion of a number of substances. The review presents the latest data on the biochemical diagnosis of tumors of the stroma of sex cord, including granulosa cell tumor of the ovary. The importance of hormones,
Aim: to identify clinical and histologic features of pure stromal ovarian tumors.Materials and methods. We analyzed the clinical data from patients treated and followed up at the Blokhin National Medical Research Center of Oncology and the National Center of Oncology and Hematology of the Kyrgyz Republic.Results. Data on necrobiotic changes, malignancy, stages of the disease and the survival of 14 patients with pure stromal ovarian tumors have been obtained.Conclusion. The main factors of unfavorable prognosis in patients with ovarian tecoma are tumor necrosis, degree of malignancy and mitotic activity.
Background. Tumors of stroma of the sex cord include a family of tumors that are diverse in structure and biological characteristics, including hormone-active ovarian tumors, such as granulosa cell tumor (GCT) of the ovary and a tumor from Sertoli–Leydig cells. For these types of tumors, of particular importance is the analysis of biochemical markers, among which the most promising is inhibin B.The objective of the study. Comparative analysis of inhibin B levels in the blood serum of patients with stromal cell tumors and other types malignancies.Materials and methods. 64 patients with primary ovarian tumors were examined: 31 – GCT of the ovary, 16 – tumors from Sertoli–Leydig cells, 17 – adenocarcinomas. Comparison group – 20 patients with malignant tumors of other localizations, control – 74 healthy women and 37 patients with benign ovarian tumors. Inhibin B was determined in blood serum using the standardized Inhibin B Gen II ELISA (Beckman Coulter, USA) immunoassay.Results. The analysis of inhibin B levels in last days of the luteal phase, show an increase of marker level in patients with GCT and tumors from Sertoli–Leydig cells, while in ovarian adenocarcinomas and malignant tumors of other locations inhibin B secretion doesn’t differ from the control. The sensitivity of inhibin B in diagnostics of GCT was 93.5 %, in tumor from Sertoli–Leydig cells – 81.3 % with specificity – 100 %.Conclusion. Inhibin B is an effective biomarker of GCT and ovarian tumors from Sertoli–Leydig cells, which results must be interpreted according the functional state of the ovaries.
Background. Tumors of stroma of the sex cord include a family of tumors that are diverse in structure and biological characteristics, including hormone-active ovarian tumors, such as granulosa cell tumor (GCT) of the ovary and a tumor from Sertoli–Leydig cells. For these types of tumors, of particular importance is the analysis of biochemical markers, among which the most promising is inhibin B. The objective of the study. Comparative analysis of inhibin B levels in the blood serum of patients with stromal cell tumors and other types malignancies. Materials and methods. 64 patients with primary ovarian tumors were examined: 31 – GCT of the ovary, 16 – tumors from Sertoli–Leydig cells, 17 – adenocarcinomas. Comparison group – 20 patients with malignant tumors of other localizations, control – 74 healthy women and 37 patients with benign ovarian tumors. Inhibin B was determined in blood serum using the standardized Inhibin B Gen II ELISA (Beckman Coulter, USA) immunoassay. Results. The analysis of inhibin B levels in last days of the luteal phase, show an increase of marker level in patients with GCT and tumors from Sertoli–Leydig cells, while in ovarian adenocarcinomas and malignant tumors of other locations inhibin B secretion doesn’t differ from the control. The sensitivity of inhibin B in diagnostics of GCT was 93.5 %, in tumor from Sertoli–Leydig cells – 81.3 % with specificity – 100 %. Conclusion. Inhibin B is an effective biomarker of GCT and ovarian tumors from Sertoli–Leydig cells, which results must be interpreted according the functional state of the ovaries.
Aim: to identify clinical and histological criteria for sex cord ovarian stromal tumors (OSTs).Materials and Methods. The retrospective non-comparative study was based on the main inclusion such as histologically verified sex cord OSTs. A standard examination algorithm was analyzed (ultrasound, blood tests, CT or MRI of the abdominal and pelvic organs). All clinical data were obtained from patients treated and monitored in clinical units at the Blokhin National Medical Research Center of Oncology and the National Center of Oncology and Hematology of the Kyrgyz Republic.Results. Data were obtained on the frequency of necrobiotic changes, malignancy, disease stages and their impact on survival in 456 patients. The 10-year survival rate for OSTs patients with vs. without intra-tumor necrobiotic changes was significantly lower (17.2 % and 78.1 %, respectively).Conclusion. The main factors of unfavorable prognosis in patients with granulosa cell ovarian tumors were disease stage and intra-tumor necrobiotic changes.