The prognostic value of image analysis in ovarian cancer

Article Abstract:

In recent years, there has been an increase in research interest in the use of automated cytometry (a method of measuring and counting cells, which can also be used to determine the DNA content of tumor cells) in the examination of tumor specimens for prognostic clues. Many researchers have employed flow cytometry, in which dissociated cells or cell nuclei are trickled past a laser beam and individually quantified. While this technique has been instrumental in establishing that cellular DNA content is a significant prognostic factor, the method is essentially statistical, and single cells cannot be individually scrutinized. Furthermore, mixtures of normal and cancerous cells cannot be resolved, and especially uncommon cell types cannot be distinguished. These problems may be circumvented with the use of image analysis. Image analysis usually employs a sensitive video camera and image analysis software on a small computer. Since the video camera may be used to examine the same piece of tissue examined by the pathologist, the quantitative information obtained by the video image analysis complements the observations of the pathologist. Cells such as inflammatory cells are contaminants for flow cytometry, but may be taken into account in image analysis. The authors have used image analysis to examine 42 cases of epithelial ovarian cancer. Several parameters were correlated with traditional tumor grade as determined by a pathologist. High grade cancers (cancers with a low degree of differentiation and high malignant potential) were found to have greater average nuclear areas than that of lower grade tumors. Higher grade tumors were also found to have a greater number of hyperploid cells (cells with abnormally high numbers of chromosomes). When specimens were stained using the Feulgen technique, which stains DNA, the average number of nuclei with high DNA content was correlated with poorer survival. The authors emphasize that the methods of image analysis cannot replace the pathologist, but can provide useful supplementary data. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Prognosis, Cytodiagnosis

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Ovarian metastases of breast carcinoma: a clinicopathologic study of 59 cases

Article Abstract:

Among U.S. women in 1988, cancer of the breast was the leading form of cancer and the second leading cause of cancer-related death. A primary breast cancer is capable of spreading (metastasis) to the ovaries and causing the development of secondary malignant tumors. Secondary ovarian cancers represent between six and 28 percent of all ovarian malignant tumors. Research has indicated that cancer of the breast is the origin of 38 percent of secondary ovarian cancer and is ranked as the leading source of cancer that has spread to the ovaries. Studies indicate that Stage II cancer of the breast may metastasize to the ovaries within about 24 months. For all stages of breast cancer reviewed (Stages II through IV) metastasis of cancer from the breast to the ovaries usually takes 11.5 months. Ovarian cancer is a possible indicator of an advanced metastasis and the prognosis in these cases is poor, with patients less than 50 years of age having the most favorable survival rates. Thirty-one percent of ovarian cancer sites are small, less than one millimeter in diameter, making early detection difficult. Furthermore, many patients with ovarian cancer in its early stages appear to have normal, disease-free, ovaries; unusual vascular formation in and around the ovaries may be a helpful indicator of ovarian cancer in its early stages. The researchers conclude that breast cancer represents the major primary site responsible for secondary ovarian metastases, and that the interval between the diagnosis of breast cancer and the spread of the cancer to the ovaries is related to the initial stage of the breast cancer.

Research

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Inflammatory symptoms in breast cancer: correlations with growth rate, clinicopathologic variables, and evolution

Article Abstract:

Inflammatory breast cancer (IBC) includes a number of diseases which can be subdivided into three categories, depending on the growth rate of the tumor. The groups include: fast-growing tumors with a doubling time of less than 90 days; intermediate cases with a doubling time between 90 and 180 days; and slow-growing tumors with a doubling time greater than 180 days. Correlations were made between doubling times and various clinical and pathologic variables in 75 patients with IBC. Younger patients' tumors were more often rapidly growing. Fifty-seven percent of the fast growing tumors were from women under 40 years old. This coincides with increased severity of cancer in younger patients. When the tissues were examined, the fast growing tumors generally had a more severe pathology. Symptoms of inflammation were not associated with the doubling time, but were related to the size of the tumor and the involvement of regional lymph nodes. The time of the appearance of metastases was correlated with doubling time. Metastases were seen earlier in fast growing tumors with shorter doubling times. The doubling time of a tumor can be used as a value when assessing possible treatments and in the prognosis of a patient with breast cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Analysis, Case studies, Inflammation, Pathology

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