Objective To analyze the characteristics of hepatic metastasis of pure immature ovarian teratoma and explore its proper diagnosis and *** Eighteen cases of hepatic metastasis of pure immature ovarian teratoma were inc...
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Objective To analyze the characteristics of hepatic metastasis of pure immature ovarian teratoma and explore its proper diagnosis and *** Eighteen cases of hepatic metastasis of pure immature ovarian teratoma were included in this study. The clinical stage, operation, chemotherapy and histopathology of primary and secondary tumors as well as the data from long term follow-ups were analyzed retrospectively,Results All of the hepatic metastatic tumors were located on the surface of the liver. 61.1% (11/18) of them were clinical stage Ⅲ and 44.4% (8/18) were grade 1 at first operation. The hepatic metastatic rate was 16.7% (3/18) in the standard adjuvant chemotherapy group but increased markedly to 31.2% (15/48) in the irregular chemotherapy group. Auxiliary diagnostic methods could not indicate the correct results. The surgical resection rate of hepatic metastasis of pure immature ovarian teratoma was 94.4% (17/18). There were less complications in the group with tumor diameter less than 15 cm. The follow-up time ranged from 3 to 205 months with a mean of 20.9 months. The 3-year-survival rate was 77.8% (14/ 18), and mortality rate was 22.2%. The 5- and 10-year-survival rate was 55.6% (10/18) and 38.9% (7/18), respectively. The rate of loss in follow-up was 22.2% (4/18) and 38.9% (7/18), respectively, and one patient has survived for more than 17 *** The hepatic metastatic rate of pure immature ovarian teratoma could be decreased using standard adjuvant chemotherapy. Suitable surgical treatment could reduce complications and improve the prognosis for patients.
目的构建能自我激活的活性半胱氨酸天冬氨酸蛋白酶(caspase)3分子,并探讨其对卵巢上皮性癌(卵巢癌)细胞的致凋亡作用。方法利用基因重组技术构建活性 caspase-3分子——rev-caspase-3及其重组腺病毒——Ad-rev-casp3;应用免疫组化方法、细胞计数试剂盒8、流式细胞仪和蛋白印迹法分别检测 rev-caspase-3作用后卵巢癌细胞系 AO 细胞中活性 caspae-3蛋白的表达情况、细胞存活率、凋亡率、细胞周期、caspase-3活性亚单位 p17和聚(腺苷二磷酸-核糖)多聚酶(PARP)的分解产物 p85的表达水平,应用透射电镜观察 rev-caspase-3作用后细胞的超微结构,实时 PCR 技术检测细胞中凋亡相关基因的表达情况;建立卵巢癌裸鼠皮下及腹腔移植瘤模型,观测 rev-caspase-3作用后裸鼠生存情况及肿瘤体积的变化。结果 Ad-rev-casp3作用后的 AO 细胞中显著表达活性 caspase-3蛋白,细胞质明显棕染;细胞中活性 caspase-3亚单位 p17和 PARP 裂解片段 p85的表达水平升高。Ad-rev-casp3以感染复数(MOI)为70作用后的 AO 细胞存活率为30.3%,凋亡率为40.2%。Ad-rev-casp3以 MOI=10作用后的细胞凋亡率只为3.4%,但此时 S 期细胞比例高达56.5%,G_1期比例下降至9.8%,与未感染 Ad-rev-casp3(MOI=0)的 AO 细胞的 S 期和 G_1期比例显著不同(P 均<0.05)。Ad-rev-casp3作用后的 AO 细胞呈现显著的凋亡形态改变,电镜下见明显的凋亡小体形成;细胞中活性 caspase-3基因的表达水平显著升高,为9.44。Ad-rev-casp3能显著延长荷瘤裸鼠的生存期,平均生存时间为(213±16)d,并显著抑制移植瘤的生长,在第1次注射后53 d 时抑瘤率为70%。结论表达 rev-caspase-3的重组腺病毒载体对卵巢癌细胞有强烈的致凋亡作用,并可显著延长荷瘤裸鼠的生存期,抑制肿瘤生长。
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