| Review Diagnosis And Therapy Of Lymph Node Metastasis In Ovarian Epithelial Cancer(EOC)Lymph node metastasis is one of the common ways of metastasis in epithelial ovarian cancer(EOC).Diagnosis and therapy of lymph node metastasis in EOC are still a debate,which has been a hot topic in academic circles.Surgery is one of important therapies for lymph node metastasis in EOC.Although most scholars support that systematic lymphadenectomy is an important method to diagnosis and therapy of lymph node metastasis in EOC.However,concernd the complication risk of systematic lymphadenectomy caused by surgery,whether all patients with EOC should underwent systematic lymphadenectomy still controversial.This Chapter aim to report the agreement and controversy about diagnosis and therapy to lymph node metastasis in EOC,according to groups of reports about the bulk of cases.Chapter 1 Prognostic Factors Of Ovarian Epithelial Carcinoma In Stage IIIObjective: To study the factors that influencing the prognosis and discuss the difference of prognosis between the two different transfer status in stageⅢ epithelial ovrian cancer.Methods: 117 patients with stageⅢ Epithelial ovarian cancer treated in Department of Gynecologic oncology,Affiliated Tumer Hospital of Guangxi Medical University from 2006 to 2015 were retrospectively analyzed.It was used to calculate survival rate and draw survival curves by Life Tables,compare the survival time of different levels of every factor by Kaplan-Meierand.Finally,a Cox Regression was used for multi-variate analysis.Results: 117 patients with stageⅢ epithelial ovarian cancer,the3-year,5-year OS were 43.5%,34.7%respectively.The median survival time was 31 months.Cox Regression regression analysis was performed on factors such as age,surgical satisfaction,pathological type,degree of differentiation,lymph node dissection,lymph node metastasis,preoperative CA125,and ascites cancer cells.Conclusion: In this study,lymph node metastasis is an independent prognostic factor in patients with epithelial ovarian cancer.Chapter 2 A Meta Analysis Of Prognosis Of Lymph Node Metastasis In Figo III-Ⅳ Epithelial Ovarian CancerObjective: To evaluate systematic lymphadenectomy will improve OS(overall survival)of ovarian cancer patients.Methods:We retrieval PUBMED database,MEDLINE database,EMBAS database,Cochrane Library,WANFANG database,CNKI and CBM in the Internet.The literature search was limited to the period of January,1995,through December,2019.The language was restricted to English and Chinese.We selected EOC patients who had undergone staging surgery and systematic lymphadenectomy(Experimental group),and EOC patients who had not undergone lymph node resection(Control group).The collected articles were evaluated according to the inclusion criteria and exclusion criteria.Result: We analyzed 15 studies with Review Manager5.0.Overall,systemic lymphadenectomy can improve the total 5 year OS(RR:0.72;95%CI=0.61-0.85)in advanced ovarian cancer,but the RCTs does not support this conclusion.Conclusions: Systemic lymphadenectomy may improve the total 5 year os in advanced epithelial ovarian cancer.Systemic lymphadenectomy does not improve the 5 years OS in patients who undergone optimal debulking.However,mostly included studies are non randomized controlled trials,and there may be many bias.The role of systemic lymphectomy for OS in EOC require further explored.Chapter 3 The Genomics Study Of Lymph Node Metastasis In Epithelial Ovarian CancerObjective: to screen out lymph node metastasis related genes and their coding proteins in epithelial ovarian cancer and to predict their signaling pathways.Methods: ovarian cancer tissue and positive lymphoid tissue of 3 patients with epithelial ovarian cancer confirmed by pathological diagnosis of lymph node metastasis and 3 cases of epithelial ovarian cancer patients without lymph node metastases were selected,and 163 up-regulated genes were screened by comparative method,while 729 genes down-regulated.Excavating related signal pathways through several online tools.Results: 163 up-regulated genes and 729 down-regulated genes were screened out.The pathways involved are as follows: Integrin signaling pathway,Inflammation mediated by chemokine and cytokine signaling pathway,PDGF signaling pathway.The genes that overlap in these pathways are excavated,and the genes that may participate in the lymph node metastasis of ovarian epithelial cancer are MMP2,COL1A1,CAT,FGF18,PDGFβ,and PDGFRβ.Conclusion: the metastasis mechanism of epithelial ovarian cancer may involve many different pathways and genes.Genes such as MMP2,COL1A1,CAT,FGF18,PDGFβand PDGFRβmay play a key role in this study.Further studies will validate the gene.Chapter 4 Gene Expression In Tissue And Lymph Node Of Epithelial Ovarian CancerObjective: To verify the expression of these gene(MMP2?FGF18?COL1A1?COL6A1?PDGFβ)in primary ovarian epithelial cancer and lymph nodesMethods: 46 cases of epithelial ovarian cancer with lymph node metastasis confirmed by pathology,and 47 cases of epithelial ovarian cancer without lymph node metastasis were selected.Tissue microarray was made and the expression of these gene(MMP2?FGF18 ?COL1A1?COL6A1?PDGFβ)in different tissues was detected by immunohistochemical staining.Results: The positive expression rate of MMP2?COL6A1 were 72.04%?49.46% in epithelial ovarian cancer and 73.12%?44.08% in lymph nodes.The positive expression rate were 59.65%?30.70% in non-metastatic lymph nodes and 93.05%?50.00% in metastatic lymph nodes.The expression rate of metastatic lymph node tissue were significantly higher than that of non-metastatic lymph node tissue.The sensitivity,specificity,positive predictive value and negative predictive value of MMP2 combinated COL6A1 were 88.89%,52.63%,51.61% and 87.1% respectively.Conclusion: The expression of MMP2 and COL6A1 gene has no effect on the prognosis of patients with ovarian cancer,but MMP2?COL6A1 are involved in the occurrence and development of lymph node metastasis in epithelial ovarian cancer.There are potential genes,which could be evaluated the metastatic lymph of epithelial ovarian cancer. |
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