Global Mirna Expression Profiling And Prognostic Analysis Of Ovarian Clear Cell Carcinoma Arising From Endometriosis

PART1 Global miRNA expression profiling of ovarian clear cell carcinoma arising from endometriosisOBJECTIVE:In this research,we try to use microarray gene chip technology to find the differently expressed miRNA between eutopic endometrium,endometriosis,atypical endometriosis,ovarian clear cell carcinoma(OCCC),and control groups.METHODS:We used microarray gene chip technology measured formalin-fixed paraff in-embedded(FFPE)of 4 patients who were demonstrated as ovarian clear cell carcinoma arising from endometriosis and their compares.Then find the differently expressed genes,then put them into GO-enrichment Analysis,Pathway-enrichment Analysis,miRNA-Gene-Network,miRNA-pathway-Network.Then choose the key miRNAs to test and verify in 6 patients using RT-PCR.RESULT:From eutopic endometrium,endometriosis,atypical endometriosis to ovarian clear cell carcinoma,miRNA-199b-5p shows a trend of progressively diminishing,while miRNA-200a-3p and miRNA-200b-3p shows a biphasic trend,descending in endometriosis and atypical endometriosis and then ascending in ovarian clear cell carcinoma.We also compared OCCC arising from endometriosis,endometriosis associated OCCC but not arising from endometriosis and OCCC without endometriosis.The latter two groups have similar expression of miR-20a-5p,miR-93-5p,miR-203a and miR-328,and both of them are lower than the first group.CONCLUSION:MiR-199b-5p,miR-200a-3p,miR-200b-3p,miR-20a-5p,miR-20b-5p,miR-106a-5p,miR-93-5p,miR-203a?miR-328 may play an important role in studing OCCC arising from endometriosis?PART2.Clinical and pathological characteristics and prognostic analysis of ovarian clear cell carcinoma(OCCC)OBJECTIVE:To summarize the clinical and pathologic characteristics of ovarian clear cell carcinoma(OCCC)and investigate the prognostic value of endometriosis.METHODS:The medical records of patients diagnosed with OCCC who had undergone complete staging surgery between 2000 to 2016 were retrospectively reviewed.All pathology reports were reviewed.RESULT:A total of 264 patients were included in this study and 84(31.8%)of them who had coexisting endometriosis was defined as endometriosis associated ovarian cancer(EAOC).We devided them into two subgroups:patients with tumors arising in endometriosis according to Sampson and Scott criteria(n=42,50%),and patients with endometriosis found in ovary or peritoneum but not meet Sampson and Scott criteria(n=42,50%).Patients with concurrent endometriosis were approximately 5 years younger,more likely to be diagnosed before menopausal,more likely to have an early stage and have higher chance to have optimal cytoreductivesurgery.The univariate survival analysis showed that concurrent endometriosis was a significant prognostic factor for both overall survival(OS)and Disease free survival(DFS),but in the multivariate analysis,independent prognostic factors of both OS and DFS are FIGO stage,residual tumor size and LVSI.CONCLUSION:Comparing with OCCC without concurrent endometriosis,EAOC patients showed distinct clinical and pathological features.Independent prognostic factors of both OS and DFS are FIGO stage,residual tumor size and LVSI,concurrent endometriosis isn't an independent prognostic factor for OS or DFS in the multivariate analysis.PART3.Ovarian teratoma associated with anti-NMDA-receptor encephalitis:a clinical case series.OBJECTIVE:To summarize the clinical features of patients with ovarian teratoma and anti-N-methyl-D-aspartate receptor(NMDAR)encephalitis.METHODS:The clinical information of 21 female patients with ovarian teratoma and anti-NMDAR encephalitis in Peking Union Medical College Hospital and Beijing Tiantan Hospital from Jun 2011 to Oct 2016 were retrospectively summerized.RESULT:The respiratory prodromes were observed in 13 patients before the onset of psychiatric symptoms.Patients always presented with psychosis,seizures and bizarre dyskinesia.Antibodies to NMDAR in serum and cerebrospinal fluid(CSF)were both positive in 19 patients,1 patient only had positive anti-NMDAR antibody in CSF,and 1 patient had negative anti-NMDAR antibody in both serum and CSF.The average diameter of ovarian teratoma is 4 cm.Two patient had bilateral tumor and one patient had immature teratoma grade I.The psychiatric symptoms were dramatically relieved by tumor resection and immunotherapy in most patients.Three patients had symptomatic or tumor recurrence during follow-up and no patient died.CONCLUSION:Ovarian teratoma with anti-NMDAR encephalitis always presents with psychiatric symptoms which could be misdiagnosed as psychiatric diseases,viral encephalitis or seizure.Patients respond to tumor resection and immunotherapy well.