Ovarian carcinomas and borderline ovarian tumors : - molecular markersand operative treatment
Appears in the following Collection
AbstractThe majority of women with ovarian cancer are diagnosed with metastasis. At present there is no satisfactory screening test available for the general population. Women with borderline ovarian tumors (BOT) are more often diagnosed at early stage of disease and are more often younger than women with invasive ovarian cancer. In this thesis, short-term outcome after two different surgical approaches (laparoscopy and laparotomy) for BOT was evaluated. Laparoscopy has its advantages and is as safe as laparotomy for smaller tumors.
There is a need for more knowledge of the molecular events that lead to development of ovarian cancer in order to improve its diagnosis and treatment. Ovarian cancer tissues were analyzed for the expression of the transcription factor AP-2γ and the tyrosine kinase receptor p-TrkA. The thesis shows that protein upregulation of AP-2γ and activation of p-TrkA are late events in tumor progression, and are most frequently seen when the tumor has become metastatic. Therefore, these factors cannot be used as early tumor markers in ovarian cancer tissue, but TrkA could possibly be involved in targeted ovarian cancer therapy in the future.
Also, 200 women with ovarian tumors scheduled for adnexal surgery have participated in a prospective biobank study in the Ph.d. thesis. The inflammation marker calprotectin and the angiogenic protein endoglin (sEng, soluble endoglin) were measured in plasma from these women. Calprotectin was elevated in women with ovarian cancer as compared to women without cancer, whereas no difference was found for sEng. Although calprotectin was slightly inferior to the currently used ovarian cancer marker CA125 in differentiating between women with cancer and benign adnexal tumors, there is a possibility that calprotectin could be used in a panel of multiple protein biomarkers in the future to improve detection of ovarian cancer.
LIST OF PAPERS
Paper I: Elin Ødegaard, Anne Cathrine Staff, Anton Langbrekke, Vibeke Engh, Mathias Onsrud. Surgery of borderline tumors of the ovary: retrospective comparison of short-term outcome after laparoscopy or laparotomy. Acta Obstetricia et Gynecologica 2007;86;620-626. Artikkel
Paper II: Elin Ødegaard, Anne Cathrine Staff, Janne Kærn, Vivi Ann Flørenes, Juri Kopolovic, Claes G. Tropé, Vera M. Abeler, Reuven Reich, Ben Davidson. The AP-2γ transcription factor is upregulated in advanced-stage ovarian carcinoma. Gynecologic Oncology 2006;100:462-468. Artikkel
Paper III: Elin Ødegaard, Anne Cathrine Staff, Vera M. Abeler, Juri Kopolovic, Mathias Onsrud, Philip Lazarovici, Ben Davidson. The activated nerve growth factor receptor p-TrkA is selectively expressed in advanced-stage ovarian carcinoma. Human Pathology 2007;38:140-146. Artikkel
Paper IV: Elin Ødegaard, Ben Davidson, Bente Vilming Elgaaen, Magne K. Fagerhol, Vibeke Engh, Mathias Onsrud, Anne Cathrine Staff. Circulating calprotectin in ovarian carcinomas and borderline tumors of the ovary. Am J Obstet Gynecol. 2008 198(4):418.e1-7. Artikkel
Paper V: Elin Ødegaard, Ben Davidson, Vibeke Engh, Mathias Onsrud, Anne Cathrine Staff. Assessment of endoglin and calprotectin as potential biomarkers in ovarian carcinoma and borderline tumors of the ovary. American Journal of Obstetrics and Gynecology, accepted for publication December 2007.