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Title: The usage of sHLA-G blood serum concentration levels in patients with ovarian cancer and endometriosis in peritoneal cavity
Abstract:
Ovarian cancer in the early stages of development does not cause symptoms, so at the time of diagnosis, most patients are in III or stage IV according to FIGO, with a low 5-years' survival. Endometriosis is a very common disease, characterized by the lack of effective treatments and an increased risk of developing ovarian cancer. The study of cancer immunology, hypotheses reduced the effectiveness of the immune system in endometrial ectopia endometriosis and predisposed to ovarian cancer, suggest that underlying these diseases may be a phenomenon of escape from immune surveillance of cancer. Ovarian cancer and endometriosis have demonstrated the ability to regulate the activity of the immune system. HLA-G is a non-classical histocompatibility antigen, which inhibits the immune system. It is also found in soluble form in serum. It has been shown to increase expression of HLA-G together with the progression of cancer, but there is a lack of clinical applications of HLA-G, and no data about the serum concentration of HLA-G in patients operated on. Increased expression of HLA-G has been demonstrated in ectopic endometrium in the peritoneal fluid of women with endometriosis. There is no evidence of the sHLA-G in endometriosis located in the peritoneal cavity. Aim of this study was to assess the levels of sHLA-G in the serum of women surgically treated for deep endometriosis ; , ovarian endometriosis, ovarian cancer, endometriosis in different phases of the menstrual cycle and different clinical advancement according to rAFS, ovarian cancer before and after surgical cytoreduction, depending on the clinical stage according to FIGO, the type and histological differentiation, presence of ascites. sHLA-G were compared in the serum of women with ovarian cancer, endometriosis and ovarian deep and the reference group, taking into account the phases of the menstrual cycle. There were investigated sHLA-G concentration in serum of 146 women, including 56 surgically treated for endometriosis in the peritoneal cavity, including 32 cases of ovarian endometriosis, deep endometriosis in 24 cases, and in 50 women operated for ovarian cancer. Reference group of 40 women surgically treated for infertility (n = 21) and pelvic organ prolapse disorders (n = 19). Group of patients with endometriosis and a reference group were divided into subgroups depending on the phases of the menstrual cycle. Cycle phase was determined by: measuring the serum concentration of estradiol, progesterone and follicle stimulating hormone (FSH), knowing the date of last menstrual period, the average length of menstrual cycle and the result of ultrasound examination of ovaries and endometrium, in women after hysterectomy on the basis of histopathological examination of the endometrium. ; Group with endometriosis were divided according to the severity of the disease by rAFS, location and symptoms. The ovarian cancer group was divided according to the clinical stage by FIGO, histological type and stage, presence of ascites. Excluded: women using contraception, hormone therapy, other gynecological diseases, the presence of inflammation associated with systemic diseases, diabetes, thyroid disease. The concentration of sHLA-G in serum were measured by ELISA (ExBio, Czech Republic). In 98% of women with endometriosis sHLA-G was detected in serum. It has been shown statistically significant difference between I and IV of the severity of endometriosis by rAFS, concentrations increased with increasing sophistication. sHLA-G levels were at a similar level, taking into account the symptoms of endometriosis. Not shown a correlation between sHLA-G in serum and the age of the patients. It was found higher sHLA-G in women: with deep endometriosis the endometrial cysts, with deep endometriosis in the secretory phase of the proliferative phase, secretory phase in deep endometriosis compared to cysts. In 94% of patients with ovarian cancer sHLA-G was present in serum. It was shown the significantly higher levels of sHLA-G in FIGO stages III and IV than in I and II. There were no significant differences depending on the differentiation and histological type, presence o ; f ascites. It was not shown a correlation between serum sHLA-G and CA-125 serum. It was shown the significantly higher levels of sHLA-G prior to surgery as compared to the concentration after the treatment. ROC curve showed the diagnostic usefulness of measuring sHLA-G in serum of patients with endometriosis and ovarian cancer, especially advanced. The lowest concentration of sHLA-G was observed in the control group of women in the menopausal stage, while the highest in deep endometriosis in the secretory phase and in ovarian cancer. The conclusions of the study: 1. The protein concentration of sHLA-G in serum was higher in patients with ovarian cancer compared to the reference group and depend on the clinical stage of cancer according to FIGO classification and the degree of histological differentiation; 2. The protein concentration of sHLA-G in serum was higher in patients with endometriosis compared to the reference group and depend on the clinical stage of disease according to the classification rAFS. Such behavior of the sHLA-G in ovarian cancer and endometriosis may suggest that the development of these diseases with different clinical characteristics, is essential to the state of the immune system, which is one of the markers of sHLA-G protein; 3. It was observed decreased concentration of sHLA-G in serum after cytoreductive surgery for ovarian cancer, which may ; indicate a relationship between tumor mass and the concentration of sHLA-G. Assessment of the behavior of sHLA-G in serum of patients with ovarian cancer may be one of the indicators to monitor the process of carcinogenesis in the ovary; 4. Clinical application of measuring sHLA-G levels in serum of patients may provide the information necessary to determine the indications for immunotherapy, as one example of combination therapy in ovarian cancer.
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Last modified:
Mar 17, 2023
In our library since:
Jun 23, 2022
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http://dl.cm-uj.krakow.pl:8080/publication/4752
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| Edition name | Date |
|---|---|
| ZB-115303 | Mar 17, 2023 |
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