Differential tumor microenvironment in human ovarian cystic tumors.
OBJECTIVE
Cells and soluble mediators obtained from tumor effusions are useful in evaluating the tumor microenvironment. Our aim was to examine cytologically and to quantify the leukocyte infiltrate, nitric oxide, cytokines and tumor markers in the intracystic fluid from patients with a cystic adnexal mass, for a possible differentiation between benign and malignant findings.


METHODS
Sixty-six women who had their cystic fluids collected were prospectively divided into benign tumor (22, 33.3%), malignant tumor (10, 15.2%) or other gynecological alterations (34, 51.5%). Cytology, total and differential leukocyte counts were determined by light microscopy. Tumor markers, cytokines and nitric oxide were assayed in the supernatants using the Immulite system, ELISA and Griess reaction, respectively.


RESULTS
The sensitivity and specificity of the cytological analysis was 66.7% and 97.7%, respectively. The levels of CA 19.9, CA 15.3, alpha-fetoprotein, carcinoembryonic antigen, progesterone and beta-HCG were significantly higher in the benign and/or malignant group than in the other gynecological alterations. Also, the local concentrations of CA 15.3 and beta-HCG were significantly higher in malignant than in benign tumors. In malignant tumors, increased leukocyte counts and higher concentrations of IL-6, IL-10 and nitric oxide were detected than in benign tumors or other gynecological alterations.


CONCLUSIONS
In malignant tumors, the microenvironment could be differentiated from benign tumors or other gynecological alterations by cystic fluid analysis.
Tavares Murta
Beatriz Martins
BM
Department of Biological Sciences, Faculty of Medicine of Triângulo Mineiro, Uberaba, MG, Brazil. bmurtafarmaco@dcb.fmtm.br
Cunha
Fernando de Queiróz
Fde Q
Miranda
Rodrigo
R
Adad
Sheila Jorge
SJ
Murta
Eddie Fernando Candido
EF
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D018394:CA-125 Antigen / Q000032:analysis; D018395:CA-19-9 Antigen / Q000032:analysis; D002272:Carcinoembryonic Antigen / Q000032:analysis; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000032:analysis; D003536:Cystadenocarcinoma / Q000737:chemistry / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004958:Estradiol / Q000032:analysis; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000032:analysis; D015850:Interleukin-6 / Q000032:analysis; D007958:Leukocyte Count; D008875:Middle Aged; D009569:Nitric Oxide / Q000032:analysis; D010048:Ovarian Cysts / Q000737:chemistry / Q000175:diagnosis*; D010051:Ovarian Neoplasms / Q000737:chemistry / Q000175:diagnosis*; D011374:Progesterone / Q000032:analysis; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D000509:alpha-Fetoproteins / Q000032:analysis
D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D018997:Chorionic Gonadotropin, beta Subunit, Human; D015850:Interleukin-6; D000509:alpha-Fetoproteins; D016753:Interleukin-10; D009569:Nitric Oxide; D011374:Progesterone; D004958:Estradiol