title: Differential tumor microenvironment in human ovarian cystic tumors.
abstract: 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.
authors.affiliation: Department of Biological Sciences, Faculty of Medicine of Triângulo Mineiro, Uberaba, MG, Brazil. bmurtafarmaco@dcb.fmtm.br
authors.forename: Beatriz Martins
authors.initials: BM
authors.lastname: Tavares Murta
authors.forename: Fernando de Queiróz
authors.initials: Fde Q
authors.lastname: Cunha
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Miranda
authors.forename: Sheila Jorge
authors.initials: SJ
authors.lastname: Adad
authors.forename: Eddie Fernando Candido
authors.initials: EF
authors.lastname: Murta
mesh_terms: 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
chemical_list: 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