title: Is it possible to diagnose malignancy from fluid in cystic ovarian tumors?
abstract: OBJECTIVE
  p53 gene mutations are frequently identified in ovarian cancer tissue. The aim of this study was to investigate whether wild type or mutated genomic DNA can be identified in ovarian cystic fluid specimens.
  
  
  METHODS
  Forty-eight Japanese patients with cystic ovarian tumors (30 benign cysts, 8 borderline malignant tumors, and 10 cancers) were investigated. Cystic fluid and tumor tissue were obtained during surgery. After DNA extraction from the cystic fluid, polymerase chain reaction (PCR) and sequence analysis for exons 4-9 of the p53 gene was performed. In two cases of mucinous cystic tumor of borderline malignancy and endometrioid adenocarcinoma, the p53 gene sequences were determined. Immunohistochemical staining for abnormal p53 gene product was also performed.
  
  
  RESULTS
  DNA was successfully extracted from all cystic fluid specimens. Furthermore, exons 4-9 of the p53 gene could be identified by electrophoresis from all samples. In a mucinous cystic tumor of borderline malignancy, one point mutation was identified at codon 223 in exon 6 (CCT → CTT) of the p53 gene. Aberrant p53 gene product was also observed in the tumor cells by immunohistochemical staining. Moreover, in another case of endometrial adenocarcinoma, a point mutation at codon 245 in exon 7 (GGC → AGC) was detected by the direct sequencing of the amplified Exon. Notably, the mutation was not present in the peripheral blood (PB) sample and tissue specimens from the patient.
  
  
  CONCLUSIONS
  In cystic ovarian tumors, cystic fluid may provide informative material for molecular studies since it reflects the p53 status of tumor tissue in the cyst wall. This system might help to identify ovarian malignancy without resection of the tumor tissues.
authors.affiliation: Department of Obstetrics and Gynecology, Kochi Medical School, Kochi, Japan. Electronic address: rurikooooo@hotmail.com.
authors.forename: Ruriko
authors.initials: R
authors.lastname: Yamada
authors.forename: Nagamasa
authors.initials: N
authors.lastname: Maeda
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Oguri
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Adachi
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Mutsuo
authors.initials: M
authors.lastname: Furihata
authors.forename: Takao
authors.initials: T
authors.lastname: Fukaya
mesh_terms: D000328:Adult; D001483:Base Sequence; D018269:Carcinoma, Endometrioid / Q000175:diagnosis* / Q000235:genetics; D020420:Cyst Fluid / Q000737:chemistry*; D004273:DNA, Neoplasm / Q000032:analysis*; D005091:Exons; D005260:Female; D016158:Genes, p53 / Q000235:genetics*; D006801:Humans; D009154:Mutation; D010048:Ovarian Cysts / Q000737:chemistry*; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000235:genetics; D017354:Point Mutation; D016133:Polymerase Chain Reaction / Q000379:methods; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis
chemical_list: D004273:DNA, Neoplasm; D016159:Tumor Suppressor Protein p53
keywords: Cystic fluid; Cystic ovarian tumor; Gene mutation; p53