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Peritoneal angiogenesis in patients with ascites
142
SOCIETY
OF GYNECOLOGIC
ONCOLOGISTS
ABSTRACTS
membrane protein for clear cell tumors; myosin for smooth muscle, and myoglobin for skeletal muscle differentiation of mixed mesodermal tumors; estrogen, progesterone, and testosterone for gonadal stromal tumors; a variety of peptide hormones for ovarian carcinoids; thyroglobulin for benign and malignant struma ovarii; alpha-fetoprotein and alpha-I-antitrypsin for endodermal sinus tumors and yolk sac elements of embryonal carcinomas; hCG for trophoblastic elements of germ cell tumors; and CEA for Krukenberg tumors. With the aid of immunoperoxidase, the original diagnosis of 48 ovarian tumors were either modified or completely reclassified. The data confirm that as a simple, specific, and highly sensitive technique, immunoperoxidase has much to offer in histogenetic diagnosis of human tumors, particularly in those of ovarian origin. 21. Identi$cation, Fluid
of Ovarian
Localization, Carcinoma
and Properties of an Immunosuppressive Factor Found in the Ascitic Patients. BERTRUM SHEID, M.D., AND JOHN BOYCE, M.D.
Generalized immunosuppression often accompanies oncogenesis as a functional aspect of the disease process. Recently, a growing body of information in tumor immunology has evolved which demonstrates that generalized immunosuppression of the cancer patient may be a direct result of immunosuppressive factors secreted by the malignant cells. In our studies, we have demonstrated that the immunosuppressive factor found in cell-free ascitic fluid derived from ovarian cancer patients (an inhibitor of T- and B-lymphocyte proliferation) is due to its leakage from the plasma membranes of malignant carcinoma cells and accompanying macrophages. Whole cells, separated from freshly aspirated ascitic fluid, were separated by Ficoll gradients into subfractions of: (a) cellular debris; (b) lymphocytes, neutrophiles, plasma cells (100: 1: I); (c) mesothelial cells, macrophages, lymphocytes (60:40:5); (d) mesothelial cells and macrophages (80:20); and (e) mesothelial cells and adenocarcinoma cells (IO: I). By sucrose gradient techniques and differential analysis, the predominant immunosuppressive factor (70% of the total) was found to be associated with the membranes of macrophages and adenocarcinoma cells. The immunosuppressive factor was determined to be polypeptide in nature and have a molecular weight of 1500-2000 Da. The number of malignant cells in the ascitic fluid were too few to successfully differentiate, biochemically, between the immunosuppressive factor extracted from macrophages and carcinoma cells. 22. Peritoneal
Angiogenesis
Mith Ascites. JACKSON B. BEECHAM, M.D., PAUL KUCERA, M.D., AND THOMAS A. BONFIGLIO, M.D.
in Patients
M.D., B. FREDERICK HELMKAMP,
We have studied vascular patterns on the peritoneum occurring in patients with epithelial ovarian cancer. Fifteen women have been evaluated, along with fifteen controls selected from patients with either benign disease or nonovarian gynecologic cancers. In addition, we have studied five patients with ovarian cancer without ascites, as well as eight other patients (two with peritoneal mesotheliomas, two with cancer of the pancreas, three patients at second-look surgery, and one with metastatic breast cancer and ascites from cirrhosis of the liver). Color photographs and pathologic sections with vascular staining have been collated. Neovascularization occurred in all women with ascites from epithelial ovarian cancer; distribution of vascular change was confined to the parietal peritoneal surfaces, although the serosa of the intestine also demonstrated similar changes in a number of cases. Other than the commonly observed gross venous engorgement in the omentum, neovascular arborization was not apparent in the omental or mesenteric fat. Angiogenesis did not occur in any ovarian cancer patients without ascites, either at primary or reassessment surgery. The amount of ascites appeared to be commensurate with the degree of vascular proliferation. Our findings suggest that ascites in epithelial ovarian cancer occurs in conjunction with peritoneal angiogenesis, and supports the contention that ascites fluid is produced by non-tumor-bearing peritoneum. This presumably could occur from diffusion of serum constituents across an extensive capillary network, into the abdomen. 23.
Cathepsin-B: A Promising Tumor Marker. BERND-UWE SEVIN, REYNALD~ RAMOS, R. C. BISHOP, AND HERVY E. AVERETTE.
J.
P.
PERRAS,
J. C. CRAMER,
We isolated a cathepsin-B-like enzyme (CB) from urine of cancer patients. Partial characterization of this enzyme indicates that urine-CB is similar to CB isolated from human liver. We analyzed urine CB levels (UCB) using an enzymatic assay in GYO patients. The normal level was defined as
SOCIETY
OF GYNECOLOGIC
ONCOLOGISTS
ABSTRACTS
membrane protein for clear cell tumors; myosin for smooth muscle, and myoglobin for skeletal muscle differentiation of mixed mesodermal tumors; estrogen, progesterone, and testosterone for gonadal stromal tumors; a variety of peptide hormones for ovarian carcinoids; thyroglobulin for benign and malignant struma ovarii; alpha-fetoprotein and alpha-I-antitrypsin for endodermal sinus tumors and yolk sac elements of embryonal carcinomas; hCG for trophoblastic elements of germ cell tumors; and CEA for Krukenberg tumors. With the aid of immunoperoxidase, the original diagnosis of 48 ovarian tumors were either modified or completely reclassified. The data confirm that as a simple, specific, and highly sensitive technique, immunoperoxidase has much to offer in histogenetic diagnosis of human tumors, particularly in those of ovarian origin. 21. Identi$cation, Fluid
of Ovarian
Localization, Carcinoma
and Properties of an Immunosuppressive Factor Found in the Ascitic Patients. BERTRUM SHEID, M.D., AND JOHN BOYCE, M.D.
Generalized immunosuppression often accompanies oncogenesis as a functional aspect of the disease process. Recently, a growing body of information in tumor immunology has evolved which demonstrates that generalized immunosuppression of the cancer patient may be a direct result of immunosuppressive factors secreted by the malignant cells. In our studies, we have demonstrated that the immunosuppressive factor found in cell-free ascitic fluid derived from ovarian cancer patients (an inhibitor of T- and B-lymphocyte proliferation) is due to its leakage from the plasma membranes of malignant carcinoma cells and accompanying macrophages. Whole cells, separated from freshly aspirated ascitic fluid, were separated by Ficoll gradients into subfractions of: (a) cellular debris; (b) lymphocytes, neutrophiles, plasma cells (100: 1: I); (c) mesothelial cells, macrophages, lymphocytes (60:40:5); (d) mesothelial cells and macrophages (80:20); and (e) mesothelial cells and adenocarcinoma cells (IO: I). By sucrose gradient techniques and differential analysis, the predominant immunosuppressive factor (70% of the total) was found to be associated with the membranes of macrophages and adenocarcinoma cells. The immunosuppressive factor was determined to be polypeptide in nature and have a molecular weight of 1500-2000 Da. The number of malignant cells in the ascitic fluid were too few to successfully differentiate, biochemically, between the immunosuppressive factor extracted from macrophages and carcinoma cells. 22. Peritoneal
Angiogenesis
Mith Ascites. JACKSON B. BEECHAM, M.D., PAUL KUCERA, M.D., AND THOMAS A. BONFIGLIO, M.D.
in Patients
M.D., B. FREDERICK HELMKAMP,
We have studied vascular patterns on the peritoneum occurring in patients with epithelial ovarian cancer. Fifteen women have been evaluated, along with fifteen controls selected from patients with either benign disease or nonovarian gynecologic cancers. In addition, we have studied five patients with ovarian cancer without ascites, as well as eight other patients (two with peritoneal mesotheliomas, two with cancer of the pancreas, three patients at second-look surgery, and one with metastatic breast cancer and ascites from cirrhosis of the liver). Color photographs and pathologic sections with vascular staining have been collated. Neovascularization occurred in all women with ascites from epithelial ovarian cancer; distribution of vascular change was confined to the parietal peritoneal surfaces, although the serosa of the intestine also demonstrated similar changes in a number of cases. Other than the commonly observed gross venous engorgement in the omentum, neovascular arborization was not apparent in the omental or mesenteric fat. Angiogenesis did not occur in any ovarian cancer patients without ascites, either at primary or reassessment surgery. The amount of ascites appeared to be commensurate with the degree of vascular proliferation. Our findings suggest that ascites in epithelial ovarian cancer occurs in conjunction with peritoneal angiogenesis, and supports the contention that ascites fluid is produced by non-tumor-bearing peritoneum. This presumably could occur from diffusion of serum constituents across an extensive capillary network, into the abdomen. 23.
Cathepsin-B: A Promising Tumor Marker. BERND-UWE SEVIN, REYNALD~ RAMOS, R. C. BISHOP, AND HERVY E. AVERETTE.
J.
P.
PERRAS,
J. C. CRAMER,
We isolated a cathepsin-B-like enzyme (CB) from urine of cancer patients. Partial characterization of this enzyme indicates that urine-CB is similar to CB isolated from human liver. We analyzed urine CB levels (UCB) using an enzymatic assay in GYO patients. The normal level was defined as