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• W2912787672 abstract "Ovarian tumors involve a wide range of neoplasms, from innocuous benign tumorsto aggressive cancers. Not seldom are they found by chance, without any notablesymptoms, and, as cancers, they may already have metastasized at that point. Thediagnostic golden standard includes vaginal ultrasound (US) along with serumbiomarkers, traditionally CA125, to assess tumor characteristics. The correctpreoperative diagnosis of cancer is essential, as it allows a prompt referral to a center,where the operations are performed by gynecologic oncologists. In ovarian cancer(OC), effective and correct primary surgery is the most important prognostic factor.On the other hand, conservative follow-up may be sufficient for benign tumors.Against this background, the aim of this thesis was to study advanced USmodalities and to discover new possible biomarkers or methods to distinguishovarian pathology preoperatively. First, we examined 100 at least 50-year-old womenscheduled for surgery with an unclear ovarian tumor using traditional US andcomparing it to various US scoring methods and three-dimensional ultrasound (3DUS) with power Doppler (PD). The findings were compared with the results ofexaminations made by another experienced US examiner and also withhistopathological diagnoses. None of the advanced US methods exceeded theaccuracy of the subjective opinion of an expert. In addition, the 3D US with PDadded no significant value to traditional methods. However, the results produced bytwo examiners were in good agreement.To extend our investigation, we collected urine samples from 71 women withindefinite adnexal masses and from 22 controls, and analyzed urinary polyaminesusing liquid chromatography-tandem mass spectrometry (LC-MS/MS). Polyaminesare naturally occurring components of all mammalian cells and have many functions,including cell growth. They are linked to carcinogenesis, and especially theirdiacetylated forms are found to be elevated in many cancers, although not previouslyin OC. In Study II, we showed that diacetylated spermine (DiAcSpm) wassignificantly elevated in urine from OC patients. While the levels of DiAcSpmdiffered even between low-stage OCs and benign ovarian tumors, the highest levelswere found in high-grade OCs. Urinary DiAcSpm was even more sensitive thanserum CA125 with its commonly used cutoff value (35 U/mL): their respectivesensitivities were 86.5% and 75.7%.Based on previous experiments on the ability of dogs to detect the odor of cancer,urine samples (60 from women with adnexal tumors and 18 from controls) were alsoexamined using field asymmetric waveform ion mobility spectrometry (FAIMS), anovel artificial olfactory technology. In our proof-of-concept Study III, we usedFAIMS to differentiate between ovarian malignancy and benign tumors or controlswith respective accuracies of 77.3% and 81.3%. When only high-grade cancers weretaken into account, the accuracy in distinguishing them from low-grade cancers was88.7%. Even low-grade…" @default.
• W2912787672 created "2019-02-21" @default.
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• W2912787672 date "2019-01-01" @default.
• W2912787672 modified "2023-09-26" @default.
• W2912787672 title "Preoperative Evaluation of Ovarian Tumors" @default.
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