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KMID : 0377619910560010007
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Korean Jungang Medical Journal
1991 Volume.56 No. 1 p.7 ~ p.8
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OVARIAN TUMORS-PAST AND PRESENT
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Barber, Hugh R.K
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Abstract
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The ovarly is an organ of complexity and variety and steroidogenesis. All vertebrate species have ovaries and, therefore, exhibit complex reproductive phenomena. The phylogenetic development of the ovary will be quickly reviewed as will the comparative anatomy.
In comparative anatomy, in birds the left ovary and oviduct develop to maturity and organs on the right side atrophy. It is interesting that if they live long enough they develop an ovarian cancer similar to the common epithelial ovarian cancer seen in humans.
Embryology
The ovaries and testes have very similar developments until about the fourth month of embryonic life in humans. The gonadal ridge, primitive germs cells, indifferent gonads, for both the ovary and testis will be reviewed. This will give an opprotunity to identify where tumors arise. In addition, it will provide an opportunity to show that the testis and the ovary develop the same type of germ cells and gonadal stromal tumors. Since the testis has a tunica albuginea, the epithelium on the surface disappears and, therefore, there are no common epithelial ovarian cancers in the testis.
Early History
A quick review will be given of the past history of the ovary and the time that deGraaf identified the ovary and ovum as separate entities from the testis.
Ephraim McDowell
The Current Management of Ovarian Cancer
The aggressive surgical management will be reviewed and the adjuvant therapy will be discussed.
Tumor Markers
Tumor markers will be discussed in detail as well as the new work on receptor mechanisms. In addition, the HER-2/neu oncoprotein has been identified as a gene among those that develop ovarian cancer and will be discussed. Alpha-L-Fucosidase, which is often elevated in the sera of patients with a family history of ovarian cancer, will be reviewed and its significance discussed.
New Approaches in the Management of Ovarian Cancer
The use of the Cusa and the laser will be reviewed. A slide will be presented on some of the new chemotherapeutic agents, such as, Ifosfamide and Mesnex as well as Taxol. The mechanisms multidrug resistance will be presented.
Tumor cells often become refractory to diverse drugs with different mechanisms of cytotoxic action. It has been shown that a glycoprotein which is P glycoprotein has been associated with multidrug resistance of cells and its mechanism will be discussed. Research is being conducted to determine if P glycoprotein may serve as a prognostic indicator for response to chemotherapy.
Summary
The highlights of the past, present and potential for management of ovarian cancer will be highlighted.
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KEYWORD
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