Thibault Benoît, D'Angelo Romina, Rigal Samy, White-Koning Mélanie, Bataillon Guillaume, Guillermet-Guibert Julie, Basset Céline
Centre de Recherches en Cancérologie de Toulouse, CRCT, Université de Toulouse, Inserm, CNRS, Toulouse, France.
LABEX TouCAN, Toulouse, France.
J Ovarian Res. 2025 Apr 8;18(1):74. doi: 10.1186/s13048-025-01653-y.
High-grade serous carcinoma of the ovary is the most frequent intraperitoneal malignancy in women. It is associated with a poor prognostic outcome owing to the late appearance of clinical signs leading to a delayed diagnosis, and with resistance to platinum-based chemotherapy. One of the clinical signs is the development of ascites. The detection of neoplastic cells in ascites fluid is important as it indicates tumor progression and is associated with shorter survival. Microscopic cytospin analysis of this fluid reveals the cytological and architectural features of the neoplastic cells, allowing the pathologist to identify rapidly the malignancy and the histologic type. In association with immunocytochemistry, this process ensures a definite diagnosis and provides a specific etiology. Our objective was to provide proof-of-principle that the automatized analysis of general cytomorphological criteria, such as carcinomatous cell clustering, in malignant ascites fluid is of prognostic value in high-grade serous carcinoma. We performed a retrospective analysis of the ascites fluid of 24 advanced-stage high-grade serous ovarian cancer patients naïve of treatment. We found that the low number of neoplastic cell clusters in fluid was significantly associated with shorter overall and progression-free survival after adjusting for WHO performance status, Sugarbaker score, age and BMI. These results were independent of the peritoneal implantation of neoplastic cells. We believe this is a promising strategy to improve high-grade serous carcinoma diagnostics using a more informative but simple analysis of ascites tumor cell morphology.
卵巢高级别浆液性癌是女性最常见的腹膜内恶性肿瘤。由于临床症状出现较晚导致诊断延迟，且对铂类化疗耐药，其预后较差。临床症状之一是出现腹水。腹水中肿瘤细胞的检测很重要，因为它表明肿瘤进展且与较短生存期相关。对这种液体进行显微镜下细胞离心涂片分析可揭示肿瘤细胞的细胞学和结构特征，使病理学家能够快速识别恶性肿瘤及其组织学类型。结合免疫细胞化学，这一过程可确保明确诊断并提供具体病因。我们的目的是提供原理证明，即对恶性腹水中一般细胞形态学标准（如癌细胞聚集）进行自动化分析对高级别浆液性癌具有预后价值。我们对24例未经治疗的晚期高级别浆液性卵巢癌患者的腹水进行了回顾性分析。我们发现，在调整了世界卫生组织体能状态、Sugarbaker评分、年龄和体重指数后，腹水中肿瘤细胞簇数量少与较短的总生存期和无进展生存期显著相关。这些结果与肿瘤细胞的腹膜种植无关。我们认为，这是一种很有前景的策略，可通过对腹水肿瘤细胞形态进行更具信息量但简单的分析来改善高级别浆液性癌的诊断。
