Que outra utilidade clínica poderão ter as ascites no carcinoma do ovário?
Keywords:
Carcinoma do ovário, Ascite, Processamento citológico, Biomarcadores, Resistência à quimioterapiaAbstract
Ascites in ovarian carcinoma (OC) is one of the signs of peritoneal metastization and is often present at diagnosis in advanced stages and disease recurrence. This serous fluid can support the diagnosis and drained for symptomatic relief in advanced phases and subsequently discarded. In this context, ascitic fluid analysis is a unique opportunity to monitor the kinetics of tumor cells during disease progression without the need for additional invasive procedures. The objective of this work was to estimate the potential of this biological material to evaluate the expression of proteins associated with resistance to chemotherapy (QT). We received ascites from IPO-Porto patients diagnosed with high-grade serous carcinoma obtained at diagnosis (n=8) and during treatment (n=8). After centrifugation of the entire volume of the drained ascitic liquid, the samples were fixed in formaldehyde and embedded in histogelTM, followed by histological processing. In these cytological samples, the immunocytochemistry technique was performed to evaluate the expression of four biomarkers associated with resistance to therapy (ALDH1, SOX2, CD44v6 and P-gp). Our results indicate that centrifugation of the total volume drained from patients contain, in general, a satisfactory number of cells to perform several histological techniques and molecular studies. The expression of cancer stem cell markers, ALDH1, SOX2 and CD44v6, in samples before QT was often negative or with low expression levels. However, in the samples received after QT, there is an increase in the number of samples with expression of at least one of these biomarkers. The expression of the multidrug resistance marker (P-gp) was exclusively observed in samples of patients after QT. The results of this study are indicators of the potential of the evaluation of stem markers or associated with QT resistance in ascitic fluids drained from patients during the disease course and reveal a new clinical utility of ascites in the context of OC.
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