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Contains fulltext : 136096.pdf (Publisher’s version ) (Closed access) Considering the high mortality of ovarian cancer, novel approaches for diagnostics and therapy are urgently needed. Cancer initiation, progression, and invasion occur in a complex and dynamic microenvironment which depends on the interplay between host cell responses and tumor activity. Chondroitin sulfate (CS), a special highly sulfated sugar, forms an important intermediate player in this respect. Depending on the (micro)structural diversity of chondroitin sulfate chains, various ligands interact with this special group of glycosaminoglycans, making it a key molecule for many physiological and pathological processes, including cancer development. This review focuses on the various functions of chondroitin sulfate in tumor growth, angiogenesis, dissemination and immunosilencing of ovarian cancer. We also shed light on possible future diagnostic and therapeutic modalities for ovarian cancer based on the large variety in chondroitin sulfate microstructure and function. It is concluded that the class of chondroitin sulfate represents an attractive target to interfere with the process of ovarian tumorigenesis.

Contains fulltext : 137482.pdf (Publisher’s version ) (Closed access) Serous ovarian cancer is suggested to develop from epithelium embryologically derived from the Mullerian ducts. The aim of the current study is to thoroughly, analyze the epithelium derived from the Mullerian ducts (cervix, endometrium and fallopian tubes) in serous ovarian cancer patients. Sixty women diagnosed with serous ovarian carcinoma were included in this multicentre, observational study. Tissues were embedded completely for histological assessment, in accordance with the SEE-Fim and SEE-End protocol (Sectioning and Extensively Examining of the Fimbriated end; and-Endometrium), and prevalence of cervical, as well as endometrial and tubal pathology was analyzed. In 31 (52%) cases, a pathologic lesion was identified, and in 16 (27%) of these cases coexistence of pathologic lesions. In 1 case, severe dysplasia was found in the cervix, in 9 (15%) cases endometrial intraepithelial carcinoma, in 19 (32%) cases atypical hyperplasia, and in 23 (43%) cases serous tubal intraepithelial carcinoma. Serous tubal intraepithelial carcinoma was seen significantly more often concurrent with endometrial atypical hyperplasia or endometrial intraepithelial carcinoma than with benign endometrium (64 vs 28%; P=0.01). To conclude, histological assessment of epithelium derived from Mullerian ducts of serous ovarian cancer patients resulted in the identification of endometrial intraepithelial carcinoma, serous tubal intraepithelial carcinoma and/or endometrial atypical hyperplasia in more than half of cases. Coexistence of these pathologic lesions was common, and might represent an effect of field carcinogenesis or tumor implantation of migrating cells.

Bladder cancer (BC) comes in two flavors: as non-muscle invasive (NMI) and as muscle invasive (MI) disease. These two subtypes differ in their genetic aberrations. In NMI-BC mutations in the FGFR3 oncogene are found with a frequency of 75%, whereas mutations in the TP53 tumor suppressor gene prevail in MI-BC. Mutations in the RAS genes occur in 15% of BC of all stages and are mutually exclusive with FGFR3 mutations. Mutations in the PIK3CA gene are found in about 13% and these almost exclusively co-occur with FGFR3 mutations. NMI-BC with FGFR3 mutations are genetically stable, but FGFR3 wild type NMI-BC and MI tumors are genetically unstable. In this paper, we discuss the use of these genetic aberrations in relation to recurrence, progression, surveillance, and therapeutic options. As of yet, there is no biomarker that can predict recurrences or the rate of recurrences when they occur. We show that FGFR3 mutations are associated with a decreased risk of progression, and a better survival both in BC and in upper urinary tract cancer. Microsatellite analysis (MA) in order to detect loss-of-heterozygosity can be used to detect recurrences in urinary cells of patients under surveillance. The results of a Dutch randomized trial show that consecutive positive MA results are a strong predictor for future recurrences. Using FGFR3 mutation analysis for those patients who have an FGFR3 mutant tumor will enhance performance of urine-based surveillance. Although FGFR3 mutations occur in only 20% of MI tumors, these tumors often have a high expression of the FGFR3 protein. This suggests that this receptor could present a target for adjuvant therapy in MI-BC. However, whether the FGFR3 pathway is active in these tumors remains to be established.

Epigenetic modifications have been shown to contribute to the pathogenesis of various cancers including bladder cancer. Hypermethylation in cancer is often found in CGIs in the 50 regions of genes. Although the list of aberrantly methylated genes in cancer is expanding, only a few genes so far were investigated for their usefulness as tumor biomarkers for early diagnosis and risk assessment of bladder cancer. Thus, a genome-wide screening of aberrant methylation of CGIs is needed to identify bladderspecific epigenetic markers. In this study, we performed a genome-wide screening for DNA methylation in different bladder cancer subtypes using differential methylation hybridization coupled with Agilent 244k human CpG island microarrays. We next validated the genome-wide data on a 384-plex custom Illumina Golden Gate Methylation Assay, which is based on bisulfite conversion. We found and validated a large number of possible novel epigenetic biomarkers for early detection and prognosis of bladder cancer. We also observed that subgroups of bladder tumors cluster separately due to their different methylation patterns, suggesting possible differences in pathogenesis. Our data clearly showed that the adjacent CpG loci within a CGI were comethylated. In contrast, CGIs neighboring a methylated island were usually not methylated. The data showed no bias toward promoter methylation, as the relative proportion of methylated islands in genes was similar to those encompassing promoter regions. We observed that 70% of the methylated genes are downregulated in bladder cancer. Moreover, gene body methylation also seems to be negatively correlated with gene expression. Interestingly, we found an overrepresentation of methylated genes in those genes that are the target of polycomb group protein complexes in embryonic stem cells. Further validation of selected CGIs on a separate group of bladder cancers on a custom Illumina Golden Gate Methylation assay allowed us to confirm 70% of CGIs differentiating bladder cancers from normal cells, besides validating CGIs discriminating subgroups of bladder tumors. In conclusion, this is the first genome-wide study on bladder cancer, which identified potential methylation target genes that provide putative biomarkers that may be correlated with disease course, as well as insight into the pathogenesis of bladder cancer subtypes. CLINICAL IMPACT OF GENOME-WIDE ASSOCIATION STUDIES FOR CANCER