Epithelial ovarian tumors: Clinicopathological correlation and immunohistochemical study

Abstract

Background:Ovarian cancer is the third leading site of cancer among women, trailing behind cervix and breast cancer.Aim:This study was undertaken to analyze the immunohistochemical (IHC) profile of estrogen receptors (ER), progesterone receptors (PR), Ki-67, and p53 in various ovarian epithelial tumors and attempt correlation with clinical and histopathological findings.Materials and Methods:The present study was conducted over a period of 4 years. A technique of manual tissue array was employed for cases subjected for IHC. The primary antibodies used were ER, PR, p53, and Ki-67. A correlation was attempted between histopathological and IHC findings. Results were subjected to statistical analysis. Software program “the primer of biostatistics 5.0” was used for calculation of interrelationships between the analyzed ER, PR, p53, and Ki-67 expression and histological factors by Pearson's Chi-square test. The results were considered to be significant when the P < 0.05.Results:There were 110 cases of surface epithelial ovarian tumors (SEOT) encountered over the period of 4 years. The expression of ER was more in malignant tumors (13/16, 81.25%) than borderline (9/12, 75%) and benign (20/82, 24.39%). As compared to ER, the expression of PR was more in benign (51/82, 62.19%) than borderline (8/12, 66.67%) and malignant tumors (9/16, 56.25%). The expression of PR was more in benign tumors than borderline and malignant tumors. However, this was not statistically significant (Chi-square = 0.335 with 2 degrees of freedom; P = 0.846). The expression of p53 was less in benign (5/82, 6.1%) than borderline (9/12, 75%) and malignant tumors (13/16, 81.25%). The expression of Ki-67 was more in malignant (4/82, 4.88%) than borderline (10/12, 83.33%) and benign tumors (15/16, 93.75%). In all the above cases, the difference was statistically significant (P < 0.05). There was statistically significant difference in the expression of ER, PR, p53, and Ki-67 in the patients with age <40 years and above 40 years (P = 0.912). A positive correlation was observed in p53 expression and tumor grade. Similar correlation was seen in Ki-67 and tumor grade. It was also noted that mean Ki-67 labeling index (Li) had also increased with tumor grade. In the case of serous tumors, ER was expressed in all high- and low-grade tumors. The expression of PR was more in low-grade tumors than high-grade ones. P53 expression was seen in all high-grade tumors and 33.34% of low-grade tumor. The Ki-67 Li was more in high-grade tumors than low-grade tumors. Expression of ER, p53, and Ki-67 was higher in tumor showing metastasis. The mean Ki-67 Li was also higher in metastasizing tumors. However, PR expression was less in metastasizing tumors than nonmetastasizing tumors.Conclusion:IHC marker report of ER, PR status, and Ki-67 if included in each pathology report will pave the way for better understanding of biological behavior and modify treatment strategies.

Hormone receptors expression in ovarian cancer taking into account menopausal status: a retrospective study in Chinese population

“…In our current study, we found that the majority of serous carcinomas of borderline epithelial ovarian cancer were ER and PR positive (93%), whilst 28% or 33% of women with mucinous carcinoma of borderline epithelial ovarian cancer were ER or PR positive. Interestingly, we also found that PR positivity in both subtypes of borderline epithelial ovarian cancer was higher than that in malignant epithelial ovarian cancer which was consistent with previous findings [ 20 ].…”

“…Although borderline epithelial ovarian cancer (with its two major histologic tumor subtypes, serous carcinoma and mucinous carcinoma) is another subset of epithelial ovarian cancer that has better clinical outcomes, the frequency of ER or PR positivity has not previously been well studied. One previous study showed 75% of cases were ER positive, and 67% of cases were PR positive [ 20 ], however that study did not take into account the further subtypes of borderline epithelial ovarian cancer. In our current study, we found that the majority of serous carcinomas of borderline epithelial ovarian cancer were ER and PR positive (93%), whilst 28% or 33% of women with mucinous carcinoma of borderline epithelial ovarian cancer were ER or PR positive.…”

The Putative Role of TP53 Alterations and p53 Expression in Borderline Ovarian Tumors - Correlation with Clinicopathological Features and Prognosis: A Mini-Review

“…In another report, only 6.6% of BOTs were p53-positive in contrast to benign ovarian tumors where positive reaction was not identified 73 . Interestingly, all 5 mucinous borderline tumors and 4 (57%) out of 7 serous borderline tumors expressed p53 in a recent paper from India 72 . In a work from Poland, as many as 90% of OCs and 94% of BOTs showed positive p53 immunoreactivity, and the staining pattern differed significantly between malignant tumors and BOTs 74 .…”

“…Some data reported a complete lack of p53 expression in ovarian tumors of low-malignant potential or a low (<5%) immunoreactivity 45 , 63 - 72 . For example, none of 10 BOTs revealed p53 expression pattern by Gursan et al 69 .…”

The positivity of estrogen receptor and progesterone receptor may not be associated with metastasis and recurrence in epithelial ovarian cancer

“…To date such studies are limited. A recent study with a relatively small sample size (n = 16) reported higher positivity of ER and lower positivity of PR in epithelial ovarian cancer with metastases 19 . Another study with small sample size (n = 8) also reported higher positivity of ER in metastatic epithelial ovarian cancer 24 .…”