Immunohistochemical expression of Forkhead Box (Fox) A1 and P53 in epithelial ovarian cancer

Abstract

Background: Ovarian cancer (OC) is the fifth cause of cancer mortality in females. There were an estimated 300,000 new cases of OC diagnosed worldwide in 2018, corresponding to 3.4% of all cancer cases among women. The high mortality rate of OC attributed to asymptomatic growth of the tumor leads to its diagnosis at advanced stages. About 85% - 90% of OC are epithelial including serous, endometrioid, clear cell, and mucinous carcinoma. Aim: To study the immunohistochemical (IHC) expression of FOXA1 and p53 in epithelial OC and its association with prognostic indicators such as age, tumor size, stage, grade, and histological type. Materials and methods: The study included 52 cases with EOC from the pathology department, faculty of medicine, Aswan, and Sohag Universities, in the period from January 2017 to December 2019. This study involved 52 patients with OC and a median age of 53 years. Different histological types were included as 37 serous, 12 mucinous, 1 case endometroid 2 cases clear cell OC. The study cases were classified into 22 Grade I, 16 Grade II, and 20 Grade III. About 22 cases were at stage I, 9 at stage II, 11 at stage III, and 10 at stage IV. Tissue sections were stained using the IHC technique with FOX A1 at a dilution of 1:100 and p53 at 1:100. Results: A statistically significant correlation was found between FOX A1 expression and advanced patient's age, high grade, advanced stage, ruptured capsule, and ascites, regardless of tumor laterality. No significant association was found between p53 immunoexpression and the same clinic-pathological parameters although p53 was associated with serious type. Conclusion: FOXA1 immunoexpression in EOC is considered a poor prognostic factor in EOC. FOXA1 could be a potential therapeutic target and prognostic marker in EOC.

Value of Forkhead Box A1 (FOX A1) Immunohistochemical Expression in Epithelial Ovarian Carcinoma

“…We discovered a strong correlation between FOX A1 expression and advanced patients' age (P=0.01). This came in agreement with Elnashar et al (22) . However, it disagreed by Abouhashem et al (16) who revealed that there was no association between patient age and FOXA1 expression.…”

“…FOX A1 expression was significantly correlated with tumor), bilaterality (P > 0.001), in this work .This results agreed with Elnashar et al (22) , Wang et al (13) , and disagreed with Sheta et al (8) they reported that although there was a propensity for unilateral tumors to express more FOXA1 than bilateral ones, this difference did not achieve statistical significance.…”

“…This finding was nearer to that found by Elnashar et al (22) who reported that the mean age of the cases was 52.27 years and to that reported by Wang et al (13) found that the patient's mean age was 54.5 years .Additionally,…”

“…This finding was similar to that of Wang et al (13) who noted that 46.4% of tumors were bilateral. However other studies found that bilaterality of tumors were predominant (22) , while Sheta et al (8) found that unilateral was the predominant .…”

“…These results were close to Yousef et al (25) who noted that 55.8% of cases and 57.7% of cases, respectively, involved capsule rupture had positive peritoneal cytology and demonstrated high expression of FOX A1 in these cases of EOC. Also, Elnashar et al (22) found that FOXA1 expression was highly significantly associated with tumors that had ruptured capsules and ascites.…”