ABSTRACT
Background: This study aims to assess the expression of estrogen receptor alpha (ERα), progesterone receptor A (PRA),Her-2-neu, p53, and Ki-67 in epithelial ovarian tumors and evaluate their correlation with various clinicopathologic variables.Materials and Methods: A total of 50 cases of epithelial ovarian tumors received from the department of obstetrics andgynaecology and surgical oncology were included in this study. Immunohistochemistry (IHC) was performed on sections takenfrom paraffin-embedded tissue blocks. Chi-square test and ANOVA were used for statistical analysis.Results: Among 50 cases of ovarian epithelial tumors, 26 (52%) malignant, 18 (36%) benign, and 6 (12%) borderline. The medianage of patients was higher (53 years) in malignant tumors. ERα had lower expression in benign (27.7%) and PRA had higherexpression in malignant (69%) while Her-2-neu and p53 were negative in benign tumors. ERα and PRA had higher expressionin serous (57.1% and 53.6%), postmenopausal (83.3% and 70%), advanced stage (55.6% and 53.3%), Grade 3 (44.4% and40%), and tumors with ascites (77.8% and 53.3%). Her-2-neu and p53 were negative in benign and higher in malignant (23%and 58%), serous (66.7% and 67%), Grade 3 (57% and 35%), and tumors with ascites (71% and 88%). Ki-67 had a significanthigher expression in malignant (52 ± 28) and Grade 3 tumors (72 ± 20) as compared to benign tumors (4 ± 2).Conclusion: The difference in expression of these markers among benign, borderline, and malignant tumors reveals their rolein differentiation and prognostication of ovarian tumors. Ovarian tumors are extremely heterogeneous as proved by the lackof coexpression of these markers. Tumors with adverse prognostic factors express ERα and PRA; this supports the mitogenicrole of estrogen and estrogenic regulation of PR. Her-2-neu and p53 are expressed only in malignant tumors supporting theirrole in the differentiation of borderline and malignant tumors. Similarly, differential expression of Ki-67 in tumors with adverseprognostic factors would help in prognostication and differentiation.
ABSTRACT
BACKGROUND: In order to improve the efficacy of endometrial carcinoma (EC) treatment, identifying prognostic factors for high risk patients is a high research priority. This study aimed to assess the relationships among the expression of estrogen receptors (ER), progesterone receptors (PR), human epidermal growth factor receptor 2 (HER2), Ki-67, and the different histopathological prognostic parameters in EC and to assess the value of these in the management of EC. METHODS: We examined 109 cases of EC. Immunohistochemistry for ER, PR, HER2, and Ki-67 were evaluated in relation to age, tumor size, International Federation of Gynecology and Obstetrics (FIGO) stage and grade, depth of infiltration, cervical and ovarian involvement, lymphovascular space invasion (LVSI), and lymph node (LN) metastasis. RESULTS: The mean age of patients in this study was 59.8 ± 8.2 years. Low ER and PR expression scores and high Ki-67 expression showed highly significant associations with non-endometrioid histology (p = .007, p < .001, and p < .001, respectively) and poor differentiation (p = .007, p < .001, and p <. 001, respectively). Low PR score showed a significant association with advanced stage (p = .009). Low ER score was highly associated with LVSI (p = .006), and low PR scores were associated significantly with LN metastasis (p = .026). HER2 expression was significantly related to advanced stages (p = .04), increased depth of infiltration (p = .02), LVSI (p = .017), ovarian involvement (p = .038), and LN metastasis (p = .038). There was a close relationship between HER2 expression and uterine cervical involvement (p = .009). Higher Ki-67 values were associated with LN involvement (p = .012). CONCLUSIONS: The over-expression of HER2 and Ki-67 and low expression of ER and PR indicate a more malignant EC behavior. An immunohistochemical panel for the identification of high risk tumors can contribute significantly to prognostic assessments.
Subject(s)
Female , Humans , Endometrial Neoplasms , Gynecology , Immunohistochemistry , Lymph Nodes , Neoplasm Metastasis , Obstetrics , Prognosis , ErbB Receptors , Receptors, Estrogen , Receptors, Progesterone , Receptors, SteroidABSTRACT
Background: This study aims to evaluate the expression of estrogen receptor alpha (ER α), progesterone receptor A (PRA), Her-2-neu, p53, and Ki-67 in epithelial ovarian tumors and their correlation with various clinicopathologic variables. Materials and Methods: This study included 60 consecutive cases of epithelial ovarian tumors. Sections of 4 μm were taken from paraffin embedded tissue blocks for immunohistochemistry (IHC). Statistical analysis was done using Chi square test, ANOVA. Results: ER α had lower expression in benign (29%) and PRA higher expression in malignant (63.6%) tumors. ERα, PRA had higher expression in serous (72.72%, 57.14%), postmenopausal (81.8%, 71.42%), advanced stage (63.63%, 52.38%), grade 3 (45.45%, 38.09%), and tumors with ascites (90.90%, 85.7%). Her-2-neu, p53 were negative in benign and higher in malignant (21%, 57.6%), serous (71.42%, 57.89%), grade 3 (57.14%, 31.57%), and tumors with ascites (85.7%, 84.21%). Ki-67 had a significant higher expression in malignant (48.6± 26.76), serous (55.43± 27.85), and grade 3 tumors (68 ± 22). CA-125 levels were significantly higher in malignant, serous, advanced stage, grade 3 and ER α, Her-2-neu and p53 positive tumors. Conclusion: ERα, PRA expression in tumors with adverse prognostic factors support the mitogenic role of estrogen and estrogenic regulation of PR. Her-2-neu and p53 expression only in malignant tumors suggest their carcinogenic role and aid in the differentiation of borderline and malignant tumors. Higher Ki-67 in tumors with adverse prognostic factors would help in prognostication and differentiation. Lack of co-expression of markers proves the extreme heterogeneity of ovarian tumors. These markers may aid in differentiation and prognostication of ovarian tumors.