Expression of Immunohistochemical Markers Estrogen Receptor Alpha, Progesterone Receptor A, Her2-neu, p53, and Ki-67 in Epithelial Ovarian Tumors and Their Correlation with Clinicopathologic Variables

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.