ABSTRACT
Seromucinous tumors belong to a group of ovarian epithelial tumors. They were originally described as tumors characterized by Müllerian endocervical differentiation. Molecular genetic studies have indicated these tumors as endometriosis-associated tumors due to the presence of ARID1 gene mutations. However, the histogenesis of these neoplasms is still unstudied.
Subject(s)
Endometriosis , Ovarian Neoplasms , Cell Differentiation , Female , Humans , Molecular Biology , Mutation , Ovarian Neoplasms/geneticsABSTRACT
Epithelial ovarian tumors may cause various diagnostic problems of practical relevance. For the distinction between cystadenomas and borderline tumors/atypically proliferative tumors, a minimum extent of 10% of the atypical epithelial proliferation has been suggested by the WHO. The micropapillary variant of serous borderline tumors is more frequently associated with invasive growth and extraovarian lesions. Extraovarian lesions of borderline tumors are relevant for prognosis and cause a higher stage; their classification is crucial. Traditionally, they were classified into noninvasive and invasive implants based on their morphology. Based on the 2014 WHO classification, invasive lesions should be designated as low-grade serous carcinomas whereas only noninvasive lesions are considered implants. The most frequent invasive growth pattern in low-grade serous carcinomas consists of haphazardly arranged tumor cell nests and small papillae in clefts, whereas mucinous and endometrioid carcinomas mainly show a confluent glandular pattern with maze-like and cribriform structures. For metastatic mucinous tumors a nodular growth pattern is characteristic; ruling them out requires clinical information including imaging and immunohistochemistry. Differential diagnosis between low-grade and high-grade serous carcinoma is based on the degree of nuclear polymorphism and mitotic count. The seromucinous tumor category replaces the endocervical subtype of mucinous tumors and resembles histologically, biologically, and on the molecular level serous and endometrioid tumors. Endometrioid tumors with fibromatous stroma need to be distinguished from tumors with Sertoli cell differentiation and well-differentiated neuroendocrine tumors. For differential diagnosis of epithelial ovarian tumors, in particular carcinomas, a panel of antibodies for immunohistochemistry is very useful under consideration of histomorphology.
Subject(s)
Carcinoma, Endometrioid , Cystadenoma, Serous , Ovarian Neoplasms , Diagnosis, Differential , Female , Humans , PrognosisABSTRACT
BACKGROUND: The aim of this study is to determine the prognostic values of PDL1 expression in ovarian epithelial tumors and to detect the presence of FOXP3-positive T reg cells in the tumor microenvironment. METHODS: This study included patients with benign, borderline or malignant ovarian serous tumors (n=82), mucinous cancer (n=17) and endometrioid cancer (n=36). FOXP3 and PDL1 were immunohistochemically evaluated and compared with histopathological and clinical prognostic parameters. RESULTS: There was no expression of PDL1 in any tumor cell. However, PDL1-positive inflammatory cells were seen in 10 cases (7.3%) with mucinous carcinoma (n=6), endometrioid carcinoma (n=2), borderline (n=1), and benign (n=1) serous tumors. It was also determined that there was a significant positive correlation between PD-L1 expression in tumor infiltrating cells and survival (P<0.01). In 47 (34.3%) cases, there were FOXP3-positive cells. The number of FOXP3-positive cells was significantly higher in ovarian cancer, especially in serous and endometrioid carcinomas, rather than benign and borderline tumors (P=0.007). But there was no statistically significant association between the survival times and the presence of T regs (P=0.241). CONCLUSIONS: This study demonstrated that the presence of FOXP3 and PDL1-positive regulatory T cells in TILs was associated with mainly malignant tumors. We also found that the presence of PD-L1-positive inflammatory cells has a positive effect on survival.
ABSTRACT
In this study we showed that second-harmonic generation (SHG) microscopy combined with precise methods for images evaluation can be used to detect structural changes in the human ovarian stroma. Using a set of scoring methods (alignment of collagen fibers, anisotropy, and correlation), we found significant differences in the distribution and organization of collagen fibers in the stroma component of serous, mucinous, endometrioid and mixed ovarian tumors as compared with normal ovary tissue. This methodology was capable to differentiate between cancerous and healthy tissue, with clear cut distinction between normal, benign, borderline, and malignant tumors of serous type. Our results indicated that the combination of different image-analysis approaches presented here represent a powerful tool to investigate collagen organization and extracellular matrix remodeling in ovarian tumors.
Subject(s)
Diagnostic Imaging/methods , Microscopy/methods , Ovarian Neoplasms/diagnosis , Collagen/metabolism , Female , Humans , Ovarian Neoplasms/metabolism , Ovarian Neoplasms/pathologyABSTRACT
OBJECTIVE: To verify the pattern of p53 and TGF-beta protein expression in benign and malignant epithelial ovarian tumors. METHODS: An immunohistochemical technique was applied to formalin-fixed paraffin-embedded samples of 22 benign and 9 malignant epithelial ovarian tumors using p53 monoclonal antibody and TGF-beta polyclonal antibody. Expressions of p53 and TGF-beta protein in two histological types were compared, and correlated with clinico-pathologic findings of the respective cases. RESULTS: p53 immunoreactivity of high or intermediate degree was detected in 2 out of 22 benign (9%) and 5 out of 9 malignant (55%) cases. On the other hand, intermediate to high TGF-beta expression was found in 17 out of 22 benign (77%), and 3 out of 9 malignant (33%) cases. The prevalence differences of p53 and TGF-beta expression between benign and malignant groups were statistically significant (p<0.05). In addition, the prevalence of immunoreactivities of p53 and TGF-beta in malignant tumor didn't show any association with age, tumor size, histologic types and stage. CONCLUSION: Our results suggest that p53 expression and loss of TGF-beta expression may play an important role in the malignant transformation of ovarian epithelial cells. However further studies seem to be necessary to know the exact relationship between their roles.
Subject(s)
Epithelial Cells , Hand , Prevalence , Transforming Growth Factor betaABSTRACT
Objective To study the relationship between in situ telomerase activity and the expressin of bcl-2 and p53 proteins in human ovarian epithelial tumors(OETs), and explore their effect in pathogenesis of ovarian cystadenocarcinoma. Methods The telomerase activity of ovarian epithelial tumors was measured by in situ telomerase activity labeling (ISLT), and bcl-2 and p53 expression was detected by SP immunohistochemical method. Results ⑴The positive rates of telomerase in ovarian cystadenocarcinomas(OCAC), their surrounding ovarian tissues(SOT),borderline cystadenomas(BCA),and cystadenomas(CA)were 92 3%(24/26), 0(0/26), 42 8%(9/21) and 0(0/15) respectively, and the positive rate was significantly higher in OCAC than that in SOT, BCA and CA(P0 05); ⑵The positive rates of Bcl-2 in OCAC, SOT, BCA and CA were 65 38%(17/26), 0(0/26), 52 38%(11/21) and 26 66%(4/15) respectively, which were significantly higher in OCAC and BCA than those in SOT and CA(P0 05). Conclusion The results indicated that overexpression of bcl-2 protein may be related to telomerase activation, the telomerase activation induced by bcl-2 overexpression may result in malignant transformation of ovarian epithelials, and p53 mutation may not affect telomerase activity during ovarian cystadenocarcinogenesis.
ABSTRACT
To evaluate the relationship between the expression of CA 125, CA 19-9, and CA 15-3 and ovarian epithelial tumors, immunohistochemical stainings were performed and analyzed to the types of tumor, and the degree o malignancy and differentiation in the total 42 cases. The results were summarized as follows: 1) The expression of CA 19-9 and CA 15-3 was demonstrated in most cases of benign, borderline and malignant mucinous tumors. All types tumors were negative for CA 125. 2) All types of serous tumors including benign, borderline and malignant revealed strong positive reaction for CA 125 and CA 15-3 in contrast to some weak positivity for CA 19-9. Expression of CA 125 was significantly increased in high grade serous adenocarcinomas compared with low of grade. 3) Endometrioid carcinomas revealed strong positive reaction for CA 15-3 in contrast to some positivity for CA 125 and CA 19-9. One case of Brenner tumor expressed CA 19-9 and CA 15-3 without expression of CA 125. 4) Serum CA 125 levels were elevated in 80% and CA 15-3 levels in 100% of ovarian epithelial malignancy. The correlation between serum levels and staining intensities was moderate.
