Maraei Awadh Ali Makhashen, Hatta Ahmad Zailani, Shiran Mohd Sidik, Tan Geok Chin
Department of Pathology and Obstetrics, Universiti Kebangsaan Malaysia, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia.
Indian J Pathol Microbiol. 2012 Apr-Jun;55(2):187-91. doi: 10.4103/0377-4929.97865.
Ovarian cancer is the 6 th most common cancer among women. In ovarian tumors, the borderline category is not well defined due to the difficulty in assessing stromal invasion. The World Health Organization (WHO) defined it as tumor that lacks obvious invasion of the stroma with mitotic activity and nuclear abnormalities intermediate between clearly benign and unquestionably malignant. Telomerase is expressed in many human cancers and is hence a potential biomarker for cancer. Immunohistochemical study of anti-human telomerase enzyme reverse transcriptase (hTERT) antibody allows direct visualization of its expression. The aim of this study was to determine the expression of hTERT and serum CA-125 level in ovarian epithelial tumors, and their ability to distinguish borderline tumor from malignancy.
This was a retrospective study on 68 ovarian epithelial tumors, comprising of 41 cystadenocarcinoma, 22 borderline tumor and five cystadenoma. By immunohistochemistry, hTERT expression was graded as negative (0-10%), focal (11-25%), regional (26-75%) and diffuse (>75%) positivity.
hTERT protein expression in ovarian cystadenocarcinoma, borderline tumor and cystadenoma were 71.4%, 59.1% and 0%, respectively. hTERT and CA-125 had a linear relationship with tumor grade and stage. hTERT protein is detected as large granules/speckled in the cytoplasm and nuclei of ovarian tumors.
hTERT protein was highly expression in ovarian epithelial carcinoma. However, the difference between carcinoma and borderline tumor was not statistically significant (P-value = 0.51). It is not an independent biomarker to differentiate borderline tumor from malignant tumor. We suggest using the combination of hTERT immunohistochemistry and serum CA-125 to evaluate difficult situations where histological evaluation fails to distinguish malignant from borderline ovarian tumor.
卵巢癌是女性中第六大常见癌症。在卵巢肿瘤中，由于评估间质浸润存在困难，交界性肿瘤类别定义不明确。世界卫生组织（WHO）将其定义为缺乏明显间质浸润、具有有丝分裂活性且核异常介于明显良性和无疑恶性之间的肿瘤。端粒酶在许多人类癌症中表达，因此是一种潜在的癌症生物标志物。抗人端粒酶逆转录酶（hTERT）抗体的免疫组织化学研究可直接观察其表达。本研究的目的是确定hTERT在卵巢上皮性肿瘤中的表达及血清CA - 125水平，以及它们区分交界性肿瘤与恶性肿瘤的能力。
这是一项对68例卵巢上皮性肿瘤的回顾性研究，包括41例囊腺癌、22例交界性肿瘤和5例囊腺瘤。通过免疫组织化学，hTERT表达分为阴性（0 - 10%）、局灶性（11 - 25%）、区域性（26 - 75%）和弥漫性（>75%）阳性。
卵巢囊腺癌、交界性肿瘤和囊腺瘤中hTERT蛋白表达分别为71.4%、59.1%和0%。hTERT和CA - 125与肿瘤分级和分期呈线性关系。在卵巢肿瘤的细胞质和细胞核中，hTERT蛋白表现为大颗粒/斑点状。
hTERT蛋白在卵巢上皮癌中高表达。然而，癌与交界性肿瘤之间的差异无统计学意义（P值 = 0.51）。它不是区分交界性肿瘤与恶性肿瘤的独立生物标志物。我们建议联合使用hTERT免疫组织化学和血清CA - 125来评估组织学评估无法区分恶性与交界性卵巢肿瘤的困难情况。
