Naik Pooja S, Deshmukh Sanjay, Khandeparkar Siddhi Gaurish Sinai, Joshi Avinash, Babanagare Shridhar, Potdar Jyostna, Risbud Neelesh Sharad
Department of Pathology, Shrimati Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.
Department of Obstetrics and Gynaecology, Shrimati Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.
J Midlife Health. 2015 Oct-Dec;6(4):178-83. doi: 10.4103/0976-7800.172349.
Ovarian cancer is the third leading site of cancer among women, trailing behind cervix and breast cancer.
This study was undertaken to analyze the immunohistochemical (IHC) profile of estrogen receptors (ER), progesterone receptors (PR), Ki-67, and p53 in various ovarian epithelial tumors and attempt correlation with clinical and histopathological findings.
The present study was conducted over a period of 4 years. A technique of manual tissue array was employed for cases subjected for IHC. The primary antibodies used were ER, PR, p53, and Ki-67. A correlation was attempted between histopathological and IHC findings. Results were subjected to statistical analysis. Software program "the primer of biostatistics 5.0" was used for calculation of interrelationships between the analyzed ER, PR, p53, and Ki-67 expression and histological factors by Pearson's Chi-square test. The results were considered to be significant when the P < 0.05.
There were 110 cases of surface epithelial ovarian tumors (SEOT) encountered over the period of 4 years. The expression of ER was more in malignant tumors (13/16, 81.25%) than borderline (9/12, 75%) and benign (20/82, 24.39%). As compared to ER, the expression of PR was more in benign (51/82, 62.19%) than borderline (8/12, 66.67%) and malignant tumors (9/16, 56.25%). The expression of PR was more in benign tumors than borderline and malignant tumors. However, this was not statistically significant (Chi-square = 0.335 with 2 degrees of freedom; P = 0.846). The expression of p53 was less in benign (5/82, 6.1%) than borderline (9/12, 75%) and malignant tumors (13/16, 81.25%). The expression of Ki-67 was more in malignant (4/82, 4.88%) than borderline (10/12, 83.33%) and benign tumors (15/16, 93.75%). In all the above cases, the difference was statistically significant (P < 0.05). There was statistically significant difference in the expression of ER, PR, p53, and Ki-67 in the patients with age <40 years and above 40 years (P = 0.912). A positive correlation was observed in p53 expression and tumor grade. Similar correlation was seen in Ki-67 and tumor grade. It was also noted that mean Ki-67 labeling index (Li) had also increased with tumor grade. In the case of serous tumors, ER was expressed in all high- and low-grade tumors. The expression of PR was more in low-grade tumors than high-grade ones. P53 expression was seen in all high-grade tumors and 33.34% of low-grade tumor. The Ki-67 Li was more in high-grade tumors than low-grade tumors. Expression of ER, p53, and Ki-67 was higher in tumor showing metastasis. The mean Ki-67 Li was also higher in metastasizing tumors. However, PR expression was less in metastasizing tumors than nonmetastasizing tumors.
IHC marker report of ER, PR status, and Ki-67 if included in each pathology report will pave the way for better understanding of biological behavior and modify treatment strategies.
卵巢癌是女性中第三大常见癌症部位，仅次于宫颈癌和乳腺癌。
本研究旨在分析各种卵巢上皮性肿瘤中雌激素受体（ER）、孕激素受体（PR）、Ki-67和p53的免疫组化（IHC）特征，并尝试将其与临床和组织病理学结果相关联。
本研究历时4年。对进行免疫组化的病例采用手工组织芯片技术。使用的一抗为ER、PR、p53和Ki-67。尝试将组织病理学和免疫组化结果进行关联。结果进行统计学分析。使用软件程序“生物统计学基础5.0”通过Pearson卡方检验计算分析的ER、PR、p53和Ki-67表达与组织学因素之间的相互关系。当P<0.05时，结果被认为具有统计学意义。
在4年期间共遇到110例表面上皮性卵巢肿瘤（SEOT）。ER在恶性肿瘤中的表达（13/16，81.25%）高于交界性肿瘤（9/12，75%）和良性肿瘤（20/82，24.39%）。与ER相比，PR在良性肿瘤中的表达（51/82，62.19%）高于交界性肿瘤（8/12，66.67%）和恶性肿瘤（9/16，56.25%）。PR在良性肿瘤中的表达高于交界性和恶性肿瘤。然而，这在统计学上无显著差异（卡方=0.335，自由度为2；P=0.846）。p53在良性肿瘤中的表达（5/82，6.1%）低于交界性肿瘤（9/12，75%）和恶性肿瘤（13/16，81.25%）。Ki-67在恶性肿瘤中的表达（4/82，4.88%）低于交界性肿瘤（10/12，83.33%）和良性肿瘤（15/16，93.75%）。在上述所有病例中，差异具有统计学意义（P<0.05）。年龄<40岁和>40岁患者的ER、PR、p53和Ki-67表达存在统计学显著差异（P=0.912）。p53表达与肿瘤分级呈正相关。Ki-67与肿瘤分级也有类似的相关性。还注意到平均Ki-67标记指数（Li）也随肿瘤分级增加。在浆液性肿瘤中，ER在所有高分级和低分级肿瘤中均有表达。PR在低分级肿瘤中的表达高于高分级肿瘤。P53表达见于所有高分级肿瘤和33.34%的低分级肿瘤。Ki-67 Li在高分级肿瘤中高于低分级肿瘤。ER、p53和Ki-67在有转移的肿瘤中表达较高。转移肿瘤的平均Ki-67 Li也较高。然而，PR在转移肿瘤中的表达低于非转移肿瘤。
如果在每份病理报告中纳入ER、PR状态和Ki-67的免疫组化标记报告，将为更好地理解生物学行为和调整治疗策略铺平道路。
