Індивідуалізація тактики лікування хворих із епітеліальними пухлинами яєчників з урахуванням клініко-морфoлогічних ознак та додатковим визначенням імуногістохімічних маркерів

Abstract

The complexity of clinical diagnosis (asyptomatic) of epithelial ovarian tumors and large number of morphological (histological) types of their structure requires in modern conditions applying additional immunohistochemical markers that allows you to individualization the treatment tactics and determine prognosis. The objective: to determine immunohistochemical markers (ER, PR, p53, Ki-67, CD34, E-cadherin) in tumors of the ovaries for individualization treatment and prognosis. Patients and methods. Ovarian neoplasms among 30 patients. Morphological and histological immunohistochemical methods. Results. The largest part of our study of ovarian endometrioid cyst neoplasms amounted to – 15 cases (50%), serous cyst 4 cases (14%), serous borderline tumors-3 cases (10%), the serous borderline malignancy tumor of type well differentiated serous adenocarcinoma GI-II–1 (3%), a case of mucinous cyst – 1 (3%) case, borderline mucinous tumor – 3 (10%) case 2 (7%) case combination of endometrioid and serous cysts, 1 (3%) case-mature dermoid cyst. Receptors of estrogen, progesterone and the proliferation marker Ki-67 are key predictive markers, high rate of 70% and the first low rate of less proliferation than 10% indicates a favorable prognosis and lets you customize the hormonal treatment with serous and endometrioid cysts, particular more favourable cases when border serous cysts. Mutant protein p53 helps to determine, in particular in the group of borderline serous and mucinos tumor adverse events which are subject to active monitoring and clinical application of preventive chemotherapy. Cell adhesion marker E-cadherin had practical significance in differential diagnosis, in particular for rendering the epithelial lining in endometrioid cysts, the absolute correlation decrease cell adhesion (intensity expression) is not detected in different histological types (factor into «true» membrane and atypical expression in the cytoplasm), antigen CD34 also, marker of vascular density did not have applied practical significance due to cystic ovarian neoplasm morphological structure, lack of unified field measuring micro-vessels. Conclusion: neoplasm the ovaries along with the classical histological method of advisable include immunohistochemistry markers, which allow you to more accurately determine their biological nature, improve diagnostics, individualized treatment and tactics determine prognosis. Key words: epithelial ovarian tumors, diagnosis, treatment, immuhistochemical method.