The Association between Estrogen and Progesterone Receptors Expression with the Stages of Endometrioid-type Ovarian Carcinoma at Sanglah General Hospital, Bali, Indonesia: A Preliminary Study

Abstract

BACKGROUND: Ovarian cancer is the most common cause of death among gynecologic malignancies. Poor prognosis is mainly due to the high incidence of advanced stage at the time of diagnosis as well as low estrogen receptor (ER) and progesterone receptor (PR) expression. Based on it, further understanding is needed to predict the course of disease.
 AIM: This study aims to evaluate the expression of ER and PR with the stages of endometrioid-type ovarian carcinoma as the more frequent type carcinoma at Sanglah General Hospital, Bali.
 METHODS: An analytical cross-sectional study was conducted among 36 samples of endometrioid-type ovarian carcinoma examined at Anatomical Pathology Laboratory, Faculty of Medicine, Udayana University/Sanglah General Hospital, Denpasar. The histopathological diagnosis, grade, and tumor size, as well as determination on hematoxylin-eosin staining were assessed. The expression of ER and PR was examined using immunohistochemical stain. Data were analyzed using the SPSS version 15 software for risk analysis and p < 0.05 was assumed statistically significant.
 RESULTS: Most of the samples were from 41 to 50 years of age group (41.7%) and the average age was 51.1 ± 9.80 years old. Based on the degree of differentiation, Grade 2 was the most common cases (38.9%). However, the tumor size assessment revealed that T3 was predominant (41.7%). Positive ER and PR expressions were obtained in 18 samples (50.0%) and 14 samples (38.9%), respectively. Fisher’s exact test showed a significant association between ER expression with grade (odds ratio [OR]: 6.25; 95% confidence interval [CI] 1.327–29.432; p = 0.018) and tumor size (OR: 4.375; 95% CI 1.027–18.629; p = 0.043). A similar findings also found in PR expression with grade (OR: 15.60; 95% CI 1.728–140.829; p = 0.004) and tumor size (OR: 6.12; 95% CI 1.394–26.876; p = 0.016).
 CONCLUSION: ER and PR expressions are significantly associated with grade and tumor size in the endometrioid-type ovarian carcinoma.