Surface Epithelial Tumors Research Articles

A Three-year retrospective analysis of tumour like conditions of the Ovary in Tirunelveli Medical College Hospital

The Ovaries Are Paired Oval Structures In Females, Developing From The Gonadal Ridges, And Located One On Each Side Of The Uterus In The Ovarian Fossa. These Are Very Complex Organs In Terms Of Embryology And Histology. It Undergoes Cyclical Changes From Adolescence To Menopause And Gives Rise To Different Types Of Cells, Each Of Which Has The Capacity To Produce Different Type Of Tumours1. Due To Constant Endocrine Stimulation And Subsequent Traumatic Insults By Ovulation, These Are The Primary Sites For Tumour Development. Different Types Of Tumours Tend To Occur In Different Age Group. Both Primary And Metastatic Tumours Occur In The Ovary With Variable Histomorphological Patterns.2 Ovarian Cancer Is One Of The Most Common Neoplasm In Developed Countries, Ranking 7th Position In Incidence And 6th Position In Mortality3.It Constitutes About 6.6% Of All Malignant Tumours Of The Female Genital Tract3.In India, Incidence Of Ovarian Cancers Come Next To Cervical And Endometrial Cancers Among The Gynaecological Cancers. According To National Cancer Registry Programme Of Indian Council Medical Research, The Proportion Of Ovarian Cancer Varied From 1.7-8.7 In Various Urban And Rural Areas, It Also Showed That Recent Increase In Incidence. Both Chennai Cancer Registry And Dindigul Ambilikkai Cancer Registry Showed An Age Adjusted Incidence Rate Of 6.0cases Per 10, 0000women4, Whereas It Was 16.23 In United States.3 Ovarian Cancers Area Heterogeneous Group Of Neoplasms Of Three Main Subtypes: - Surface Epithelial, Germ Cell And Sex Cord Stromal Tumours With Wide Morphological Variations. No Age Group Is Free From The Tumour. In Adult Age Group Surface Epithelial Tumours Are The Commonest Neoplasm Constituting 65.5% Of Ovarian Neoplasms. In Younger Age Group, Germ Cell Tumours Are The Commonest Ovarian Neoplasms And Constitute Two Third Of Ovarian Tumours Out Of Which, One Third Are Malignant. Sex-Cord Stromal Tumours Can Occur At Any Age Group And Are Usually Functional In Nature. So The Determination Of Various Histological Patterns Is Very Important In Diagnosis As Well As Prognosis Of Ovarian Tumors5. Ovarian Cancer Has Got A Poor Prognosis Among All Gynaecological Cancers. The Overall 5year Survival Rate Is Approximately 45% Due To Late Stage At Diagnosis6.Unlike Cervical Cancer, Identification Of High Risk Population For Ovarian Malignancy And Ideal Screening Method Is Not Available. A Number Of Non Neoplastic Lesions Can Occur From Neonatal Period To Postmenopausal Age Group. Most Are Functional In Nature And Resolve With Minimal Treatment. Some Of The Non Neoplastic Lesions Like Massive Edema Of Ovary, Stromal Hyperplasia, Large Follicular Cyst, Pregnancy Luteomas, And Granulomatous Inflammation Can Be Confused With Neoplasm Clinically, Intraoperatively Or On Morphological Examination. The Main Aim Lies In Distinguishing Ovarian Neoplasms From The Wide Spectrum Of Non-Neoplastic Lesions. Despite The New Techniques Like Imaging And Genetic Studies, The Diagnosis Of Ovarian Tumour Is Mainly Dependent Upon Histopathological Examination. The Present Study Is Being Undertaken To Review In Detail The Different Varieties Of Ovarian Lesions In And Around Tirunelveli And Assess Their Characteristics With Regards To Incidence, Age And Histopathological Appearances.

Histopathological Study of Ovarian Tumors at a Tertiary Care Hospital of Central Nepal

Background: Ovarian tumors are histogenetically varied and complex tumors spanning all age groups. They account for 30% of all gynaecologic cancers. Malignant tumors carry a high mortality due to its late detection and ineffective screening programs. Current study aims at finding association between age at presentation and size of tumor with behavior of tumors and also association between category of tumor and age at presentation.
 Methods: This Hospital record based cross-sectional (historical) study was carried out on 158 cases of ovarian tumors received in Department of Pathology, College of Medical Sciences and Teaching Hospital during a time period of five and a half years from January 2012 to June 2017.
 Results: Age of the patients ranged from 12 to 88 years with maximum cases 96 (60.8%) in 20 – 40 years age group. The mean ±SD of age was 36.6±14.4 years. Majority of the cases 137 (86.7%) were benign. Sixteen (10.1%) cases were malignant and 5 (3.2%) cases were borderline. Majority of both benign and malignant cases were seen in 20 – 40 years age group. Size of the tumors ranged from 2 – 30 cm with mean±SD of 9.9±5.0 cm and maximum 93 (58.9%) cases in the size range of 5 – 10 cm. Majority of both benign and malignant tumors were in the size range of 5 – 10 cm. There was no association of age at presentation and size of tumor with behavior of tumor (p > 0.05). Sevety five (47.5%) cases were germ cell tumors, 72 (45.6%) cases were surface epithelial-stromal tumors, 9 (5.7%) cases were sex cord-stromal tumors, 1 (0.6%) was bilateral with surface epithelial tumor in right ovary and germ cell tumor in left ovary and 1 (0.6%) case was soft tissue tumor not specific to ovary. Majority of cases of germ cell tumors were seen below 40 years age whereas significant proportion of surface epithelial-stromal tumors was seen after 40 years with significant association between category and age at presentation (p < 0.05). Most common histopathological diagnosis overall was dermoid cyst in 43.7% cases.
 Conclusions: Benign ovarian tumors were more common than malignant ones. Malignancy was seen in all age groups and in any size tumor. Surface epithelial-stromal tumors and germ cell tumors were roughly equal in frequency with slight predominance of latter. Germ cell tumors were common in younger whereas surface epithelial-stromal tumors were more common in older individuals. Histopathological examination in any ovarian tumor at any age with any size is mandatory.

A Study of β-Catenin and PTEN Expression in Ovarian Surface Epithelial Neoplasms and their Correlation with Grade and Stage in Malignant Cases

A Study of β-Catenin and PTEN Expression in Ovarian Surface Epithelial Neoplasms and their Correlation with Grade and Stage in Malignant Cases

Study of frequency and histopathological pattern of soft tissue tumours in tertiary care centre of Gandhinagar, Gujarat

Background: Ovaries are complex intra-pelvic organs of the female reproductive system. Ovarian cancer accounts for 3% of all cancers in females and is the fifth most common cause of cancer death in women. Early menarche, late menopause, nulliparity and high socioeconomic status are associated with an increased risk for ovarian neoplasms. Histo-pathological diagnosis remains the mainstay to differentiate neoplastic lesions from non-neoplastic lesions. Aims and objectives: This study aims to analyze the view of ovarian tumors with respect to clinical presentation, gross and microscopic characteristics and also to study the frequency and histopathological patterns of ovarian tumours. Materials and Methods: This study comprised of 100 cases of ovarian tumours received in the Department of Pathology, GMERS Medical College, Gandhinagar were analysed. Their gross features, microscopic findings were analysed in detail. Ovarian tumours were divided into benign and malignant categories and their further sub typing were done according to WHO Classification. Results: Out of total 100 cases, 76 were benign and 24 were malignant. Out of 100 cases, 62% were between 21-40 years of age followed by 28% were between 41-60 years of age. Most common presenting symptom was pain in abdomen followed by lump in abdomen and heavy menstruation. Out of total 100 cases, 70% were surface epithelial tumours, 24% were germ cell tumours and 6% were sex cord stromal tumours. Conclusion: To conclude we recommend microscopic histopathological examination of every ovarian mass in order to assess the importance of pathological grading and staging and they must be classified correctly so that the patient can be provided with appropriate treatment and prognosis.

Retrospective Study of histomorphological spectrum of ovarian tumours in GCS Medical College, Hospital and Research Center, Ahmedabad

Background and objectives: Ovarian tumours accounts for 30% of female genital cancers and have become increasingly important not only because of the large variety of neoplastic entities but also because they have gradually increased the mortality rate. Ovarian neoplasm remains asymptomatic until there is massive ovarian enlargement which causes compression of pelvic structures, ascites, abdominal distension or distant metastasis.Thus present study was undertaken to analyze the frequency of various histomorphological spectrum, histological subtypes and age distribution pattern of ovarian tumours. Methods: Retrospective study was carried during period of 1st June 2017 to 30st November 2018, 57 cases of ovarian neoplastic lesions were taken from the records of the department. Results: A total number of 57 cases were studied. Among these, 41cases (71.92%) were of benign tumours, 2 cases (3.50%) were of borderline tumours and 14 cases (24.56%) were of malignant tumours. Serous cystadenomas (26/41) (63.41%) were the commonest benign tumours followed by Mucinous cystadenomas (6/41)(14.63%). Among the malignant surface epithelial tumours serous cystadenocarcinomas (6/14) (42.86%) were most common followed by Mucinous cystadenocarcinomas (3/14) (21.43%). Germ cell neoplasms constituted 19.30% of all ovarian neoplasms. Conclusion: Ovarian tumours cannot easily be diagnosed by clinical symptoms only, histological examination is therefore necessary for diagnosis and grading of ovarian tumours. Females with family history of endometrial and breast carcinoma has got increased incidence of ovarian carcinoma and ovary is also common site for metastasis from other primary gynecological as well as non gynecological carcinomas e.g. endometrium, stomach and breast. Hence present study was carried out in the department of pathology for early diagnosis of ovarian carcinomas, their histological sub typing and their age distribution pattern.

To assess the utility of proliferative marker Ki-67 in surface epithelial ovarian tumor

Background: Surface epithelial ovarian tumor (SEOT) accounts for more than 90% of all the ovarian tumors and are the most lethal one. Cellular proliferation plays a significant role in the clinical behavior and aggressiveness of ovarian tumor. Proliferative activity of the tumor can be assessed using the proliferative marker Ki-67, which has both diagnostic and prognostic values. Aim and Objective: The aim and objective of this study was to assess the expression of proliferative marker Ki-67 in various SEOT and correlate its level of expression with clinicopathological parameters including the International Federation of Gynecology and Obstetrics (FIGO) staging and preoperative CA-125 level. Materials and Methods: The study was a cross-sectional and observational study carried out in the Department of Pathology, JNMC, Sawangi, Wardha, over 2 years. It included 74 patients with surgically resected specimen of SEOT. Ki-67 immunohistochemistry was performed in all the 74 cases, and the percentage of immunopositive cells was expressed as Ki-67 labeling index (Ki-67 LI). Results: Out of 74 cases, 54 were benign and 20 were malignant which comprised serous and mucinous histological subtypes. Ki-67 expression was found to be positive only in malignant tumors (Ki-67 LI >1%). High Ki-67 LI was associated with high-grade serous cystadenocarcinoma (48.5%), advanced FIGO staging (40.5%), and high CA-125 levels. However, there was no association between Ki-67 LI and histological subtype. Conclusion: Ki-67 is a cost-effective proliferative marker. Therefore, immunohistochemical assessment of Ki-67 expression can be included in routine histopathological report of SEOT for diagnosis and prognostication which will help in better understanding of the biologic behavior of the tumor and modifying treatment strategies.

Brenner tumor of the ovary: Incidental finding with unusual combinations

The most common ovarian tumors are surface epithelial tumors, comprising 58% of all ovarian tumors. Among them, serous and mucinous cystadenomas are the most common (35%). A Brenner tumor is a rare, mostly benign type of ovarian epithelial neoplasm with an incidence of 1%–2%. Rarely, they occur in other locations, including the testis. The majority of Brenner tumors are benign; however, some can be malignant. These are most frequently found incidentally on pelvic examinations or during laparotomy. In the present case series, we report three cases of Brenner tumors diagnosed incidentally on histopathology. The first case was a rare combination of serous cystadenoma, with a focus showing a Brenner tumor in the wall of serous cystadenoma. The second case was a proliferating Brenner tumor in the wall of mucinous cystadenoma, and the third case had bilateral benign Brenner tumors.

Fertility preservation surgeries in gynecological malignancies at a tertiary care institute in South India

Background: Fertility preservation surgery is a method to preserve the fertility potential of women without affecting the management of Gynecological cancer. It is important to know the type of malignancies and age group at which these are diagnosed and managed as this differs from centre to centre. Aims and Objectives: The aim was to find out the spectrum of Gynaecological malignancies in young women and to find out the type of malignancies in which Fertility sparing surgery was feasible. Materials and Methods: This is a retrospective analysis of young women (≤ 40 years of age) with Gynaecological malignancies who underwent fertility sparing surgeries from January 2017 to December 2018 in the department of Obstetrics and Gynaecology, JIPMER, Puducherry, South India Results: Out of 558 women with Gynecological malignancies admitted for management, 127 were ≤ 40 years of age. The most common malignancy was Ovarian (58%) followed by Cervix (24%) and Endometrium (14%). In Ovarian carcinoma, surface epithelial tumors were the commonest (62%) followed by Germ cell tumors (31%). Fertility sparing surgery was feasible in all germ cell tumors and only 30 % of surface epithelial tumors as the mean age at presentation was 25 years. In women with carcinoma cervix and carcinoma endometrium the mean age was 37 and 35 years respectively and all of them completed their family. Conclusion: In this retrospective cohort, fertility sparing surgery was needed only in Ovarian malignancies.

Tumors of the conjunctiva and cornea.

Tumors of the conjunctiva and cornea comprise a large and varied spectrum of conditions. These tumors are grouped into two major categories of congenital and acquired lesions. The acquired lesions are further subdivided based on origin of the mass into surface epithelial, melanocytic, vascular, fibrous, neural, histiocytic, myxoid, myogenic, lipomatous, lymphoid, leukemic, metastatic and secondary tumors. Melanocytic lesions include nevus, racial melanosis, primary acquired melanosis, melanoma, and other ocular surface conditions like ocular melanocytosis and secondary pigmentary deposition. The most frequent nonmelanocytic neoplastic lesions include squamous cell carcinoma and lymphoma, both of which have typical features appreciated on clinical examination. The caruncle displays a slightly different array of tumors compared to those elsewhere on the conjunctiva, as nevus and papilloma are most common, but oncocytoma and sebaceous gland hyperplasia, adenoma, and carcinoma can be found. In this report, we provide clinical description and illustration of the many conjunctival and corneal tumors and we discuss tumor management.

A Study of Histomorphology of Ovarian Neoplasms

Background: Ovarian malignancy is one of the most common causes of cancer deaths in females in Bangladesh. Due to poor early symptoms and lack of screening protocol, it is detected later in the clinical course of the disease. It is also one of the most treatable tumors because majorities are sensitive to chemo-radiation. An accurate histology is often a critical factor in achieving optimum treatment response.
 Objective: To study the frequency and histological patterns of neoplastic ovarian lesions.
 Methodology: A retrospective cross sectional study was done. We analyzed the data compiled from ovarian lesions biopsied and reported in a private diagnostic center from January 2008 to December 2015.
 Results: Out of 231 ovarian specimens only 66 were neoplastic lesions, while the rest were nonneoplastic cysts. The age range was 9 to 65 years with a mean of 36.58 ±10.45. 73 percent (48) were benign, 6.01 percent (4) were borderline and 21.21 percent (14) were malignant. Surface epithelial tumors were the most common ovarian neoplasm (n=48; 72.73%) followed by germ cell tumor (n=14; 21.21%) and sex cord stromal tumor (n=4; 6.01%). Serous cystadenoma was the commonest benign tumor (23) followed by dermoid cyst (11), and mucinous cystadenoma (10). Only 4 borderline malignant tumors were found; 03 of which were mucinous and 01 serous. The number of malignant tumor was 18. Malignant mucinous neoplasm was the commonest, in both invasive carcinoma (05) and borderline group (03).
 Conclusion: Benign ovarian neoplasm was more common than malignant ones. Surface epithelial tumor was the frequent group followed by germ cell tumor. Serous cystadenoma was most common among benign tumors whereas mucinous cystadenocarcinoma was the commonest malignant tumor.
 J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 25-28

Histopathological Profile of Ovarian Masses

Aims: The aim of this study was to evaluate the incidence of neoplastic as well as non-neoplastic ovarian lesions and to find out the frequency and age distribution of benign and malignant ovarian neoplasms.Methods: A retrospective cross sectional study on a series of cases was performed in the Department of Pathology, Patan Academy of Health Sciences, Patan Hospital, Lalitpur, Nepal from April 2011 to March 2016. Data from the histopathology database were analyzed using SPSS version 16.0.Results: During the study period, surgical specimens of 528 ovarian masses were received at our institution. Among them, 399 cases (76%) were neoplasms and 129 cases (24%) were non-neoplastic lesions. Benign, borderline and malignant neoplasms were 89.7%, 1.8% and 8.5% respectively. Benign neoplasms were more common in 21-30 years and malignant in 41-50 years age group. There were 156 (39.1%) surface epithelial tumors, 236 (59.1%) germ cells tumors and 6 (1.5%) sex cord stromal tumors. Mature cystic teratoma, followed by serous cystadenoma was the most frequently encountered benign tumor. Serous cystadenocarcinoma was most prevalent in the malignant group. Among the non-neoplastic masses, the most common was endometriotic cyst (55%) followed by corpus luteal cyst (29%).Conclusions: Ovarian neoplasms are more common than non-neoplastic lesions. Malignant tumors affect older women more frequently than younger women. Mature cystic teratoma was the most frequently encountered benign tumor. Serous cystadenocarcinoma was most prevalent in the malignant group. Endometriotic cyst was the most common non-neoplastic lesion.

Role of Her-2 Neu as Prognostic Indicator in Surface Epithelial Tumors of Ovary

Role of Her-2 Neu as Prognostic Indicator in Surface Epithelial Tumors of Ovary

IMMUNOHISTOCHEMICAL EXPRESSIONS OF PAX8 IN OVARIAN SURFACE EPITHELIAL TUMORS

Background: PAX8 is a nuclear transcription factor with limited expression in normal and neoplastic tissues, it has the potential to induce tumorigenesis and is expressed in a tissue during neoplastic transformation. PAX8 is a useful marker to distinguish gynecologic cancers from non-gynecologic malignancies. Objective: To assess the immunohistochemichal expression of PAX8 in ovarian surface epithelial tumors. Methods: This study included a total of 100 ovarian tissue paraffin blocks, 70 tissue paraffin blocks of ovarian tumors obtained from patients who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy and 30 tissue paraffin blocks were the control group included normal ovarian tissue and fallopian tubes tissue. From each paraffin block, 2 sections were taken, one was stained with the routine hematoxylin and eosin stain and the other section was stained immunohistochemically for PAX8. Results: PAX8 showed a high significant difference in its immunohistochemical expression between the control group and the case group with the highest expression in malignant ovarian surface epithelial tumors (P < 0.001). Also, PAX8 showed a highly significance in the expression of PAX8 in relation to histopathological types (P < 0.001) except for the mucinous tumors, which showed statistically non-significance (P = 0.641), also, a highly significant relation with the increment of tumor grade (r = 0.769, P < 0.001). PAX8 showed a non-significant relation with increase of the age (r = 0.147, P= 0.225), with tumor stage (r = 0.433, P = 0.057), with the presence of ascites (P = 0.446). Conclusion: The highly significant differences in the immunohistochemical expression of PAX8 in the ovarian surface epithelial tumors tissues compared to the control groups reflect its important role in ovarian tumorigenesis. Besides PAX8 can be used as an important marker for discriminating ovarian non-mucinous from mucinous tumors. Also, there is a possible role of PAX8 in the development and differentiation of ovarian malignant surface epithelial tumor. Keywords: Ovarian surface epithelial tumors, ovarian carcinoma, transcription factor, paired box antigen, PAX8, immunohistochemistry Citation: Al-Shami SA, Qasim BJ, Hassan AM. Immunohistochemical expressions of PAX8 in ovarian surface epithelial tumors. Iraqi JMS. 2018; 16(3): 298-307. doi: 10.22578/IJMS.16.3.9

IMMUNOHISTOCHEMICAL EXPRESSION OF CD133 IN OVARIAN SURFACE EPITHELIAL TUMORS

Background: The identification of antigenic profile of the cancer stem cells might have relevant clinical implication as they're able to proliferate and self-renew, in turn sustaining tumor growth. CD133 is one of robust surface marker for cancer stem cells in various neoplastic human tissues, including ovaries. It is associated with the clinical outcome of patients. Objective: To assess the immunohistochemichal expression of cancer stem cell marker (CD133) in ovarian surface epithelial tumors. Methods: This study included a total of 100 ovarian tissue paraffin blocks, 70 tissue paraffin blocks included ovarian tumors obtained from patient who underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy, while 30 tissue paraffin blocks assigned as the control group included normal ovarian tissue and fallopian tubes tissue. From each paraffin block, 2 sections were taken, one was stained with hematoxylin and eosin stain and the other section was stained immunohistochemically for CD133. Results: CD133 showed a high significant difference in its immunohistochemical expression between the control group and the case groups with the highest expression seen in malignant ovarian surface epithelial tumors (P < 0.001). CD133 expression was highly significantly associated with histopathological type (P < 0.001). CD133 also showed a significant relation to age (r = 0.254, P= 0.034), tumor grade (r = 0.794, P < 0.001), tumor stage (r = 0.543, P= 0.013) and presence of ascites (P < 0.001). Conclusion: CD133 expression revealed a highly significant differences in the ovarian surface epithelial tumors tissues compared to control group, which reflect its important role in ovarian carcinogenesis. Keywords: Ovarian surface epithelial tumors, ovarian carcinoma, cancer stem cells, cancer stem cell marker, CD133, immunohistochemistry Citation: Al-Shami SA, Qasim BJ, Hassan AM. Immunohistochemical expression of CD133 in ovarian surface epithelial tumors. Iraqi JMS. 2018; 16(3): 308-318. doi: 10.22578/IJMS.16.3.10

Histopathological Study of Ovarian Lump and Serum Tumor Marker Ca 125 estimation as a Screening Tool

Background: Ovarian tumor is the fourth commonest cancer in female in Nepal. About 80% is benign and 20% of these tumors are malignant. Due to its complex nature, vagueness and non-specificity of the symptoms it produces, the ovarian neoplasm can mislead both the doctor and patients. Hence this study was undertaken with aims & objectives to study the morphology of ovarian specimens as well as estimate serum CA125 as screening tool. Material and Methods: A study of over one year comprised of 75 specimens of ovary diagnosed in the Department of Pathology, Nobel medical college and teaching hospital, Biratnagar. After thorough gross examination and preparation of H&E stained slides the lesion of ovary were classified as per WHO classification. Also, preoperative blood samples were obtained from patients for estimation of serum CA125 level. Blood samples was also drawn from 20 healthy females in reproductive age group who acted as controls. Results: Of the 75 cases of ovarian mass, based on histology 75% were benign, and 25% were malignant. Surface epithelial tumors were the commonest (68%) of all ovarian tumor, followed by germ cell tumors (13%), sex cord–stromal tumors (6%). Serous Cystadenoma (29%) was the commonest benign tumor and serous cystadenocarcinoma (9%) commonest malignant neoplasm. CA125 levels was raised in epithelial ovarian cancers. Maximum rise was seen in serous cystadenocarcinoma. Exceptionally a small percentage of epithelial cancer showed normal level (false negative). Also, few benign tumors, non-epithelial tumors and even non-neoplastic lesions showed false positive rise in CA125 (false positive). Conclusion: Accurate histopathological evaluation of ovarian specimen is necessary both in terms of therapeutic intervention as well as prognosis. CA125 is an important screening tool for detection of epithelial ovarian cancers. Journal of Nobel Medical College Volume 7, Number 1, Issue 12, January-June 2018, Page: 30-36

Study of histopathologic patterns of borderline and malignant ovarian tumor

Introduction: Ovarian cancer is the cause of a high case-fatality ratio, and most of the cases are diagnosed in late stages. Aims and objectives: To find the frequency of different types of histomorphological types and their correlation with age, side and size distribution and how it helps in managements of these lesions. Methodology: A retrospective analysis of all malignant ovarian tumours received and processed at the Pathology Department of Hassan institute of medical sciences. Results: The ovarian tumours included 22 borderline and malignant cases. Surface epithelial tumours (Borderline and malignant tumours) was the most common accounting for 56.6%. Next common group was Sex cord stromal tumours constituting 26.1% followed by Germ cell tumours accounting for 17.3%. Conclusion: There was single case of Tertoma, Endometrioid carcinoma and Malignant mixed germ cell tumour constituting 4.3%. Maximum number of cases occurred in 4th decade of life.

Evaluation of the role of HIF-1α and GLUT-1 in the pathogenesis of ovarian surface epithelial tumors and their prognostic impact

Evaluation of the role of HIF-1α and GLUT-1 in the pathogenesis of ovarian surface epithelial tumors and their prognostic impact

Cytokeratin Expression Profile Study in Malignant Ovarian Tumors

Background: Expression of cytokeratin is seen in varied ovarian tumors including primary surface epithelial tumors, Granulosa cell tumors, Sertoli – Leydig cell tumors, non dysgerminomatous germ cell tumors and metastatic carcinomas. The aim of the study is to demonstrate various patterns of cytokeratin expression in epithelial and non-epithelial malignant ovarian tumors. Methods: Materials for the present study of 39 cases of malignant ovarian tumors obtained from the patients admitted during the period of two years. For histopathological examination, 10% formalin fixed embedded representative tissue sections were studied with Haematoxylin and Eosin. Detailed microscopic examination was carried out. Application of IHC for cytokeratin expression study was carried by streptavidin – biotin complex method. The details of clinical history and relevant investigations were obtained. Results: The total number of malignant ovarian tumors studied during two year period was 39 cases. Among that, serous tumors was the most common [25 cases (64.6%)], followed by Sex cord stromal tumors [6 cases (15.3%)], metastatic tumors [4 cases (10.2%)] and Germ cell tumors [4 cases (10.2%). Cytokeratin was positive in >50% of serous epithelial cells, followed by krukenberg tumor and showed focal positivity in non-epithelial tumors. Conclusion: Evaluation for pancytokeratin (AE 1 / AE 3) in the context of ovarian tumors is useful only in specific instances including identification of epithelial differentiation in an apparently undifferentiated neoplasms and distinction of dysgerminoma from non dysgerminomatous germ cell tumors. Non dysgerminomatous germ cell tumors characteristically express cytokeratin diffusely and strongly, whereas in dysgerminoma it shows only focal and weak expression.

The Comparative Study of the Frequency of P53 and Ki67 Markers in Ovarian Epithelial Tumors and Their Relationship with Survival in Patients Presenting to Shahid Sadoughi Hospital of Yazd in 2013–2017

Ovarian cancer is the fifth cause of cancer death among women. P53 gene and Ki67 can play a significant role in the progression of tumors. This study was conducted to review the frequency of P53 and Ki67 markers in different types of ovarian epithelial tumors and their relationship with the prognosis of the disease. This descriptive analytical study was done on all paraffin-embedded blocks of patients with ovarian surface epithelial tumors (malignant, benign, and borderline) referred to pathology ward of Shahid Sadoughi educational General Hospital from 2013 to 2017 by using the census method. Ki67 and P53 immunohistochemical tests were then performed on all the samples. Data such as (age, pathology report, survival status, affected side, size of tumor) were extracted from the hospital folders. Data were analyzed in SPSS version 22. P < 0.05 was set as the level of statistical significance. A total of 86 cases, including 40 serous and mucinous carcinomas, 36 serous and mucinous cystadenomas, and ten serous and mucinous borderline tumors, were examined. The mean age of the patients was 44.29 ± 16.91 years, and their age range was 15–79. A significant relationship was found between the type of tumor and the frequency of P53 and Ki67 (P < 0.05). Nonetheless, no significant relationships were observed between tumor grade and these two markers. Ki67 staining susceptibility was significantly higher in the undifferentiated tumors than in the others (P < 0001). The mean survival was 40.67 months, and a significant relationship was observed between age and survival (P < 0.002) and age and the frequency of P53 and Ki67 and tumor type (P < 0.05). The results of this study showed that both P53 and Ki67 are predictors of overall survival, tumor type, disease grade, and disease prognosis in patients with different ovarian epithelial tumors and can be used in them alongside biopsy.

Histopathological diagnosis of ovarian mass

Background: Ovarian cysts are common forms of gynecological problems that can be range from physiological cysts to highly aggressive neoplastic lesions. The purpose of this study was to investigate prevalence and frequency of different histopathological patterns of ovarian lesions and their correlation with various parameters in Ahvaz, Iran.Materials and Methods: This is the retrospective study of patients with the ovarian masses at Ahvaz Imam Khomeini Hospital from 2010 - 2015. The relevant clinical details about the patient were retrieved from hospital data. Clinical characteristics of patients such as patient's age, presenting signs and symptoms, histopathological diagnosis, mass type, mass subtype, size of cysts and ovary which is involved were noted. Results: Two hundred sixty seven specimens of ovarian tumor obtained for histopathological examination. Of these, 163(61.0%) were tumor like, 96(36.0%) were benign tumor and 8(3.0%) were malignant. The most common tumor like conditions was Corpus luteum cyst (43.4% cases), among benign and malignant tumors, mature cystic teratoma (17.2% of total) and Epithelial tumors (n=4) were most common. There is a statistically significant positive relation between age and various ovarian masses. (P= 0.002). Histopathological diagnosis wasn't correlated with ovarian involvement.Conclusion: Benign tumors are more common than malignant tumors in all age groups. Germ cell tumors followed by surface epithelial cell tumors are the commonest tumor. Mature cystic teratoma was the most common tumor. Unilaterality is more frequently seen in ovarian tumors and various tumors are seen in various age groups.