IMMUNOHISTOCHEMICAL PROFILE OF ENDOMETRIOSIS-ASSOCIATED OVARIAN CARCINOMA

Objective: Endometriosis association with cancers is strongly supported by epidemiological criteria and shared protective factors, being identified as endometriosis-associated ovarian carcinoma (EOC). In this context, our study objective has been the evaluation of selected immunohistochemical markers expression (ER, PR, p53, and Ki-67) in both endometriosis and EOC as an attempt to identify common pattern of expression, in support of similar molecular pathway involved in their pathogenesis. Material and Methods: Our study comprised 19 cases of EOCs. The routine and immunohistochemical staining have been performed, followed by results statistical processing. Results: The following data have been assessed in EOCs: tumor size, histological type, ovarian capsule invasion, TNM and FIGO staging. The histological types have been: endometrioid (8 cases) and non-endometrioid (11 cases of clear cell, high-grade serous, and mixed types). FIGO stages have been: stage I (4 cases), stage II (6 cases), stage III (8 cases), and stage IV (1 case). Histological grades have been: G1 (1 case), G2 (6 cases), and G3 (12 cases). Conclusions: The comparison between immunohistochemical staining and different clinicopathological variables supported that the altered expression of steroid receptors in ovarian endometriotic tissue and EOC are involved in malignant transformation and progression. p53 is contributing to endometriosis pathogenesis and EOC progression. EOCs are associated with low Ki-67 index compared to more aggressive types of tumors. In conclusion, the immunohistochemical expression of ER, PR, and p53 corroborated with clinicopathological features support the mechanism of endometriosis transition to EOC, provide tools for prognosis evaluation, and open new perspectives of therapy