EVALUATION OF HER2/neu EXPRESSION IN OVARIAN EPITHELIAL TUMOURS

Abstract

BACKGROUND Ovarian cancers are most lethal of all gynaecological malignancies and becoming a leading cause of death due to malignancy in female. This may be attributed to its late clinical presentation and poor response to current treatment modalities. Many targeted treatment modalities are under intense clinical trials. One such approach is based on the demonstration of HER-2/neu overexpression. According to literatures, HER-2/neu expression varies widely in ovarian epithelial tumours. This study was conducted to describe the expression of HER-2/neu in different types of ovarian epithelial tumours using a scoring system and to identify the proportion of cases with HER-2/neu positivity in benign, borderline and malignant ovarian epithelial tumours. MATERIALS AND METHODS A descriptive study was conducted to assess HER-2/neu immunoreactivity in 91 cases of ovarian surface epithelial tumours received in the Department of Pathology, Government Medical College, Kottayam during a period of 18 months (April 2016-September 2017). RESULTS Of the 91 ovarian surface epithelial tumours studied 52 were benign (57.1%), 6 were borderline (6.6%) and 33 were malignant (36.3%). Among the malignant tumours, serous malignancies were the largest group with 19 cases (57.6%) followed by 9 mucinous carcinomas (27.3%), 3 clear cell carcinomas (9.1%), 1 malignant Brenner (3%) and 1 seromucinous carcinoma (3%). IHC with HER-2/neu was done in all the 91 cases, which showed score 0 in 54.9%, score 1+ in 25.3%, score 2+ in 16.5% and score 3+ in 3.3%. All benign and borderline cases were HER-2/neu negative. Among 33 ovarian malignancies, 9.1% were HER-2/neu positive (Score 3+). Among the mucinous carcinomas, 33.3% showed significant overexpression of HER-2/neu. All other histological types were negative (p value < 0.05). There was no statistical association between HER-2/neu positivity and other clinico-pathological parameters such as age, presence of ascites, CA-125, size and stage of the ovarian tumours (p value > 0.05). CONCLUSION Mucinous carcinomas are associated with significant overexpression of HER-2/neu, hence trastuzumab would be a treatment option for patients with mucinous carcinoma showing HER-2/neu overexpression.