Spectrum of epithelial ovarian tumors with HER2/neu expression by the carcinomas among patients admitted in a tertiary care hospital in Eastern India

Abstract

Background: Women in India constitute a neglected part of the society and their sufferings are least highlighted. Ovarian cancer is a fatal disease that affects them silently. Its incidence is rising with progressively enlarging elderly population. Early diagnosis is challenging, since majority of the cases of ovarian carcinomas are detected in advanced stage with nonspecific symptoms. Neo-adjuvant chemotherapy, a useful therapeutic modality, is limited by toxicity and resistance. Hence, targeted therapy is now being proposed to overcome these hurdles. Objectives: 1. To study the histopathological spectrum of epithelial ovarian tumors. 2. To study the expression of HER2/neu among carcinomas on immunohistochemistry. Materials and Methods: It was an observational, descriptive, cross-sectional study carried out among 68 patients admitted in the hospital, who were newly diagnosed as having primary epithelial ovarian tumor. Postoperatively, the surgical specimens were processed accordingly. Histopathological sections were examined under Hematoxylin and Eosin stain. Histopathologically confirmed carcinomas were analyzed for HER2/neu expression status on immunohistochemistry. Statistical analysis was carried out using SPSS software, version 20. Results: Of the total cancer cases, 64.71% were benign, 5.88% borderline, 29.41% malignant. Serous type constituted majority for both benign and malignant variants (59.09% and 70% respectively). Overall, serous type constituted 58.82% of total population studied. Risk of malignancy index score was >200 for 95% of carcinomas in sharp contrast to benign tumors (15.91%). Grade 3+ HER2/neu expression was found in 35% of malignant cases, of which 85.71% were at advanced stage (FIGO III and IV). Conclusion: Serous type was the most common type of epithelial ovarian tumor. Risk of malignancy index score had strongly correlated with the malignant nature of tumor (p < 0.001). Grade 3+ HER2/neu expression was associated with advanced stage carcinomas.

Clinicopathological study of epithelial neoplasms of ovary with special reference to the expression of P53 and Her2/neu in epithelial carcinoma

“…Mucinous carcinoma did not show positive expression of Her2/neu. This finding is concordant with the study done by Sarkar et al (2015), 19 Verma et al (2018) and Goel et al (2014) 20 where 35%, 69.37% and 72.2% serous carcinoma were Her2/neu positive respectively. In the study done by Sarkar et al, only serous carcinoma showed Her2/neu positivity.…”

EVALUATION OF HER2/neu EXPRESSION IN OVARIAN EPITHELIAL TUMOURS

“…These findings are comparable with studies done by Sarkar et al 1 and Goel S et al 2 Serous tumours formed the majority with 59.3% followed by 35.2% mucinous tumours, 3.3% clear cell carcinomas, 1.1% malignant Brenner tumour and 1.1% seromucinous carcinoma. These findings were comparable with studies by Sarkar et al 1 and Sylvia et al 3 Table 1 In the present study, among the various malignant tumours, serous malignancies formed the largest group with 57.6% followed by mucinous carcinomas (27.3%), clear cell carcinomas (9.1%), malignant Brenner (3%) and seromucinous carcinoma (3%). These findings are comparable with study by Sarkar et al, which also demonstrated serous malignancy predominance with 70% followed by mucinous 20%, Brenner 5% and others 5%.…”

Histopathological study of epithelial ovarian tumors with special reference to human epidermal growth factor receptor-2/NEU and CA-125 expression

“…Traditionally the five main subtypes of epithelial ovarian cancer are serous, mucinous, endometrioid, clear cell and transitional cell (Brenner type) tumors. 4 HER-2 (human epidermal growth factor receptor-2) protooncogene encodes a transmembrane glycoprotein belonging to EGFR tyrosine kinase receptor family. Over-expression of HER-2 initiates intracellular signalling pathways involved in cell proliferation, differentiation, migration and apoptosis.…”