Clinicopathological Correlation Of Er, Pr And Her 2 Neu In Epithelial Ovarian Tumors
DOI:
https://doi.org/10.69980/ajpr.v28i5.665Keywords:
Ovarian carcinoma, epithelial ovarian tumors, estrogen receptor, progesterone receptor, HER2/neu, immunohistochemistry, prognostic markersAbstract
Background: Expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor‑2 (HER2/neu) may reflect tumor biology and prognostic strata in epithelial ovarian tumors (EOTs). We evaluated their immunohistochemical (IHC) expression and clinicopathological correlations in a North Indian cohort.
Methods: In a five‑year study (2010–2015) at SKIMS, 50 consecutive EOTs were analyzed (benign, borderline and malignant). Routine histopathology and IHC for ER, PR and HER2/neu were performed on formalin‑fixed paraffin‑embedded tissue. Intensity was semi‑quantitatively graded (0/1+/2+/3+). For HER2/neu, 1+ was considered negative. Clinicopathological variables included histotype, grade, FIGO stage, nodal status, lymphovascular invasion (LVI), capsular invasion, metastatic status and pre‑operative CA‑125 where available.
Results: Of 50 EOTs, 8 (16%) were benign, 9 (18%) borderline and 33 (66%) malignant. Among malignant tumors, serous histology predominated (23/33; 69.7%), followed by mucinous (9/33; 27.3%) and clear cell carcinoma (1/33; 3.0%). ER was positive in 30/33 malignant cases, PR in 28/33 and HER2/neu in 5/33; all benign and borderline tumors were HER2/neu‑negative. High‑grade carcinomas more often showed higher ER and PR expression than low‑grade tumors. ER/PR positivity was enriched in cases with adverse features (metastasis, LVI, capsular invasion), while HER2/neu was largely negative across strata. Stage‑3 tumors showed higher ER/PR intensity compared with stage‑1/2. Elevated CA‑125 was more frequent in high‑grade than low‑grade disease.
Conclusions: In this cohort, ER and PR expression was significantly more frequent and stronger in malignant versus benign/borderline EOTs, and associated with higher grade and advanced stage, whereas HER2/neu overexpression was infrequent and restricted to carcinomas. These findings support potential utility of ER/PR profiling for prognostication and selection for endocrine strategies in ovarian carcinoma, while HER2/neu appears to have limited role in this setting.
References
1. Munnel EW, Taylor HC, Jr.: Ovarian carcinoma. A review of 200 primary and 51 secondary cases. Am J Obst and Gynec. 1949; 58:943-59.
2. Woodruff JD, Novak ER: Papillary serous tumors of the ovary. Am J Obst and Gynec. 1954; 67: 1112-26.
3. Scully RE. Classification of Human Ovarian Tumors, Environmental Health Perspectives. 1987; 78:15-24.
4. Young RH, Scully R E. Differential diagnosis of ovarian tumors based primarily on their pattern and cell type. Semin Diagn Pathol.2001;18:161-235.
5. Robbins and Cotran Kumar et al: Ovaries ch.22 pathologic basis of disease 8th ed. Elsevier 2010.
6. Shabani N, Mylonas I, Jeschke U, Thaqi A, Kuhn C, Puncher T. Expression of estrogen receptor alpha and beta and progesterone receptors A & Bin human mucinous carcinoma of endometrium, (Anticancer Res 2007. 27(4A):2027-33.
7. Pertschuk LP, Beddee AM, Gorelic LS, Shain SA immune cytochemical assay of estrogen receptor in Endometroid carcinoma with monoclonal antibodies Cancer 1986; 57: 1000-1004.
8. Blaustein pathology of female genital tract by Ancel Blaustein, Robert J Kurman 5th edition 2002;1266.
9. Lukanova A, Kaaks R. Endogenous Hormones and ovarian Cancer: Epidemiology and current Hypothesis. Cancer Epidemol Biomarkers Prev 2005;14:98-107.
10. Liehr JG. Is Estradiol a Genotoxic Mutagenic Carcinogen? Endocr Rev 2000; 21: 40-54.
11. Risch HA. Hormonal etiology of epithelial ovarian cancer, with a hypothesis concerning the role of androgens and progesterone.J Natl Cancer Inst 1998;90:1774-1786.
12. Berchuck A, Kamel A, Whitaker R et al. Overexpression of Her-2-/neu is associated with poor survival in advanced epithelial ovarian cancer. Cancer Research 1990: 50: 4087-4091.
13. Isola J, Kallioniemi OP, Korte JM, Wahlström T, Aine R, Helle M, Helin H. Steroid receptors and Ki-67 reactivity in ovarian cancer and in normal ovary: correlation with DNA flow cytometry, biochemical receptor assay, and patient survival. J Pathol. 1990 Dec;162(4):295-301.
14. Scambia G, Ferrandina G, Agostino GD, Fagotti A, DI Stefano M, Fanfani F, Serri and FG Mancuso S. Oestrogen and progesterone receptors in ovarian cancer. Endocrine-Related Cancer 1998,5;293-301.
15. Sylvia MT, Kumar S, Dasari P. The expression of immunohistochemical markers estrogen receptor, progesterone receptor, Her-2-neu, p53 and Ki-67 in epithelial ovarian tumors and its correlation with clinicopathologic variables. Indian J Pathol Microbiol. 2012 Jan-Mar;55(1):33-7.
16. Tyagi SP, Madan A,Mohsin S, Hameed F,Saxena K. Epithelial tumors of the ovary Indian J Pathol Microbiol. 1978 Oct;21(4):281-9.
17. Rhandhawa I, Lata P. A study of ovarian neoplasms. J Obstet Gynecol India. 1980; 30: 531-535.
18. Rajagopalan K, Rajagopalan CK, Gourikutty A.K. Ovarian tumors a clinicopatho-logical study. Ind J path Microb. 1982 79;73-75.
19. Prabhakar BR, Maingi K. Ovarian tumors prevalence in Punjab.Indian J Pathol Microbiol.1989 Oct;32(4):276-81.
20. Misra RK, Sharma SP, Gupta U,Gaur R,Misra SD: Pattern of ovarian neoplasm in eastern U.P. J obstet gynec India, 1991; 41: 242-46.
21. Quintyne KI, Landers MR, Cantwel BM. Ovarian cancer expression of ER,PR, EGFR, and HER-2 in Irish women may predict for targeted therapies: A single institution experience. J Clin Oncol 2008; 26(20 suppl; abstr 22179).
22. Ford LC, Berek JS, Lagasse LD, Hacker NF, Heins Y, Fardad Esmailian MT, Leuchter RS, Delange RJ. Estrogen and Progestrone receptors in ovarian neoplasms. Gynecologic Oncology Volume 15, Issue 3, June 1983, Pages 299-304.
23. Agarwal N, Roa DL, Murgeshan K, Verma U, Mittal S and Chapekar TN. Clinical evaluation of steroid receptors in ovarian neoplasms. Int.J. Gynaecol. Obstet. 1987, 25 145-149.
24. Tanvanich S, Tanjitgamol S, Manusirivithaya S, Jesadapatarakul S. Expression of ER and PR in Epithelial Ovarian Tumors. Vajira Med J 2008;52:249-256.
25. Tangjitgamol S, Manusirivithaya S, Khunnarong J, Jesadapatarakul S, Tanwanich S Expression of ER and PR in epithelial ovarian cancer:a clinicopathologic study Int J Gynecol Cancer.2009 May;19(4):620-7.
26. Sutton GP, Senior MB, Strauss JF, and Mikuta JJ. Estrogen and Progestrone receptors in epithelial ovarian maliganancies. Gynecologic Oncology 1986; 23(2): 176-182.
27. Buchynska LG, Iurchenko NP, Grinkevych BM, Nesina IP, Chekhun SV, Svintsitsky VS. Expression of the estrogen and progesterone receptors as prognostic factor in serous ovarian cancers. Exp Oncol 2009; 31(1): 48-51.
28. Hogdall EV, Christensen L, Hogdall CK, Blaakaer J, Gayther S, Jacobs IJ, Christensen IJ, Kjaer SK prognostic value of estrogen receptor and progesterone receptor tumor expression in Danish ovarian cancer patients: from the 'MALOVA' ovarian cancer study. Oncol Rep.2007 Nov;18(5):1051-9.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 American Journal of Psychiatric Rehabilitation
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License permitting all use, distribution, and reproduction in any medium, provided the work is properly cited.
