Yüksek Dereceli Seröz Over Kanserlerinde SET Morfolojisinin Prognoz ve İmmünohistokimyasal Belirleyiciler ile İlişkisi

Abstract

High-grade serous ovarian carcinomas are one of the gynecologic system tumors with poor prognosis as well as variable microscopic appearance. In this study, the efficacy of unusual microscopic patterns and immunohistochemical markers to determine serous cancer prognosis has been investigated. 305 high-grade serous ovarian carcinomas which providing the appropriate criteria were included to this study among 467 surgically resected ovarian carcinoma cases, reported at the Pathology Department of Hacettepe University Medical Faculty between 2001-2014. The slides of the specimens included in the study were re-assessed; clinical and pathological data were recorded. On the slides of the ovary and fallopian tube, SET (solid, pseudoendometrioid and transitional-like) morphology which is also associated with hereditary cancers were noted, as well as lesions that could be serous cancer precursors. Using the paraffin blocks of the cases, at least two separate foci representing the typical morphology of the tumor were sampled and tissue microarray blocks were constructed. Immunohistochemical studies using BRCA1, p53, ERCC1, ER and PR antibodies were applied to the serial sections from these constructed blocks. Sampling of the fimbriated end of fallopian tubes was found to be useful in detecting tubal lesions. In the light of morphological, immunohistochemical and clinical data, tumors containing SET morphology were found to have a statistically significant increase in survival as the portion of SET morphology increased. Immunohistochemical PR antibody positivity is also associated with higher survival rates. No correlation was found between the other immunohistochemical markers to survival and morphology. SET morphology is a potent candidate predictor of prognosis and a decent parameter in management of treatment for high-grade serous carcinomas.