Epithelial ovarian tumors: Clinicopathological correlation and immunohistochemical study

Borderline ovarian tumor in the pediatric and adolescent population: a clinopathologic analysis of fourteen cases

Borderline ovarian tumors (BOTs) are rare among children and adolescents. This study was to probe into the clinicopathologic characteristics and prognosis in children and adolescents with BOT. A retrospective investigation was performed on 14 adolescents younger than age 21 years diagnosed with BOT. Clinical presentation, preoperative characteristics, surgery, tumor stage, histology, and recurrence were collected. The results showed that median age at diagnosis was 17.5 years, mostly after menarche. Abdominal mass/pain were the most common presenting symptoms. Median tumor size was 14 cm. Cancer antigen-125 (CA-125) in the blood serum was elevated by 41.67% (5/12), and CA-199 was elevated by 16.67% (2/12). All patients had fertility-preserving surgery: 66.67% (8/12) via laparoscopy (LSC) and cystectomy, 33.33% (4/12) via laparotomy and unilateral salpingo-oophorectomy (USO), and 1 case recurred, and underwent panhysterectomy and bilateral salpingo-oophorectomy. 4 out of 14 tumors (28.57%) had serous and 10 of 14 (71.43%) had mucinous histology. Five tumors showed histological microinvasion. Median follow-up time was 52 months. 10 of 14 cases were alive at last follow-up without disease, and 4 of 14 cases were at lost visit. Thus BOTs in children and adolescents are very rare tumors which have excellent prognosis even in advanced stages, when managed with fertility-preserving procedures. Close follow-up is important because of the high recurrence rates many years after diagnosis.

Different TP53 mutants in p53 overexpressed epithelial ovarian carcinoma can be associated both with altered and unaltered glycolytic and apoptotic profiles

Background

p53 is a tumor suppressor and key regulator of glycolysis in cancer cells, however highly mutated in tumors. In ovarian cancer, studies concerning p53 mutations focus on the DNA binding domain since the majority of hotspot mutations affects this region. Yet, mutations in other regions such as the proline rich domain may also affect the protein’s expression and activity. The aim of this study is to investigate the effect of various positions of mutations in TP53 gene on glycolysis, apoptosis and transcription of p53 target genes.

Methods

Mutations frequency and their effect on p53 expression were assessed by PCR-SSCP, sequencing and immunohistochemistry on 30 ovarian cancer biopsies. Six tumors were cultured, as well as SK-OV-3, OVCAR-3 and Igrov-1. SK-OV-3 cells were transfected with 2 TP53 mutants. p53 transcriptional activity was assayed by qPCR, apoptosis by flow cytometry and glycolysis by glucose and lactate measurements, with quantification of glycolytic enzymes expression.

Results

Our results showed a high frequency of the P72R mutant, associated with p53 overexpression in the ovarian biopsies. However, P72R mutant cells showed similar apoptosis and glycolysis as WT cells. DNA binding domain mutations decreased the transcriptional activity of the protein and increased glucose consumption and lactate production.

Conclusion

Despite the overexpression of the P72R mutated protein in the biopsies, it showed a similar apoptotic activity and glucose regulation ability as WT p53. Knowing that p53 expression status is used for chemotherapeutic approaches and prognosis in ovarian cancer, the results obtained highlight the importance of locating TP53 mutations.

Electronic supplementary material

The online version of this article (10.1186/s12935-018-0514-2) contains supplementary material, which is available to authorized users.

The positivity of estrogen receptor and progesterone receptor may not be associated with metastasis and recurrence in epithelial ovarian cancer

The estrogen (ER) or progesterone receptors (PR) is positively associated with better clinical outcomes in ovarian cancer. Whether metastasis or recurrence of ovarian cancer is correlated with this association has not been investigated. Data on 894 women with epithelial ovarian cancer were collected and the association between ER or PR positivity and peritoneal or lymph node metastases or recurrence was analysed. ER or PR positivity was higher in high-grade, low-grade serous and endometrioid carcinoma, but lower in mucinous and clear-cell carcinoma. Significantly higher ER or PR positivity was seen in endometrioid carcinoma or high-grade serous carcinoma with peritoneal metastases, respectively, but not other subtypes. In addition, there was no significant difference in ER or PR positivity between cases with and without lymph node metastasis in these five subtypes. In recurrent high-grade serous carcinoma with peritoneal metastases (n = 103), the positivity of ER or PR was 86% and 55% respectively. Our data demonstrate that the association between ER or PR positivity and peritoneal metastases was only seen in endometrioid or high grade serous carcinoma, respectively. There was no association of ER or PR positivity and lymph node metastases. The majority of recurrent high-grade serous carcinoma with peritoneal metastases (86%) were ER positive.

MZF-1/Elk-1/PKCα is Associated with Poor Prognosis in Patients with Hepatocellular Carcinoma

Background: Protein kinase C alpha (PKCα) is a key signaling molecule in human cancer development. As a therapeutic strategy, targeting PKCα is difficult because the molecule is ubiquitously expressed in non-malignant cells. PKCα is regulated by the cooperative interaction of the transcription factors myeloid zinc finger 1 (MZF-1) and Ets-like protein-1 (Elk-1) in human cancer cells.

Methods: By conducting tissue array analysis, herein, we determined the protein expression of MZF-1/Elk-1/PKCα in various cancers.

Results: The data show that the expression of MZF-1/Elk-1 is correlated with that of PKCα in hepatocellular carcinoma (HCC), but not in bladder and lung cancers. In addition, the PKCα down-regulation by shRNA Elk-1 was only observed in the HCC SK-Hep-1 cells. Blocking the interaction between MZF-1 and Elk-1 through the transfection of their binding domain MZF-1_60-72 decreased PKCα expression. This step ultimately depressed the epithelial-mesenchymal transition potential of the HCC cells.

Conclusion: These findings could be used to develop an alternative therapeutic strategy against patients with the PKCα-derived HCC.

The Putative Role of TP53 Alterations and p53 Expression in Borderline Ovarian Tumors - Correlation with Clinicopathological Features and Prognosis: A Mini-Review

Borderline ovarian tumors (BOTs) represent an independent group among ovarian malignancies, being diagnosed at clinical stage earlier than invasive ovarian carcinomas (OCs) and characterized by a rather favorable outcome after careful surgical management. Data published worldwide showed a substantial discordance of p53 expression in BOTs. The purpose of this work was to present the current status of knowledge on the significance of TP53 gene and p53 protein product alterations in BOTs. In general, higher p53 expression patterns were reported for ovarian malignancies compared to BOTs. Serous, mucinous, and endometrioid BOTs differ substantially in relation to p53 immunostaining, but data concerning the relationship between the protein's immunoreactivity and other clinico-pathological variables are scarce. Finally, reports published to date support the view that TP53 alterations may not be commonly associated with the borderline phenotype of ovarian tumors but they probably occur during the development of invasive OCs. In light of these uncertainties, the impact of TP53 alterations and p53 expression on overall survival in women affected by BOTs requires further multi-institutional studies in large cohorts of patients.

Hormone receptors expression in ovarian cancer taking into account menopausal status: a retrospective study in Chinese population

Ovarian cancer is a major gynaecological cancer with different subtypes and studies have suggested that estrogen receptor (ER) or progesterone receptor (PR) positivity are associated with better clinical outcomes. Furthermore, the clinical outcomes of ovarian cancer are better in Asian compared to Caucasian. To date, studies investigating the ER or PR positivity in all subtypes of ovarian cancer, including borderline epithelial, are limited. In this retrospective study we investigated ER and PR positivity in Chinese women with malignant epithelial ovarian cancer (n=577), sex cord-stromal tumor (n=26) and borderline epithelial ovarian cancer (n=98) taking into account menopausal status. The positivity of ER (>85%) or PR (>58%) was higher in serous and endometrioid carcinoma of malignant epithelial ovarian cancer than that in mucinous and clear-cell carcinoma (<19% of ER or 24% of PR). The majority of serous carcinomas of borderline epithelial ovarian cancerwere ER or PR positive, but in contrast less than 33% of mucinous carcinomas of borderline epithelial ovarian cancerswere ERor PR positive.Furthermore, there was no association between the ER or PR positivity and menopausal status in both malignant and borderline epithelial ovarian cancer. We also found that the age at diagnosis with ovarian cancer was younger in Chinese women. Our data suggest that ER or PR positivity in Chinese women with ovarian cancer is similar to that of other ethnicities reported in literature, suggesting that the better clinical outcomes seen in Asian may be associated with other factors such as age at diagnosis of ovarian cancer.