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

Manisha Sarkar, Tulika Jha, Tushar Kanti Das, Vidyasagar Sau, Sukla Mitra, Kuntal Roy.


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.

Key words: HER2/neu, ovarian tumor, risk of malignancy index score

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