Clinical significance of HER2/NEU, MUC1, estrogen and progesterone receptor expression in malignant epithelial ovarian tumors

Aim: This study aimed to determine the expression of HER2neu, MUC1, estrogen and progesterone receptors immunohistochemically and investigate its effects of the expressions of these markers on clinical-pathological features and prognosis. Materials and Methods: The study group consisted of 86 patients diagnosed for epithelial ovarian cancer at Çukurova University Faculty of Medicine which were operated between June 2009 and November 14, 2018. Of these 86 patients; 46 of them are high grade serous ovarian cancer, 7 of them are low grade serous ovarian cancer, 14 of them are mucinous carcinoma,19 of them were in the histopathological type of clear cell carcinoma. The information was reviewed retrospectively. The patient's age, menopause status, body mass index, fertility, hospitalization admission tumor marker levels, presence of peroperative ascites, lymphovascular invasion, and lymph node metastasis status, stages and grades, overall survival and disease-free survival duration, recurrence and platinum resistance were recorded. MUC1, HER2neu,Estrogen, Progesterone antibodies were applied immunohistochemically to pathological samples of the patients and the expression status of these markers, relationship between clinical-pathological features and prognosis were analyzed by statistical methods. Results: No statistically significant difference detected between among study groups in terms of age, parity, body mass index while postmenopausal patients higher in high grade serous ovarian cancer group (p=0.036). In all patients in the low grade serous ovarian cancer and clear cell carcinoma groups MUC1 stained strongly positive. The frequency of MUC1 positive staining was lower in mucinous carcinoma; but it was observed that in high grade serous ovarian cancer it was higher (p<0.01). Half of the mucinous carcinoma group HER2neu stained strongly positive. In 85.7% of the low grade serous ovarian cancer group, estrogen (p=0.041) and progesterone (p=0.029) receptor was positive. Overall survival times in patients with positive estrogen receptor and progesterone receptor was found shorter. Estrogen receptor was positively stained in 20 of 22 patients in the high-grade serous carcinoma pathology group who were resistant to platinum therapy, and in 21 (95.4%) MUC1 was highly positive. MUC1 was high in 15 (93.7%) patients with positive staining. The mean survival time was 41.4±4.2 months in the high grade serous ovarian cancer group, 99.8±22.8 months in the low grade serous ovarian cancer group, 80.4±11.1 months in the mucinous carcinoma group, and 75.9±13.7 months in the clear cell carcinoma group. Presence of lymph node metastasis(OR=3.5), presence of lymphovascular invasion(OR=21.2), advanced stage(OR=13,442), platinum resistance(or=46.5), grade 3(OR=10,750), estrogen receptor positivity(OR=3.4), optimal cytoreduction(OR=17.2), high grade serous carcinoma histopathology(OR=9.2) were identified as independent prognostic factors. Conclusion: High positive staining of MUC1 in low grade serous ovarian cancer and clear cell carcinoma group patients, the higher estrogen-progesterone receptor expressions in platinum resistant patients in high grade serous ovarian cancer group, the detection of HER2neu positivity in half of the population in the mucinous carcinoma group is an important result of this study. For targeted therapy results should be taken into account in these epithelial ovarian cancers which are difficult to manage. Key Words: Clear Cell Carcinoma, Epithelial Ovarian Cancer, HER2neu, High Grade Serous Ovarian Cancer, Low Grade Serous Ovarian Cancer, MUC1, Mucinous Cancer, Estrogen Receptor, Progesterone Receptor