| ObjectiveInternational Federation of Gynecology and Obstetrics (FIGO) announced that type I epithelial ovarian cancer (EOC) arose within endometriosis in2012cancer report. As the most frequent endometriosis-concurrent type of EOC, OCCC was still an enigma on the mechanism of cancer development and progression. And the prognosis of OCCC was controversial. Whether there were two distinct subtypes of OCCC with and without concurrent EMs needs exploring. Meanwhile, recent observations underscore the importance of eutopic endometrium in the malignant transformation. In this research, IHC staining of P53、PIK3CA、ARIDIA、HNF-1β were performed on the cancer, endometriosis and eutopic endometrium tissues of ovarian clear cell carcinoma patients, hoping to find some evidence on the malignancy transforming way from endometriosis to carcinoma.MethodsSearch the medical charts at Peking Union Medical College Hospital from2000through2012,45ovarian clear cell carcinoma patients and6normal control with their follow-up were collected. The pathology sections were reviewed by at least one experienced pathologist. The IHC staining was carried out on the sections of the cancer, endometriosis and endometrium tissues. The analysis of the IHC results was performed on Image Pro Plus and we use the IHS for analyzing the results. Nonparametric Mann-Whitney U and Kruskal Wallis tests and Spearman test were applied for examining the correlation of staining results and clinical parameters. Finally, Kaplan Meier method and Cox regression analysis were used to evaluate prognostic value of the factors mentioned above.Results1. Age, menopause, gravity were statistically different between the two groups of clear cell carcinoma with or without concurrent endometriosis (P=0.002,0.002,0.010). The serum CA125, stage, grade, optimal surgical cytoreduction and survival analysis showed no differences between the two groups.2. Comparison of the cancer tissues and normal ovarian tissues, the IHC staining of P53, PIK3CA, HNF-1β were significant different (P<0.001).3. Comparison of the endometrium of cancer samples and control, the IHC staining of P53, PIK3CA, HNF-1β were not significant different (P>0.05).4. Comparison of the two ovarian clear cell carcinoma concurrent with or without endometriosis, the IHC staining was only significant different for HNF-1β(P=0.001).5. The clinical staging was significant different between the P53positive and negative groups (P=0.047).6. The univariate analysis showed that serum CA125, stage, grade, P53staining were significant prognostic factors for progression-free survival and overall survival;7. The multivariate analysis showed that P53was an independent prognostic factor for ovarian clear cell carcinoma of early stage.Conclusion1. The IHC staining of P53、HNF-1β、PIK3CA were significant different among the cancer, endometriosis and endometrium. Meanwhile, there were no abnormalities of biomarkers expression in the eutopic endometrium like the serous tubal intraepithelial carcinoma (STIC). We proposed that bad endometriosis was the chief culprit.2. Comparison of the two ovarian clear cell carcinoma groups concurrent with or without endometriosis, the staining of HNF-1β was significant different, indicating a candidate marker for OCCC concurrent with ovarian endometriosis.3. Serum CA125, stage, grade were significant prognostic factors for OCCC, according with literatures.4. P53was label for type Ⅱ EOC. In our research, we found that positive P53is relevant to OCCC of high stage, and P53was an independent prognostic factor for ovarian clear cell carcinoma of early stage. |
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