The Application Study Of The Two-tier System For Grading Ovarian Serous Carcinoma In Clinicopathology

The application study of the two-tier system for grading ovarian serous carcinoma in clinicopathologyPart I Clinicopathologic study and immunohistochemistry comparison of Pax2, p53 and Ki-67 protein expression in the low-and high-grade ovarian serous carcinomasObjective To evaluate a two-tier system for grading ovarian serous carcinoma, as well as to analyze Pax2, p53, Ki-67 protein expression and their value of prognostic evaluating in low-and high-grade serous carcinoma.Methods Thirty-eight cases of low-grade ovarian serous carcinoma and 100 cases of high-grade ovarian serous carcinoma were selected based on the two-tier grading system. Immunohistochemistry was used to detect Pax2, p53 and Ki-67 protein expression in all cases. The correlationships among the two-tier system, immunohistochemical results and prognostic parameters were analyzed.Results (1) Overall survival time, disease-free survival time and 5-year survival rate were significantly better in the low-grade serous carcinoma cases than in the high-grade serous carcinoma cases (P<0.05). (2) Significant difference in protein expressions were found between the low-and high-grade serous carcinomas. The high-grade serous carcinomas had a statistically significant higher expression of p53 and Ki-67 (P<0.05), while low-grade carcinomas had a statistically significant higher expression of Pax2 (P<0.05). (3) The Pax2 positive cases had a significantly better overall survival time and 5-year survival rate than Pax2 negative ones (P<0.05). The expressions of p53 and Ki-67 were found to have little correlation with overall survival time and disease-free survival time.Conclusions The two-tier grading system for ovarian serous carcinoma is valuable in prognostic evaluating. There are significantly different expressions of Pax2, p53 and Ki-67 between low-and high-grade ovarian serous carcinomas. Compared with p53 and Ki-67, Pax2 would more likely be a prognosis indicator for ovarian serous carcinoma. Partâ…¡The clinicopathologic analysis and molecular genetic detection of the grade 2 nuclei ovarian serous carcinomaObjective To evaluate the clinicopathologic features and molecular genetic profile of grade 2 nuclei ovarian serous carcinomas to determine whether these tumors were similar to low-grade or high-grade serous carcinomas.Methods This part included 14 cases of ovarian grade 2 nuclei serous carcinoma. Mutations of P53,KRAS,BRAF genes were investigated by using direct sequencing in all cases. And immunohistochemistry was used to detect Pax2, p53 and Ki-67 protein expression in all cases.Results (1) The low-grade serous carcinoma cases had a significantly better overall survival time than the grade 2 nuclei serous carcinoma cases (P<0.05). No significant difference in overall survival time and disease-free survival time were found between the grade 2 nuclei and high-grade serous carcinomas (P>0.05). (2) P53 mutations were identified in 57.1%(8/14) of grade 2 nuclei serous carcinoma cases. In the contrast, none of 14 cases showed mutations in KRAS and BRAF genes. (3) Significant differences in the three protein expressions were found between the low-grade and grade 2 nuclei serous carcinomas. The grade 2 nuclei serous carcinomas had a statistically significant higher expression of p53 and Ki-67 (P< 0.05), while low-grade carcinomas had a statistically significant higher expression of Pax2 (P<0.05). However, significant differences in expressions of p53, Ki-67 and Pax2 were not found in grade 2 nuclei serous carcinomas compared with high-grade serous carcinomas (P>0.05). (4) The results of a Kappa test of dependence between immunostaining and direct sequencing in assessment of P53 gene status were 0.571. Similarly, p53 immunostaining had a fair performance to predict P53 mutations with a sensitivity of 0.75, a specificity of 0.83.Conclusions The behavior and molecular genetic profile of the grade 2 nuclei serous carcinomas are similar to high-grade serous carcinomas. And p53 immunostaining is in accord with direct sequencing in assessment of P53 mutations to a certain extent.