J Gynecol Oncol.  2013 Apr;24(2):167-176. 10.3802/jgo.2013.24.2.167.

Survival of women with ovarian carcinomas and borderline tumors is not affected by estrogen and progesterone receptor status

• Sallum LF
• Sarian LO
• Lucci De Angelo Andrade L
• Vassallo J
• Soares FA
• Pinto GA
• Ferreira P
• Derchain S

• KMID: 2288549
• DOI: http://doi.org/10.3802/jgo.2013.24.2.167

Abstract

OBJECTIVE
To examine the patterns of estrogen receptor (ER) and progesterone receptor (PR) expression in borderline ovarian tumors (BOTs) and ovarian carcinomas. We also assessed the disease-free survival (DFS) and overall survival (OS) in women with ovarian carcinoma, in relation to ER and/or PR expression.
METHODS
We examined ER/PR expression in 38 BOTs and 172 ovarian carcinomas removed from patients treated at the State University of Campinas-UNICAMP (Brazil), from 1993 to 2008 and followed for up to 60 months using tissue microarray-based immunohistochemistry.
RESULTS
Twenty-eight (73.7%) mucinous and 10 (26.3%) serous BOTs were included. Ovarian carcinomas consisted mainly of 79 (46.0%) serous, 44 (25.5%) mucinous, 17 (9.8%) endometrioid, 10 (5.8%) clear-cell types. There was no significant difference of the ER/PR expression between BOT and ovarian carcinoma (p=0.55 for ER alone, 0.90 for PR alone, and 0.12 for combined expression). The level of ER/PR expression in BOTs was significantly higher in serous than in mucinous tumors (p<0.01). In carcinomas, ER/PR was higher in serous tumors than in mucinous (p<0.01) and clear cell tumors (p=0.02), and higher in endometrioid tumors than in mucinous tumors (p<0.01). DFS was affected neither by the clinical characteristics nor by combined steroid receptor status. OS was found to be significantly worse (p<0.01) only in women with stages II-IV tumors and those with residual disease after surgery (p<0.01).
CONCLUSION
Overall, serous and endometrioid tumors were predominantly ER/PR positive, whereas mucinous and clear-cell tumors were preponderantly ER/PR negative. DFS and OS were not affected by ER/PR expression.

Keyword

Borderline ovarian tumor; Estrogen receptor; Immunohistochemistry; Ovarian carcinoma; Progesterone receptor; Tissue microarray

MeSH Terms

Disease-Free Survival
Estrogens
Female
Humans
Immunohistochemistry
Mucins
Progesterone
Receptors, Progesterone
Receptors, Steroid
Estrogens
Mucins
Progesterone
Receptors, Progesterone
Receptors, Steroid

Figure

• 

  Fig. 1 Representative immunohistochemical nuclear staining of progesterone receptor (PR) and estrogen receptor (ER). (Peroxidase). (A) PR: zero score (negative). (B) PR: 1%-10% cells stained/moderate intensity (final scoring 2+2=4). (C) PR: 35%-75% cells stained/strong intensity (final scoring 4+3=7). (D) PR: ≥75% cells stained/strong intensity (final scoring 5+3=8). (E) ER: zero score (negative). (F) ER: 1%-10% cells stained/moderate intensity (final scoring 2+2=4). (G) ER: 35%-75% cells stained/strong intensity (final scoring 4+3=7). (H) ER: ≥75% cells stained/strong intensity (final scoring 5+3=8). Peroxidase (A, B) ×40, (C, D) ×100, (E, H) ×400.

• 

  Fig. 2 Kaplan-Meier depiction of overall survival probabilities of women with (A) serous/endometrioid International Federation of Gynecology and Obstetrics (FIGO) stage I; (B) mucinous/clear cells/other FIGO stage I; (C) serous/endometrioid stages II-IV; and (D) mucinous/clear cells/other FIGO stages II-IV epithelial ovarian cancer. ER, estrogen receptor; PR, progesterone receptor status.

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