IMMUNOCYTOCHEMICAL ANALYSIS OF ASPIRATION MATERIAL FROM THE UTERINE SEROUS OVARIAN CANCER DETECTION

Abstract

Objective of the study: To increase the efficiency of the diagnosis of serous ovarian cancer by the method of immunocytochemical (ICC) analysis of the expression of p53, p16, wt1 markers in cells obtained in aspiration material from the uterine cavity. Materials and methods: The cellular expression of p53, p16 and wt1 markers was determined in aspiration material from uterine cavity of 71 patients with a morphologically confirmed diagnosis of serous ovarian cancer III-IV stages (51 patients with high grade serous carcinoma and 20 patients with low grade). The results were compare with cellular expression of the same markers in groups of patients with benign ovarian tumors (n = 50), patients with secondary (metastatic) ovarian lesions (n = 50) and healthy women (n = 50). The study did not include patients with early stages of ovarian cancer because of too small number of similar cases . For cytological studies, cytopin multilayer preparations of the cytospin system were obtained. An ICC study was conducted with monoclonal antibodies to p53, p16, wt1. Results: p53 demonstrated the greatest diagnostic significance in group of patients with high grade serous carcinomas: expression was traced in 31 of 51 observations of serous carcinomas of the ovaries, which amounted to 61%. A positive reaction of wt1 was observed in 24 of 51 cases (47%), p16 expression was observed in 25 of 51 cases (49%). In the group of patients with low grade serous carcinomas (n = 20), in contrast to the group of patients with high grade serous ovarian cancer, a positive reaction of p53 was observed in 3 out of 20 cases (15%), p16 in 2 (10%), but wt1 expressed in samples of 12 (60%) patients. By ICC examination of samples collected from uterine cavity of patients with benign ovarian tumors we identify focal moderate expression of p53 in separate endometrial epithelial calls in 2 cases. Histologically, serous cystadenoma of the ovaries was detected in these patients, and in another 48 samples no positive reactions with antibodies to p53,p16,wt1 were observed. In group of patients with secondary lesion of the ovaries, as well as in the control group, positive marker reactions were not observed. Conclusions: The increased expression of p53, p16, wt1 markers in cells obtained by aspiration from the uterine cavity during an ICC study can be used as a diagnostic test for high grade serous carcinoma.