Evaluation pattern of p53 dysfunction in ovarian carcinoma and

Evaluation of the Aggressiveness of the malignant EOTs using P53
immunohistochemical markers.

Evaluating the degree
of P53 expression by the EOTs is to determine their aggressiveness which may
have been acquired as an early or late event during tumourigenesis and this
dictates if a tumour will be high grade or low grade depending on the pattern
of expression. Studies have explored the prognostic significance and pattern of
p53 dysfunction in ovarian carcinoma and the relationship between p53
overexpression and p53 mutations correlating it with their effect on overall
survival(Shahin, Hughes, Sood, & Buller, 2000), some studies
have found survival to be poorer in patient with overexpression of p53(Herod et al., 1996).

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In this study,
overexpression of p53 was detected in 25.5% of cases and wild-type expression
in 17.6% while majority of the cases 56.9 % showed a negative expression. The
13 malignant EOT cases with p53 overexpression were 12 Serous carcinoma and one
case of Adenosquamous carcinoma. This show consistency with studies by Berchuck
et al, stating that overexpression is exclusive to high grade ovarian
carcinomas and not a feature of benign or borderline EOTs(Berchuck et al., 1994). This showed
that p53 overexpression and invariable p53 mutations are common in Serous
carcinomas and they occur early in their progression to high grade Serous
carcinoma(Bernardini et al., 2010; Cole et al., 2016). Of the 9
tumours with wild type p53 expression, 6 were Serous carcinoma and 2 were
Mucinous carcinoma and also the case of Signet ring carcinoma which had a
cytokeratin profile suggestive of a metastasis. These Serous carcinomas
corresponds to a low grade Serous carcinomas and similarly the Mucinous
carcinoma also corresponds to a low grade carcinoma.(Brown & Frumovitz, 2014; Frumovitz, Schmeler,
Malpica, Sood, & Gershenson, 2010; Ludwick et al., 2005). A significant
correlation (P <0.05) was observed between p53 overexpression and histological grades (Shimizu/universal and MD Anderson grading methods), nuclear pleomorphism and mitotic activity of the malignant EOTs but, did not correlate with tumour architectural patterns. Therefore architectural pattern may not be a reliable predictor of aggressiveness. 7.4     Grading Malignant EOTs Ovarian carcinoma have been classified into 5 distinct grade groups based on histopathology and molecular genetic alterations, high-grade Serous are said to be about 70%, endometrioid 10%, clear cell 10%, Mucinous 3%, and low-grade Serous carcinomas <5%  according to studies by Prat et al (Jaime Prat, 2012). In this study we found 44.4% of Serous carcinoma with P53 high/overexpression, 11.1% of Serous carcinoma with P53 negative expression and Serous carcinoma 


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