Oestrogen Receptor, Progesterone Receptor Expression on Epithelial Tumours of Ovary and Correlation with Their Clinicopathological Features

BACKGROUND Ovarian carcinoma is one of the most lethal malignancies. Their histogenesis and complex pathogenesis remain largely unknown in spite of the many studies and research carried out in the field. The receptors for female sex hormones are implicated in the pathogenesis of ovarian tumours in many studies. This concept points out the necessity of developing a highly affected targeted therapy, which requires a proper understanding of the pathogenesis of the tumours. This study was done to evaluate the expression of these receptors on the primary epithelial tumours of the ovary and explore the possible correlation with clinical and pathological features. METHODS A hundred cases of primary epithelial tumours of the ovary were selected; tissue samples were taken from appropriate areas and processed. Tissues were cut into sections of three to five-micron thickness. Sections from the tissues were stained and examined. Once the histological type was clear, the receptor expression was assessed with immunohistochemistry markers. RESULTS Among the hundred tumours studied, serous tumours were the commonest, accounting for 65 % followed by mucinous tumours which constituted 34 %. Clear cell tumours accounted for 1 %. Endometrioid and transitional cell tumours were still rarer. Among these, oestrogen receptor (ER) was expressed in 78.5 % of serous tumours and progesterone receptor (PR) was expressed in 64.6 % of serous tumours. CONCLUSIONS Serous tumours were seen to show maximum expression of the hormone receptors among the surface tumours of ovaries. Furthermore, the expression of the receptors was more consistently seen in high-grade tumours. This finding may be of help in designing personalized hormone therapy in epithelial tumours. KEY WORDS Surface Epithelial Tumours, Receptors, ER, PR.

Reversing chemorefraction in colorectal cancer cells by controlling mucin secretion

ABSTRACT15% of colorectal cancers (CRC) cells exhibit a mucin hypersecretory phenotype, which is suggested to provide resistance to immune surveillance and chemotherapy. We now formally show that colorectal cancer cells build a barrier to chemotherapeutics by increasing mucins’ secretion. We show that low levels of KChIP3, a negative regulator of mucin secretion (Cantero-Recasens et al., 2018), is a risk factor for CRC patients’ relapse in subset of untreated tumours. Our results also reveal that cells depleted of KChIP3 are four times more resistant (measured as cell viability and DNA damage) to chemotherapeutics 5-Fluorouracil plus Irinotecan (5-FU+iri.) compared to control cells, whereas KChIP3 overexpressing cells are 10 times more sensitive to killing by chemotherapeutics. Similar increase in tumour cell death is observed upon chemical inhibition of mucin secretion by the sodium/calcium exchanger (NCX) blockers (Mitrovic et al., 2013). Finally, sensitivity of CRC patient-derived organoids to 5-FU+iri increases 40-fold upon mucin secretion inhibition. Reducing mucin secretion thus provides a means to control chemoresistance of mucinous colorectal cancer cells and other mucinous tumours.

Study of Histomorphological Spectrum of Mucinous Tumours of Ovary in a Tertiary Care Center in Thrissur, Kerala, India

BACKGROUND Mucinous ovarian tumours have various histomorphological patterns. Histopathological examination plays an important role in classifying ovarian tumours for prognosis and better treatment. Mucinous ovarian tumours are classified into benign cystadenomas, borderline mucinous tumours and malignant mucinous cystadenocarcinomas. This study was done to evaluate the distribution of ovarian tumours with respect to various parameters like age, laterality, size, loculation, stratification of cells, nuclear atypia, to study the gross morphological patterns of the various histopathological tumour types and evaluate the association between various parameters of ovarian tumours and risk of malignancy. METHODS A cross sectional study was conducted in the Department of Pathology, in a tertiary health care centre over a period of 5 years. The study includes cases of mucinous cystadenomas, borderline mucinous tumours and cystadenocarcinomas. Formalin fixed and paraffin embedded sections were reviewed. Data was collected & entered in Microsoft Office Excel 2007 sheet. RESULTS Among 32 cases of mucinous tumours studied 15 are mucinous cystadenomas, 10 are borderline tumours and 7 are cystadenocarcinomas. The mean age is 45 years. 1 case of mucinous cystadenocarcinoma showed bilateralism. 68.8 % of the tumours were more than 15 cms in size. 72 % of the tumours were multiloculated and 28 % were uniloculated. 78.1 % of the tumours have stratification of less than 4 cell-thickness. 46.9 % of tumours had no nuclear atypia, 31.2 % had mild atypia and 21.9 had severe nuclear atypia. CONCLUSIONS Benign cystadenomas were more common than malignant and borderline tumours. The mean age of presentation was 45 years. KEYWORDS Benign Cystadenomas, Mucinous Borderline Tumours, Mucinous Cystadenocarcinomas

Response evaluation of locally advanced carcinoma ovary to neoadjuvant chemotherapy at a tertiary care centre

Background: Clear cell and mucinous types of epithelial ovarian cancers are relatively chemo resistant and have a poorer prognosis compared to other histologies. Aim of the study was to study the biochemical and histopathological response and surgical outcome of various histologies to standard platin based chemotherapy.Methods: All 42 cases of locally advanced carcinoma ovary who received several cycles of neoadjuvant chemotherapy (NACT) followed by, interval cytoreductive surgery (ICS) were included in this study. Serum CA125 levels before and after neoadjuvant chemotherapy, the ability to achieve optimal cytoreduction and the presence of residual tumour in the surgical specimen were the parameters measured. Continuous variables were compared by one-way ANOVA. Categorical variables were compared by the Pearson chi-square test. Significance was defined by p values less than 0.05. Survival analysis was done using Kaplan-Meier estimation.Results: There was a 95,84% reduction in serum CA125 levels for papillary serous carcinoma compared to clear cell and mucinous varieties, which had 81.2% and 78.5% reduction, respectively. More number of papillary serous tumours were able to achieve optimal cytoreduction (72%) compared to mucinous variety (25%). Residual tumour was present in 68% of serous papillary tumours compared to 87.5% in mucinous and 80% in clear cell histology.Conclusions: Our study concludes that mucinous and clear cell types of EOC are relatively chemo resistant compared to the serous subtype. We recommend more aggressive surgery especially for mucinous tumours. In the case of ovarian cancer, we observed that the mucinous and clear cell types of EOC are relatively chemoresistant compared to the serous subtype. From the results, we recommend the more aggressive strategy of surgery as a preliminary choice of treatment especially for mucinous tumours rather than chemotherapy in patients with EOC.