Clinical significance of the immunohistochemical profile of ovarian endometrioid cysts

Objective. To identify the immunohistochemical (IHC) phenotypes on the basis of the representation of molecular markers in the endometrioid ovarian cyst (EOC) capsule (EOCC) in order to justify a differentiated approach to therapy and to reduce relapse rates. Subjects and methods. To identify the features of the IHC profile of EOCC (the expression of estrogen and progesterone receptors, Ki-67, p53) and to estimate the impact of personalized anti-relapse therapy after surgical treatment, the investigators examined 170 women with EOC, who formed three comparison groups: 1) 50 women who received anti-relapse treatment with regard to the IHC profile of EOCC; 2) 80 women who had hormone therapy after the surgical stage of treatment without regard to the IHC phenotype; 3) 40 women who refused subsequent hormone therapy after surgical treatment. Control endometrial samples were taken from 25 healthy women. Results. Four IHC phenotypes of EOCC were identified. A differentiated approach to treatment with regard to the type of the IHC prof ile showed the higher eff iciency than hormone therapy without regard to the IHC phenotype: the number needed to treat (NNT) was 2 to prevent an unfavorable outcome in one patient [95% CI, 1-2; p < 0.001] versus NNT of 3 [95% CI, 2-6; p <0.001], OR, 0.06 [95% CI, 0.02-0.25; p <0.001] versus OR, 0.42 [95% CI, 0.27-0.65;p <0.001]. Conclusion. EOCs are characterized by molecular structural and functional heterogeneity, which objectifies IHC analysis of EOCC for the selection of a pathogenetically sound medical therapy regimen.

Ki-67, p53, endometrioid ovarian cysts, immunohistochemical analysis, estrogen and progesterone receptors, Ki-67, p53, personalized treatment, relapse rate