Novel clinical and morphological predictors of malignancy in patients with ovarian endometrioid cysts

Abstract

Introduction. Endometriosis is an endless source of scientific investigations, but still the mechanisms of malignant transformation of ovarian endometriosis remain to be understood. Patients and methods. This study was conducted on surgical specimens isolated from ovarian endometri-oid cysts (OEC) and the endometriosis-associated ovarian tumors obtained after surgical operation from 117 patients. The normal level of serum CA 125 was assumed to be up to 35 IU/ml. Immunohistochemical study of MCK, CK7, CK20, CK 8/18, Calretinin, EMA, Ki67, CEA, Vimentin, Inhibin, WT1, p53, ARID1A (BAF250a), CA 125 antibodies was performed. Results. The results revealed a direct correlation between the level of serum CA 125 and the WT1 expression in the OEC epithelium (Pearson r=0.84, p<0.0001) and between the level of serum CA 125 and the p53 expression (Pearson r=0.81, p<0.0001). A striking direct correlation was found when studying the relation-ship between WT1 and p53 expression in OEC epithelium (Pearson r=0.79, p<0.0001). Conclusion. This research delineated the changes in OEC epithelium, which were similar to the serous epithelial type and associated with an extensive rise in the serum biomarker CA 125 level, which could be indicative of the early neoplastic transformation of OEC. Keywords: CA 125, WT1, p53, ovarian endometrial cyst, ARID1A, malignant transformation