Clinicopathological importance of survivin immunoexpression in reproductive age patients with serous borderline ovarian tumors

Year 2021, , 1401 - 1408, 30.12.2021

Erdem Şahin , Hulya Akgun , Yusuf Madendağ , Mehmet Mete Kırlangıç , Erol Karakaş , Nahit Topaloğlu

https://doi.org/10.17826/cumj.976041

Abstract

Purpose: The aim of the present study was to evaluate survivin immunoexpression and the clinicopathologic correlations in serous borderline ovarian tumors (BOT) patients ≤ 40 years old.
Materials and Methods: A total of 36 BOT cases were evaluated. After excluding the mucinous type and patients over 40 years of age, 20 serous BOT cases meeting the criteria were included. A similar number of benign ovarian cysts and 20 serous malign ovarian tumors were randomly included as the control group. The patients were then staged based on their surgical findings and 2014 FIGO criteria, and their histological tumor types obtained from pathological specimens were determined using WHO criteria. The survivin levels in the specimens were analyzed using immunohistochemical assays.
Results: Positive survivin expression was detected in 10% of benign tumors, 100% of serous BOTs, and 100% of serous malign ovarian tumors. Mean survivin immunoreactivity was statistically similar between groups and it was found to be significantly higher in both groups compared to the control group. Survivin expression was positively correlated with FIGO stage, tumor grade, microinvasion, and micropapillary pattern.
Conclusion: Survivin immunoexpression is correlated with the malignancy potential of serous BOTs, and that survivin immune expression may be a histopathological marker that will help in making a decision on fertility-sparing surgery and follow upin young patients.

Keywords

Serous borderline ovarian tumors, Survivin, Fertility-sparing surgery

Supporting Institution

Erciyes University Scientific Research and Project Unit

Project Number

9166

Seröz borderline over tümörleri olan reprodüktif çağdaki hastalarda survivin immünoekspresyonunun klinikopatolojik önemi

Abstract

Amaç: Bu çalışmanın amacı, 40 yaş ve altındaki seröz borderline over tümörü (BOT) olan hastalarda survivin immünoekspresyonunu ve klinikopatolojik korelasyonları değerlendirmektir.
Gereç ve Yöntem: Toplam 36 BOT vakası değerlendirildi. Musinöz tip ve 40 yaş üzeri hastalar dışlandıktan sonra kriterleri karşılayan 20 seröz BOT vakası dahil edildi. 20 benign over kisti ile 20 seröz malign over tümörü kontrol grubu olarak rastgele dahil edildi. Hastalar daha sonra cerrahi bulguları ve 2014 FIGO kriterlerine göre evrelendirildi ve patolojik örneklerden elde edilen histolojik tümör tipleri WHO kriterlerine göre belirlendi. Örneklerdeki survivin seviyeleri, immünohistokimyasal testler kullanılarak analiz edildi.
Bulgular: Pozitif survivin ekspresyonu, iyi huylu tümörlerin %10'unda, seröz BOT'ların %100'ünde ve seröz malign over tümörlerinin %100'ünde tespit edildi. Ortalama survivin immünreaktivitesi açısından gruplar arasında istatistiksel olarak fark yoktu, her iki grupta da kontrol grubuna göre anlamlı derecede yüksek olarak saptandı. Survivin ekspresyonu, seröz BOT grubunda FIGO evresi, tümör derecesi, mikroinvazyon ve mikropapiller patern ile pozitif korelasyon gösterdi.
Sonuç: Survivin immün ekspresyonunun seröz BOT'ların malignite potansiyeli ile korele olduğunu ve survivin immün ekspresyonunun genç hastalarda fertilite koruyucu cerrahiye karar vermede ve takipte yardımcı olacak histopatolojik bir belirteç olabileceğini düşündürmektedir.

Keywords

Seröz borderline over tümörleri, Survivin, Fertilite koruyucu cerrahi

Project Number

9166

References

• 1. Hauptmann S, Friedrich K, Redline R, et al. Ovarian borderline tumors in the 2014 WHO classification: evolving concepts and diagnostic criteria. Virchows Arch. 2017;470:125-42.
• 2. Trillsch F, Ruetzel JD, Herwig U, et al. Surgical management and perioperative morbidity of patients with primary borderline ovarian tumor (borderline ovarian tumor). J Ovarian Res. 2013;6:48.
• 3. Ureyen I, Karalok A, Tasci T, et al. The factors predicting recurrence in patients with serous borderline ovarian tumor. Int J Gynecol Cancer. 2016;26:66-72.
• 4. Harter P, Gershenson D, Lhomme C, et al. Gynecologic Cancer InterGroup (GCIG) consensus review for ovarian tumors of low malignant potential (borderline ovarian tumors). Int J Gynecol Cancer. 2014;24:S5-S8.
• 5. Helpman L, Beiner ME, Aviel-Ronen S, et al. Safety of ovarian conservation and fertility preservation in advanced borderline ovarian tumors. Fertil Steril. 2015;104:138-44.
• 6. Yamashita S, Masuda Y, Kurizaki T, et al. Survivin expression predicts early recurrence in early-stage breast cancer. Anticancer research. 2007;27(4c):2803±8. Epub 2007/ 08/19. PMID: 17695451.
• 7. He X, Yang K, Wang H, et al. Expression and clinical significance of survivin in ovarian cancer: A meta-analysis. PloS one, 2018;13(5):e0194463.
• 8. Zanetta G, Rota S, Chiari S, et al. Behavior of borderline tumors with particular interest to persistence, recurrence, and progression to invasive carcinoma: a prospective study. J Clin Oncol. 2001;19:2658-64
• 9. Trillsch F, Mahner S, Woelber L, et al. Age-dependent differences in borderline ovarian tumours (borderline ovarian tumor) regarding clinical characteristics and outcome: results from a sub-analysis of the Arbeitsgemeinschaft Gynaekologische Onkologie (AGO) ROborderline ovarian tumor study. Ann Oncol. 2014;25:1320-7.
• 10. Turan G, Usta CS, Usta A, et al. "The expression of HER-2/neu (c-erbB2), survivin and cycline D1 in serous ovarian neoplasms: their correlation with clinicopathological variables." J Mol Hist 2014;4: 679-87.
• 11. Lin C-K, Chao T-K, Yu C-P, et al. The expression of six biomarkers in the four most common ovarian cancers: correlation with clinicopathological parameters. APMIS Acta Pathol Microbiol Immunol Scand 2009;117:162-75
• 12. He X, Yang K, Wang H, et al. "Expression and clinical significance of survivin in ovarian cancer: a meta-analysis." PloS one 2018; 13(5):e0194463.
• 13. Seong SJ, Kim DH, Kim MK, et al. Controversies in borderline ovariantumors. J Gynecol Oncol. 2015;26:343–9.
• 14. Cusido M, Balaguero L, Hernandez G, et al. Results of the national survey of borderline ovarian tumors in Spain. Gynecol Oncol. 2007;104:617–22.
• 15. Shih KK, Zhou Q, Huh J, et al. Risk factors for recurrence of ovarian borderline tumors. Gynecol Oncol. 2011;120:480–4.
• 16. S Shin BJ, Sung YS, Cho HJ, et al. An anti-apoptotic protein human survivin is a direct inhibitor of caspase-3 and -7. Biochemistry 2001;400;1117-23
• 17. I. Tamm, Y. Wang, E. Sausville, et al. IAP-family protein survivin inhibits caspase activity and apoptosis induced by Fas (CD95), Bax, caspases, and anticancer drugs Cancer Res., 1998;58:5315-20
• 18. Plett H, Harter P, Ataseven B, et al. "Fertility-sparing surgery and reproductive-outcomes in patients with borderline ovarian tumors." Gynecol Oncol 2020;157:411-7
• 19. Sozen H, Vatansever D, Topuz S, et al. "Clinicopathological analysis of borderline ovarian tumours and risk factors related to recurrence: experience of single institution." J Obstet Gynaecol 2019;39:253-8
• 20. Qian XQ, Hua XP, Wu JH, et al. "Clinical predictors of recurrence and prognostic value of lymph node involvement in the serous borderline ovarian tumor." Int J Gynecol Cancer 2018;28:279-82
• 21. .Bendifallah S, Ballester M, Uzan C, et al. Nomogram to predict recurrence in patients with early- and advanced-stage mucinous and serous borderline ovarian tumors. Am J Obstet Gynecol 2014;211:631-6
• 22. Bendifallah S, Ballester M, Uzan C, et al. "Nomogram to predict recurrence in patients with early-and advanced-stage mucinous and serous borderline ovarian tumors." Am J Obstet Gynecol 2014;211:637-e1.