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 profile showed the higher efficiency 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.Tezikov Yu.V., Strizhakov A.N., Lipatov I.S., Kalinkina O.B., Aravina O.R., Martynova N.V.
Keywords
endometrioid ovarian cysts
immunohistochemical analysis
estrogen and progesterone receptors
Ki-67
p53
personalized treatment
relapse rate
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Received 18.10.2019
Accepted 29.11.2019
About the Authors
Yury V. Tezikov, MD, professor, head of obstetrics and gynecology chair number 1 of Federal State Budgetary Educational Institution of Higher Education «Samara State Medical University» of the Ministry of Healthcare of the Russian Federation, e-mail: yra.75@inbox.ru ORCID 0000-0002-8946-501X.443099, Russia, Samara, ul. Chapaevskaya, d. 89.
Aleksandr N. Strizhakov, MD, professor member of the Russian Academy of Science, honored doctor, head of obstetrics, gynecology and perinatology chair of I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia, Moscow, Russia. 119991, Moscow, st. Trubetskaya, d. 8, p. 2.
Igor S. Lipatov, MD, professor, professor of obstetrics and gynecology chair number 1 of Federal State Budgetary Educational Institution of Higher Education «Samara State Medical University» of the Ministry of Healthcare of the Russian Federation, e-mail:i.lipatoff2012@yandex.ru ORCID 0000-0001-7277-7431
443099, Russia, Samara, ul. Chapaevskaya, d. 89.
Olga B. Kalinkina, MD, professor, professor of obstetrics and gynecology chair number 1 of Federal State Budgetary Educational Institution of Higher Education «Samara State Medical University» of the Ministry of Healthcare of the Russian Federation, е-mail: maiorof@mail.ru ORCID 0000-0002-1828-3008
443099, Russia, Samara, ul. Chapaevskaya, d. 89.
Oksana R. Aravina, teaching assistant of obstetrics and gynecology chair number 1 of Federal State Budgetary Educational Institution of Higher Education «Samara State Medical University» of the Ministry of Healthcare of the Russian Federation, e-mail: dr.aravina@gmail.com ORCID 0000-0002-2107-1508
443099, Russia, Samara, ul. Chapaevskaya, d. 89.
Nadezhda V. Martynova, teaching assistant of obstetrics and gynecology chair number 1 of Federal State Budgetary Educational Institution of Higher Education «Samara State Medical University» of the Ministry of Healthcare of the Russian Federation, e-mail: og1samsmu @mail.ru ORCID 0000-0002-2107-1508
443099, Russia, Samara, ul. Chapaevskaya, d. 89.
Olga B. Kalinkina, MD, professor, professor of obstetrics and gynecology chair number 1 of Samara State Medical University, е-mail: maiorof@mail.ru
ORCID 0000-0002-1828-3008 443099, Russia, Samara, ul. Chapaevskaya, d. 89.
Oksana R. Aravina, teaching assistant of obstetrics and gynecology chair number 1 of Samara State Medical University, e-mail: dr.aravina@gmail.com
ORCID 0000-0002-2107-1508 443099, Russia, Samara, ul. Chapaevskaya, d. 89.
Nadezhda V. Martynova, teaching assistant of obstetrics and gynecology chair number 1 of Samara State Medical University, e-mail: og1samsmu @mail.ru
ORCID 0000-0002-2107-1508 443099, Russia, Samara, ul. Chapaevskaya, d. 89.
For citation: Tezikov Yu.V., Strizhakov A.N., Lipatov I.S., Kalinkina O.B., Aravina O.R., Martynova N.V. Clinical significance of the immunohistochemical profile of ovarian endometrioid cysts.
Akusherstvo i Ginekologiya/ Obstetrics and gynecology. 2020; 2: 116-24.(In Russian).
https://dx.doi.org/10.18565/aig.2020.2.116-124