Shalini Saurabh, Prasanna Kumar Satpathy
BACKGROUND We wanted to evaluate the relation of histopathological grading of malignant surface epithelial ovarian neoplasms and evaluate ER and Ki -67 as prognostic markers to provide the clinician a better platform for therapeutic management. METHODS All patients attending OPD and diagnosed as ovarian neoplasms were included in the study & were further subjected to histopathological & IHC studies. ER scoring was done by ALLRED scoring system (proportion score + intensity score), score 0- 2 was taken as negative and 3-8 was taken as positive. The Ki 67 labelling index was expressed as 1+ when 5-25% of cell stained, 2+ when 25-50% cells stained. 3+ when 50-75% cells stained, 4+ when 75-100% cell stained. RESULTS Total number of cases was 42. Maximum number of cases were between fifth and sixth decade of life. 31 cases (73.80%) were serous cystadenocarcinomas, 6 cases (14.29%) were mucinous cystadenocarcinomas and 4 cases (9.53%) were endometroid carcinoma. One case of clear cell carcinoma (2.38%) was also seen. Oestrogen receptor was positive in 26/31 cases (83.87%) in serous cystadenocarcinoma, 2/6 (33.33%) cases of mucinous cystadenocarcinoma and, 2/4 cases (50%) of endometroid carcinoma and the single case of clear cell carcinoma was negative for ER. The total number of cases showing ER positivity was 71.42%. 12 cases were Grade 1 carcinomas showing ER positivity 58.33% (7/11) cases and Ki67 percentage 36.88%, 22 cases Grade 2 carcinomas showing 100% ER positivity and Ki67 percentage 66.98%, 8 cases in Grade 3 carcinomas showing 62.50% ER positivity (5/8 cases) and Ki67 index 81.30%. CONCLUSIONS Serous cystadenocarcinoma was the most common of all malignant surface epithelial ovarian tumours. ER positivity was maximum in Grade 2 tumours showing that once a case is ER positive, recommendations are there for hormone therapy whatever be the degree of positivity. ER was maximally expressed in serous carcinomas followed by mucinous carcinoma followed by endometroid carcinomas. Ki67 labelling index increases with increasing grade of surface epithelial ovarian malignancies.