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A comparison of p53 and WT 1 immunohistochemical expression patterns in tubo‐ovarian high‐grade serous carcinoma before and after neoadjuvant chemotherapy
Author(s) -
Casey Laura,
Köbel Martin,
Ganesan Raji,
Tam Simone,
Prasad Rajeev,
Böhm Steffen,
Lockley Michelle,
Jeyarajah Arjun J,
Brockbank Eleanor,
Faruqi Asma,
Gilks C Blake,
Singh Naveena
Publication year - 2017
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.13272
Subject(s) - immunohistochemistry , chemotherapy , serous carcinoma , pathology , ovarian carcinoma , serous fluid , medicine , biopsy , biology , ovarian cancer , cancer
Aims The treatment of patients with tubo‐ovarian high‐grade serous carcinoma ( HGSC ) is increasingly based on diagnosis on small biopsy samples, and the first surgical sample is often taken post‐chemotherapy. p53 and WT 1 are important diagnostic markers for HGSC . The effect of neoadjuvant chemotherapy on p53 and WT 1 expression has not been widely studied. We aimed to compare p53 and WT 1 expression in paired pre‐chemotherapy and post‐chemotherapy samples of HGSC . Methods and results Immunohistochemistry ( IHC ) was carried out for p53 and WT 1 on paired omental HGSC samples pre‐chemotherapy and post‐chemotherapy. p53 IHC was recorded as normal (wild‐type) or abnormal (mutation‐type), and was further classified as overexpression, complete absence, or cytoplasmic. WT 1 IHC was classified as positive or negative. A subset of cases were further assessed for the extent of nuclear immunoreactivity of WT 1 by use of the H‐score. Fifty‐seven paired samples were stained with p53. Fifty‐six of 57 (98%) cases showed mutation‐type p53 staining. Pre‐chemotherapy and post‐chemotherapy IHC results were concordant in 55 of 57 (96%) cases. For WT 1, pre‐chemotherapy and post‐chemotherapy IHC results were concordant in 56 of 58 (97%) cases. In 23 paired WT 1 cases, the mean post‐treatment H‐score decreased from 227 [range 20–298, standard deviation ( SD ) 64] to 151 (range 0–288, SD 78) ( P = 0.0008). Conclusions Immunohistochemical expression of p53 (abnormal/mutation‐type pattern) and WT 1 in HGSC is almost universal and is largely concordant before and after chemotherapy. This finding underscores the reliability of these diagnostic markers in small samples and in surgical samples following neoadjuvant chemotherapy, with very few exceptions. A novel finding was the significant diminution in intensity of WT 1 staining following chemotherapy.