CC BY-NC-ND 4.0 · South Asian J Cancer
DOI: 10.1055/s-0045-1809307
Original Article

Immunohistochemical Expression of p53 in Epithelial Ovarian Carcinoma and Its Correlation with Clinicopathological Parameters

Farzana Sharmin
1   Department of Gynecological Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
,
Noor-e-Ferdous Noor-e-Ferdous
1   Department of Gynecological Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
,
Latifa Akhter
1   Department of Gynecological Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
,
Khairun Nahar
1   Department of Gynecological Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
,
Towhidul Islam
2   Department of Oncology, Kurmitola General Hospital, Dhaka, Bangladesh
,
Jannatul Ferdous
1   Department of Gynecological Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
› Author Affiliations

Abstract

Introduction

Mutation of p53 is often considered to be associated with high-grade epithelial ovarian cancer that carries a poor prognosis. The purpose of the study was to evaluate the pattern of immunohistochemical expression of p53 in epithelial ovarian carcinoma (EOC) and to find out its correlation with clinicopathological parameters of the disease.

Methods

This observational, cross-sectional study was conducted at the Department of Gynecological Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, from July 2022 to June 2023. A total of 50 women diagnosed with EOCs and scheduled for primary debulking surgery were selected for the study. A semiquantitative histochemical scoring method was employed for p53 nuclear staining, with over 1,000 tumor cells assessed across multiple high-power fields for percentage and intensity of staining. Positive and negative control slides were incorporated during staining procedures to ensure reliability. Statistical analyses included chi-square or Fisher's exact tests for categorical variables, Mann–Whitney tests for nonnormally distributed continuous data, and Spearman's correlation for relationships between various parameters.

Results

Of the total 50 study participants were included, 31 (62%) exhibited p53 mutations, while 19 (38%) showed no such mutations. The presence of p53 mutation was significantly associated with a family history of ovarian cancer (p = 0.001) and the histological subtypes (p = 0.046). Regarding histological subtypes, 39 (78%) cases were serous, 9 (18%) cases were mucinous, 1 (2%) case was seromucinous, and 1 (2%) case was of endometrioid variety. Preoperative median CA-125 levels were significantly higher in advanced-stage and high-grade serous ovarian carcinomas compared with early-stage and low-grade cases (p = 0.016 and p = 0.001, respectively). Although no significant association was found between p53 mutation status and serous carcinoma stage, mutation status was significantly associated with serous carcinoma grade (p = 0.042), with a moderate positive correlation (Spearman's correlation coefficient, ρ = 0.364).

Conclusion

Our study highlights the significant association of p53 mutations with a family history and histological subtypes of EOC. Elevated preoperative CA-125 levels are associated with advanced-stage and high-grade serous carcinomas. Moreover, higher-grade serous ovarian carcinomas are significantly associated with the presence of p53 mutations, providing valuable insights into pathogenesis and potential treatment strategies.



Publication History

Received: 22 January 2025

Accepted: 18 April 2025

Article published online:
19 May 2025

© 2025. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Mohamed AO, Husain NE, Elmassry RE, Alnageeb L, Elhassan M, Abdelaziz MS. Immunohistochemical expression of p53 in type I and II epithelial ovarian cancer among Sudanese women: a cross-sectional study. F1000 Res 2019; 8 (1739) 1739
  • 2 Sharadha S, Sridevi TA, Renukadevi TK, Gowri R, Binayak D, Indra V. Ovarian masses: changing clinico histopathological trends. J Obstet Gynecol India 2015; 65 (01) 34-38
  • 3 Devouassoux-Shisheboran M, Genestie C. Pathobiology of ovarian carcinomas. Chin J Cancer 2015; 34 (01) 50-55
  • 4 ACS. . Cancer facts and figures; 2021 . Accessed May 2, 2025 at: https://www.cancer.org/content/dam/CRC/PDF/Public/8773.00.pdf
  • 5 Reid F. . World Ovarian Cancer Coalition Atlas; 2020 . Accessed May 2, 2025 at: https://worldovariancancercoalition.org/wp-content/uploads/2020/10/2020-World-Ovarian-Cancer-Atlas_FINAL.pdf
  • 6 Bangladesh S. . Globocan [Internet]. The Global Cancer Observatory. 2020 . Accessed May 2, 2025 at: https://gco.iarc.fr/today/data/factsheets/populations/50-bangladesh-fact-sheets.pdf
  • 7 Elsherif S, Javadi S, Viswanathan C, Faria S, Bhosale P. Low-grade epithelial ovarian cancer: what a radiologist should know. Br J Radiol 2019; 92 (1095) 20180571
  • 8 Campion MJ, Canfell K. Berek & Hacker's Gynecologic Oncology. 7th ed.. Philadelphia: Lippincott Williams & Wilkins; 2020
  • 9 Lheureux S, Gourley C, Vergote I, Oza AM. Epithelial ovarian cancer. Lancet 2019; 393 (10177): 1240-1253
  • 10 Shabir S, Gill PK. Global scenario on ovarian cancer–its dynamics, relative survival, treatment, and epidemiology. Adesh Univ J Med Sci Res 2020; 2 (01) 17-25
  • 11 Reid BM, Permuth JB, Sellers TA. Epidemiology of ovarian cancer: a review. Cancer Biol Med 2017; 14 (01) 9-32
  • 12 Desai A, Xu J, Aysola K. et al. Epithelial ovarian cancer: an overview. World J Transl Med 2014; 3 (01) 1-8
  • 13 Choudhary P, Khatri K, Gupta M, Choudhary B. Role of expression of P53 in differentiating benign, borderline and malignant surface epithelial ovarian tumors. IOSR J Dent Med Sci 2019; 18 (10) 37-45
  • 14 Nayak S, Kumari P, Agrawal KC. Immunohistochemical expression of p53 in serous carcinoma of ovary and its correlation with clinicopathological parameters. Indian J Pathol Oncol 2020; 7 (01) 33-38
  • 15 Charkhchi P, Cybulski C, Gronwald J, Wong FO, Narod SA, Akbari MR. CA125 and ovarian cancer: a comprehensive review. Cancers (Basel) 2020; 12 (12) 3730
  • 16 Darcy KM, Brady WE, McBroom JW. et al. Associations between p53 overexpression and multiple measures of clinical outcome in high-risk, early stage or suboptimally-resected, advanced stage epithelial ovarian cancers A Gynecologic Oncology Group study. Gynecol Oncol 2008; 111 (03) 487-95
  • 17 Chang L-C, Huang C-F, Lai M-S, Shen L-J, Wu F-LL, Cheng W-F. Prognostic factors in epithelial ovarian cancer: a population-based study. PLoS One 2018; 13 (03) e0194993
  • 18 Li Y, Wang Z-C, Luo L. et al. The clinical value of the combined detection of sEGFR, CA125 and HE4 for epithelial ovarian cancer diagnosis. Eur Rev Med Pharmacol Sci 2020; 24 (02) 604-610
  • 19 Kaur K, Singh H. Correlation of p53 expression in ovarian lesions of different histogenesis-an immunohistochemical study. J Cardiovasc Dis Res 2023; 14 (05) 463-475
  • 20 Tiwari RK, Saha K, Mukhopadhyay D, Datta C, Chatterjee U, Ghosh TK. Evaluation of preoperative serum levels of CA 125 and expression of p53 in ovarian neoplasms: a prospective clinicopathological study in a tertiary care hospital. J Obstet Gynecol India 2016; 66 (02) 107-114
  • 21 Sallum LF, Andrade L, Ramalho S. et al. WT1, p53 and p16 expression in the diagnosis of low- and high-grade serous ovarian carcinomas and their relation to prognosis. Oncotarget 2018; 9 (22) 15818-15827
  • 22 Naik PS, Deshmukh S, Khandeparkar SGS. et al. Epithelial ovarian tumors: Clinicopathological correlation and immunohistochemical study. J Midlife Health 2015; 6 (04) 178-183