title: Differentiation margins of ovarian tumor pathology: first incidences of epithelial ovarian tumors monitored by marker antibodies.
abstract: The first incidence of ovarian tumors in The Netherlands was analyzed during the PALGA data. The first incidences of benign epithelial ovarian tumors reach a plateau, at a level of 60 to 65 cases per 100,000 women beyond the age of 40 years. The borderline malignant epithelial ovarian tumors account for 10 per 100,000 women aged 30 to 85, while the ovarian carcinomas reach a plateau level of 25 to 35 per 100,000 women after the age of 50. Despite the long lag period (+/- 10 years) between benign and malignant ovarian tumors, the question of whether or not all epithelial ovarian cancers develop via an intermediate step of cystadenomas is still unanswered. Therefore, we examined whether the expression pattern of intermediate filaments and tumor antigens in normal, benign, and malignant ovarian tissues might contribute to this question. The following changes in expression pattern were observed: generally, all tumor cells retained the keratin profile of the corresponding original cell type. However, in a limited number of tumor samples ectopic keratin types, such as nos. 4, 10, 13, and 14, became expressed additionally. Most epithelial ovarian tumors and mesothelial cells coexpressed vimentin. The panepithelial marker BW495/36 clearly distinguished between negatively stained normal ovarian surface mesothelium and the positively stained (inclusion) cystic epithelium. TAG-72 as well as OV-632 marked a subsequent tumor stage by discriminating between negative serous adenomas and positive serious carcinomas. TAG-72, however, stained both mucinous adenomas and carcinomas. The ovarian tumor markers (OC125, OV-TL 33, OV-TL16, MOv18), all showed an increasing expression level in the sequence order from normal cells to benign and malignant ovarian tumors. Both our epidemiological and our immunohistochemical data have shown that in the Dutch population there is a lag period of at least 10 years between the plateau levels of benign and malignant ovarian tumors. The early transformation of mesothelial cells to benign and/or malignant tumors is clearly marked by a switch on of the BW495/36 marker. Although no general transformation or progression marker from adenomas to carcinomas emerged from this study, TAG-72 might be considered a (progression) marker between the subgroup of benign and malignant serous ovarian tumors.
authors.affiliation: Department of Cell Biology and Histology, Faculty of Medical Sciences, University of Nijmegen, The Netherlands.
authors.forename: C C
authors.initials: CC
authors.lastname: van Niekerk
authors.forename: P
authors.initials: P
authors.lastname: Vooijs
authors.forename: I J
authors.initials: IJ
authors.lastname: Casparie-van Velsen
authors.forename: L G
authors.initials: LG
authors.lastname: Poels
mesh_terms: D000367:Age Factors; D000912:Antibodies, Neoplasm / Q000276:immunology; D000951:Antigens, Neoplasm / Q000378:metabolism; D002454:Cell Differentiation; D004848:Epithelium / Q000378:metabolism; D005260:Female; D006801:Humans; D007381:Intermediate Filament Proteins / Q000378:metabolism; D009426:Netherlands; D010051:Ovarian Neoplasms / Q000378:metabolism / Q000473:pathology*; D010053:Ovary / Q000378:metabolism
chemical_list: D000912:Antibodies, Neoplasm; D000951:Antigens, Neoplasm; D007381:Intermediate Filament Proteins