title: An immunohistochemical panel to distinguish ovarian from uterine serous papillary carcinomas.
abstract: Serous papillary carcinomas (SPCs) share a similar morphology regardless of whether they originate from the ovary or the uterus. Identification of the site of origin of the tumor can be a challenging and a diagnostic dilemma, particularly, in the setting of a pelvic mass or peritoneal carcinomatosis. Recognition of the site of origin influences the staging, management, and prognosis of these malignancies. The purpose of this study is to identify a panel of markers to distinguish the ovarian serous papillary carcinomas (OSPC) from the uterine serous papillary carcinomas (USPC). Formalin-fixed, paraffin-embedded archival tissue from 46 cases of SPCs (33 uterine and 13 ovarian) were stained using antibodies for estrogen receptor (ER), WT1, insulin-like growth factor-II mRNA-binding protein 3 (IMP3), p53, and p16. The OSPC expressed ER (92%), WT1 (100%), IMP3 (92%), p53 (92%), and p16 (92%). The USPCs expressed ER (30%), WT1 (64%), IMP3 (85%), p53 (64%), and p16 (76%). Only ER expression was significantly higher in OSPC compared with USPCs (P<0.001). The combined ER(+)WT1(+) phenotype was present in 92% of the OSPC, whereas only 18% of the USPCs had the same phenotype (P<0.001). Furthermore, 71% of the OSPCs expressed ER(+), p53(+), WT1(+), IMP3(+), and p16(+) immunophenotype, whereas in USPCs, the tumor cells showed immunophenotypic diversity, with only 6% of the USPCs expressing reactivity to all the 5 markers (P<0.001). This study suggests that ER alone or in combination with a limited panel of markers may be used to identify the site of origin of SPCs.
authors.affiliation: Department of Pathology, Miller School of Medicine, University of Miami-Jackson Memorial Hospital, Miami, FL, USA.
authors.forename: Yaxia
authors.initials: Y
authors.lastname: Zhang
authors.forename: Monica T
authors.initials: MT
authors.lastname: Garcia-Buitrago
authors.forename: Tulay
authors.initials: T
authors.lastname: Koru-Sengul
authors.forename: Samer
authors.initials: S
authors.lastname: Schuman
authors.forename: Parvin
authors.initials: P
authors.lastname: Ganjei-Azar
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism*; D002291:Carcinoma, Papillary / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D018284:Cystadenocarcinoma, Serous / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D010053:Ovary / Q000378:metabolism / Q000473:pathology; D014594:Uterine Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D014599:Uterus / Q000378:metabolism / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor