Study Of IHC Expression Of WT1 And P53 In Ovarian Serous Carcinoma With Emphasis On Post Chemotherapy Induced Changes -Experience From A Tertiary Care Institute From South India

Background: Serous ovarian carcinomas (SOC) are the commonest and most lethal tumors as they are most frequently diagnosed at advanced stages. Wilms tumour 1 (WT1) is a transcription factor which can behave as either an oncogene or as a tumor suppressor gene. In our study, we aimed to analyse the expression of WT1 and p53 in serous carcinomas cases and their correlation with the grade and stage. Methods: This is a retrospective study including all cases of SOCs diagnosed in five years. Tumors were graded in to low grade or high grade based on the histopathological features described in World Health Organisation (WHO) classification. IHC expression patterns of WT1 and p53 were studied. WT1 and p53 expression patterns were correlated with grade and stage. Statistical analysis performed using IBM SPSS software Version 23.0. Results: Out of 444 serous tumors, 70 were serous carcinomas (15. 76%). In that, 44 cases were without pre-surgical chemotherapy and 26 cases had presurgical chemotherapy. Of the 44 cases, 21 were typed as low grade and 23 were classified as high grade based on the histo morphology. Out of 21 low grade SOC, 16 cases (76.19%) showed WT1 positivity and in high grade cases all (23/23,100%) showed WT1 positivity. There was a significant association between the WT1 expression and higher grade of tumor. (p = 0.003). In post-chemotherapeutic cases with residual tumor, WT1 positivity was observed in 92.6% (22/24) cases, which was statistically significant. (p=0.018). Aberrant expression of p53 was observed in all cases (23/23,100%) of HGSOCs compared to 76% (16/21) of LGSOC with a p value of 0.019. Conclusion: The study highlights the role of WT1 as an emerging prognostic biomarker in ovarian serous carcinomas. HGSOC always show aberrant pattern of p53 expression as compared to LGSOC which show variable p53 expression. WT1 serves as a useful marker to identify serous origin in high grade serous ovarian cancers even in post chemotherapeutic cases.