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. 2017 Mar 1;18(3):667-671.
doi: 10.22034/APJCP.2017.18.3.667.

Histochemical and Immunohistochemical Study of α-SMA, Collagen, and PCNA in Epithelial Ovarian Neoplasm

Nungki Anggorowati  1 , Chatarina Ratna Kurniasari, Karina Damayanti, Titik Cahyanti, Irianiwati Widodo, Ahmad Ghozali, Muhammad Mansyur Romi, Dwi Cahyani Ratna Sari, Nur Arfian
Affiliations

Histochemical and Immunohistochemical Study of α-SMA, Collagen, and PCNA in Epithelial Ovarian Neoplasm

Nungki Anggorowati et al. Asian Pac J Cancer Prev. .

Abstract

Background: Alpha-smooth muscle actin (α-SMA) is an isoform of actin, positive in myofibroblasts and is an epithelial to mesenchymal transition (EMT) marker. EMT is a process by which tumor cells develop to be more hostile and able to metastasize. Progression of tumor cells is always followed by cell composition and extracellular matrix component alteration. Increased α-SMA expression and collagen alteration may predict the progressivity of ovarian neoplasms. Objective: The aim of this research was to analyse the characteristic of α-SMA and collagen in tumor cells and stroma of ovarian neoplasms. In this study, PCNA (proliferating cell nuclear antigen) expression was also investigated. Methods: Thirty samples were collected including serous, mucinous, endometrioid, and clear cell subtypes. The expression of α-SMA and PCNA were calculated in cells and stroma of ovarian tumors. Collagen was detected using Sirius Red staining and presented as area fraction. Results: The overexpressions of α-SMA in tumor cells were only detected in serous and clear cell ovarian carcinoma. The histoscore of α-SMA was higher in malignant than in benign or borderline ovarian epithelial neoplasms (105.3±129.9 vs. 17.3±17.1, P=0.011; mean±SD). Oppositely, stromal α-SMA and collagen area fractions were higher in benign than in malignant tumors (27.2±6.6 vs 20.5±8.4, P=0.028; 31.0±5.6 vs. 23.7±6.4, P=0.04). The percentages of epithelial and stromal PCNA expressions were not significantly different between benign and malignant tumors. Conclusion: Tumor cells of serous and clear cell ovarian carcinoma exhibit mesenchymal characteristic as shown by α-SMA positive expression. This expression might indicate that these subtypes were more aggressive. This research showed that collagen and α-SMA area fractions in stroma were higher in benign than in malignant neoplasms.

Keywords: Ovarian neoplasm; α-SMA; collagen; PCNA; epithelial to mesenchymal transition.

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Figures

Figure 1
Figure 1
Immunohistochemical Staining of α-SMA. The overexpression of α-SMA was detected in some subtypes of malignant ovarian epithelial tumor i.e. serous (D) and clear cell cystadenocarcinoma (F). Meanwhile, benign ovarian epithelial tumor i.e. mucinous (A) and serous (B) cystadenoma did not express α-SMA as shown, so did the mucinous (C) and endometrioid (E) cystadenocarcinoma
Figure 2
Figure 2
Immunohistochemical Staining of PCNA in Ovarian Epithelial Neoplasms. PCNA was overexpressed in mucinous carcinoma (B). Some epithelial cells of mucinous cystadenoma (A) also expressed PCNA
Figure 3
Figure 3
Sirius Red Staining of Ovarian Epithelial Neoplasms. Staining of serous cystadenocarcinoma (B) looked thinner than serous cystadenoma (A)
Figure 4
Figure 4
Stromal and Epithelial PCNA (A and B) percentages, fraction areas of sirius red (C) and stromal α-sma (D), and epithelial α-sma histoscore (E) in ovarian neoplasms classified according to malignancy. ∤, ∤∤, ∤∤∤ p<0.05
Figure 5
Figure 5
Fraction area of Stromal α-SMA and Sirius Red for Each Pathological Subtypes of Ovarian Epithelial Neoplasm. In sirius red staining, serous and mucinous cystadenoma were positively higher than malignant subtypes. Fraction area of stromal α-SMA in malignant subtypes were also detected less than the benign
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