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964 P53 Expression in the endometrium as a predictor for epithelial ovarian cancer
  1. Kartika Hapsari1,2,3,
  2. Thomas De Bruin2,
  3. J Bulten2,4,
  4. Willeke Daamen3,
  5. Joanne De Hullu2 and
  6. Johanna Pijnenborg2
  1. 1Department of Obstetrics and Gynecology, Harapan Kita National Women and Children Hospital, Jakarta, Indonesia
  2. 2Department of Obstetrics and Gynecology, Radboud university medical center, Nijmegen, The Netherlands
  3. 3Department of Medical BioSciences, Research Institute for Medical Innovation, Radboud university medical center, Nijmegen, The Netherlands
  4. 4Department Pathology Anatomy, Radboud university medical center, Nijmegen, The Netherlands


Introduction/Background Ovarian cancer has the highest mortality of all female reproductive cancers mainly attributed to advanced stage disease at diagnosis. In the last two decades, the Fallopian tube has been considered as the main site of origin for epithelial ovarian cancer (EOC), especially the most common subtype high grade serous carcinoma (HGSC). An alternative hypothesis suggests that precursor lesions may arise from the endometrium. We aim to study whether immunohistochemical (IHC) expression of P53 in the endometrium could serve as a predictor to early diagnosis of EOC.

Methodology Patients with confirmed EOC (n=29), and benign pathology as controls (n=29) were prospectively included in the DISCOVER study between December 2013 and January 2017 (van Bommel et al., 2022). Systematic histopathology review was performed on all surgical specimens, including ovaries, fallopian tubes, and preoperative endometrial sampling (pipelle). Next, IHC analysis of P53 was performed on all ovaries and endometrial biopsies. EOC and controls were compared, with special focus on the HGSC subtype.

Results Abnormal P53 expression in the endometrium was significantly more often present in EOC compared to controls, respectively 34.5% and 3.5% (Figure 1). The diagnostic accuracy of P53 expression to detect EOC resulted in a sensitivity and specificity of 34.5% and 96.6%. The positive predictive value (PPV), and negative predictive value (NPV) of P53 were 90.9% and 59.6%, respectively. Within the HGSC subtype, the sensitivity and specificity were 42.1% and 96.6%, with PPV 88.9% and NPV 71.8%.

Conclusion Based on the current findings, the expression of P53 in the endometrium may be a candidate biomarker for early detection of EOC. This minimal invasive procedure might preoperatively assist clinicians in choosing a surgical approach. Yet, results need to be prospectively validated, and study numbers need to be increased.

Disclosures No disclosure.

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