PREVALENCE AND SIGNIFICANCE OF HER-2 NEU EXPRESSION IN EARLY EPITHELIAL OVARIAN-CANCER/

Background. Although expression of the HER-2/neu oncogene may be of so me prognostic importance in advanced ovarian cancer, its role in early -stage disease has not been established. The current study examined th e prevalence and significance of HER-2/neu expression in early epithel ial ovarian cancer. Methods. The authors analyzed the expression of HE R-2/neu on frozen tumor specimens from 40 patients with early epitheli al ovarian cancer using the indirect immunoperoxidase technique with m onoclonal antibodies that detect epitopes on the extracellular domain of the HER-2/neu protein. All patients underwent comprehensive surgica l staging. HER-2/neu expression was graded as negative, weak, moderate (1+ to 2+), or strong (3+). Complete clinical data and long-term foll ow up were available for all patients. Results. The distribution of pa tients by stage was as follows: Stage IA, 6; IB, 0; IC, 14; IIA, 4; II B, 6; IIC, 10. The mean patient age was 53 years. Fourteen patients ha d serous tumors; nine, endometrioid; eight, clear cell; eight, mucinou s; and one, undifferentiated. Intratumoral heterogeneity of HER-2/neu expression was observed with most specimens. In eight specimens (20%), some areas of the tumor showed strong (3+) expression, beyond the lev el that can be seen in normal ovarian epithelium. Twenty-eight specime ns (70%) showed moderate (1+ to 2+) staining, whereas four specimens ( 10%) showed negative or weak staining. At a mean follow-up time among surviving patients of 32 months, 15 patients (37%) have had cancer rec urrence. No statistically significant relationship was found between H ER-2/neu expression and survival, disease-free survival, stage, or gra de. A significant increase was found in 3+ expression of HER-2/neu in clear cell tumors. Conclusion. Consistent HER-2/neu overexpression occ urs infrequently in early ovarian cancer, making it unlikely that such overexpression is a general early event in ovarian carcinogenesis. HE R-2/neu expression does not appear to be a strong prognostic marker in early epithelial ovarian cancer.