Histopathologic features of ovaries at increased risk for carcinoma - A case-control analysis

In this study, the pathogenesis of ovarian carcinoma was investigated by wo men predicted to be at increased risk for developing carcinoma (cases) with ovaries removed from 121 women without known predisposing conditions (cont rols). The cases included 26 women who had a unilateral invasive carcinoma and 35 women undergoing prophylactic oophorectomy for a family history of o varian cancer. As predicted by previously developed models, epithelial incl usion cysts were identified more frequently with advancing age in both case s and controls. However, the mean and maximum number of cysts per slide in a woman were not increased among cases. Surface epithelial "atypia," a desi gnation based on a composite impression of multiple features, was found in 13% of cases compared with 3% of controls (relative risk 7.1; 95% confidenc e interval, 1.9 to 26.1), but this result was based on small numbers, None of the other histologic features examined was found more often in cases fol lowing age-adjustment. Reexamination of sections with well-preserved surfac e epithelium or inclusion cysts under oil immersion demonstrated several di fferences in the detection of specific features between cases and controls and increased detection of "atypia" among cases, but none of these findings reached statistical significance, It is concluded that there may be subtle differences in the surface epithelium of ovaries predisposed to developing cancer as compared with controls, but these changes are difficult to ident ify reliably with light microscopy. Future etiologic studies should attempt to optimize specific handling and include molecular studies and epidemiolo gic analyses.