Ovarian dysplasia in prophylactic oophorectomy specimens - Cytogenetic andmorphometric correlations

BACKGROUND. Ovarian dysplasia, a potential precursor to ovarian carcinoma, has been described in ovarian tissue obtained by prophylactic oophorectomy and also adjacent to ovarian carcinoma. Women with a family history of ovar ian carcinoma, especially those of Jewish Ashkenazi descent, often test pos itive for BRCA mutant genes. Prophylactically removed ovaries, generally de scribed as normal on macroscopic examination, can exhibit a "preneoplastic phenotype" and unsuspected neoplasm. METHODS. Histologic slides of ovarian tissue from 54 Ashkenazi Jewish women were reviewed. All had a family history of ovarian carcinoma and all were tested for BRCA mutations. Forty-four women tested positive. Thirty-one wom en underwent prophylactic oophorectomy and 23 underwent oophorectomy for ov arian carcinoma. Normal, dysplastic, and ovarian carcinoma epithelial cells were analyzed morphometrically combining nuclear area measurements with ch romatin texture assessment using a novel method based on the computation of autocorrelation coefficients and a derived parameter (Beta). Discriminant analysis between classificatory algorithms was used to obtain results. RESULTS. Ovarian dysplasia was identified in 77.6% of the prophylactic ooph orectomy specimens. hn unsuspected ovarian carcinoma was diagnosed in one p rophylactic oophorectomy specimen. Of 10 women who underwent prophylactic o ophorectomy and were negative for BRCA mutations, three had ovarian dysplas ia. The average nuclear measurements of the dysplastic cells were similar t o those published previously. The new autocorrelation-based method evaluati ng nuclear texture, as revealed by tridimensional surface plots, demonstrat ed high discriminatory potential. Discriminant analysis based on nuclear ar ea and nuclear texture information resulted in the correct classification o f nearly all the cases in the three diagnostic categories. CONCLUSIONS. Ovaries removed by prophylactic oophorectomy examined in their entirely often reveal ovarian dysplasia and occasionally ovarian carcinoma . The new morphometric method used was highly discriminatory in the evaluat ion of nuclear texture. Ovarian dysplasia in women with risk factors for ov arian carcinoma is significant in early ovarian carcinogenesis. (C) 1999 Am erican Cancel Society.