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Uncertainty in the Utility of Immunohistochemistry in Mismatch Repair Protein Expression in Epithelial Ovarian Cancer
Abstract
Background: Utility of
immunohistochemistry (IHC) for mismatch repair (MMR) protein expression
has been demonstrated in colorectal
cancer but remains incompletely defined in ovarian
cancer. We evaluated MMR protein expression in three population-based
samples
of epithelial ovarian cancers. Materials and
Methods: IHC staining was performed on full-section (FS) or tissue
microarray
(TMA) slides for MLH1, MSH2, and MSH6 expression.
Results: Out of 487 cases, 147 and 340 were performed through FS and
TMA,
respectively. Overall, Loss of Expression (LoE) of
at least one MMR protein was observed in 12.7% based on an expression
score
of ≤3 (on a scale of 9). Notably, LoE was
significantly higher in TMAs (17.9%) compared to FS cases (0.7%)
(p<0.001). Conclusion:
A substantial proportion of epithelial ovarian
cancers have a loss of MMR protein expression. Protein expression
results vary
significantly by the tissue sampling methodology
utilized, raising concerns about the clinical utility of this test for
ovarian
tumors.
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