Immunochemistry & Immunopathology

Neural Signature Expressed by Cells from Ovarian Carcinoma (A Case Report)

Abstract

Rachid Kaci, Shah Shahid, Lo Dico Réa, Brouland Jean Philipe, Therwath Amu, Pocard Marc and Mirshahi Massoud

Aim: To demonstrate the presence of differentiated cells in ovarian carcinomatosis nodules after chemotherapy.

Patient and method: A patient of 85 years, who presented a pelvic mass of 10 cm. The anatomo-pathological study was performed on the biopsies (before treatment) and post operational samples (after treatment by Carbotaxol). Histological samples were analyzed with ovarian cancer markers for diagnosis. The immune cells (CD3, CD4, CD8 and CD20) and neural markers such as anti: neurofilament (NF), neural cell adhesion molecules NCAM (CD56), chromogranin A, neuronal specific enolase (NSE), S100 protein and synaptophysine were used for demonstrating the neuronal differentiation tendencies of carcinomatosis cells. Proliferation activities were studied by using proliferative index and Ki67 antibody.

Results: The histological result of biopsies of bilateral ovarian carcinomatosis showed the poorly differentiated monomorphic cell serous carcinoma (cytokeratin+, estrogen receptor+, protein S100+, anti-wilms tumor-1+ with proliferative index (31%) and high Ki67 marker (45%). Semi-quantitative histological evaluations of post operational samples presented two cellular quotas. One was composed of monomorphic cells with high proliferative index (19%) and ki67 marker (30%). In another quota, large size polymorphic cells with no proliferative index and Ki67 marker were distinguished. Before treatment, all neuronal markers except NSE and S100 protein were found negative in primary tumors. In the proliferative zone of post-operative samples, NSE and S100 protein markers persist with any other neuronal markers. These zones were highly infiltrated by CD3, CD4 and CD20 immune cells. In contrast, in degenerative non-proliferative zone, all primary tumor markers except Ki67, all neuronal markers except synaptophysine, and dramatically decreased infiltrated immune cells.

Conclusion: These results are in favors of differentiation of poorly differentiated ovarian cancer cells with high proliferative index to other tissue with no proliferation potential. Targeting of differentiation of cancer cells by differencing inductors may be a new way for cancer therapy.