Immunohistochemical Characterization Improves the Reproducibility of the Histological Diagnosis of Ovarian Carcinoma

Document Type : Research Articles


1 Research Unit UR14ES17, Cancer Epidemiology and Cytopathology in Tunisian Center, Medicine Faculty of Sousse, University of Sousse, Sousse, Tunisia.

2 Faculty of Sciences and Techniques, Sidi Bouzid, Kairouan University, Sousse, Tunisia

3 Pathology Department, Farhat Hached Hospital, Sousse, Tunisia.

4 Medicine Faculty of Sousse, University of Sousse, Tunisia.


Background: Ovarian cancer is the leading cause of gynecologic cancer-related death. Histological
assessment remains the standard clue for the diagnosis of ovarian carcinoma. Misinterpretation and inconsistent
application of histological criteria may lead to significant interobserver variability and poor reproducibility of
the diagnosis. In this study, we investigated the discrepancy in histological diagnosis and the significance of a designed
panel of immunohistochemical markers for the improvement of the diagnostic reproducibility of ovarian carcinomas.
Methods: We performed a retrospective study on 74 ovarian carcinomas. All tumor slides were independently
reviewed by two pathologists. The results for seven available immunomarkers as p53, WT-1, p16INK4A, CK7,
CK20, and estrogen and progesterone receptors were determined for all cases by immunohistochemistry. Results:
The histological diagnosis review performed using standard histology showed a concordance of diagnoses in 86% of
cases with Cohen’s kappa of 0.80. Immunohistochemical results increased significantly the diagnosis reproducibility
with a concordance of 91% and a Cohen’s kappa of 0.86 (P = 0.001). Conclusion: Although the histological diagnosis
remains reliable, the use of a designed panel of immunohistochemical markers improves significantly the interobserver
concordance and the classification accuracy of ovarian carcinomas.


Main Subjects