Histomorphological spectrum of ovarian neoplasms and expression of p53 and WT1 in surface epithelial tumors: Experience from a tertiary care institute in North-East India

Background: Ovarian tumors account for 3% of female malignancies. Immunohistochemistry (IHC) aids in the diagnosis and evaluation of tumor morphology and molecular features. Aims and Objectives: To study the histomorphological spectrum of ovarian neoplasms and evaluate p53 and WT1 expression in surface epithelial tumors (SETs), along with age-wise distribution at a tertiary center in North-East India. Materials and Methods: This retrospective study included all ovarian neoplasm cases over 2 years. IHC for p53 and WT1 was performed. Expression was analyzed using Fisher’s exact test (P<0.05 considered significant) and Microsoft Excel 2019. Results: Of 114 cases, SETs were most common (76.3%), followed by germ cell tumors (16.7%) and sex cord stromal tumors (6.1%). Aberrant p53 expression was found in 95.7% of high-grade serous ovarian carcinomas (HGSOCs). In low-grade serous ovarian carcinomas (LGSOCs), 60% showed wild-type and 40% aberrant p53 staining. p53 expression correlated significantly with WHO grade (P=0.0115). WT1 was positive in 82.6% of HGSOCs and 60% of LGSOCs, but the difference was not statistically significant (P>0.05). Conclusion: Benign tumors were more frequent than malignant ones. WT1 is a reliable marker for serous ovarian carcinoma and, when combined with p53 staining patterns, supports the diagnosis of high-grade tumors.