Assessment of Tumor-Associated Macrophage Infiltration in Epithelial Ovarian Carcinoma-An Immunohisto chemical and Clinicopathological Study
Ayman A. Khanfour and Basma M. Aly*
Departments Anatomy and *Pathology, Faculty of Medicine, Alexandria University
Background: Understanding how ovarian epithelial cells interact with and modulate their microenvironment can provide insight into the molecular mechanism(s) involved with malignant transformation and progression. These mechanisms may eventually identify novel diagnostic, prognostic and therapeutic targets.
Aim of the work: The aim of this work was to differentiate between tumor associated macrophages (TAMs) infiltration in normal and ovarian cancer specimens using immunohistochemical technique and correlate it to a set of clinicopathological parameters.
Material & Methods: The material of this retrospective study comprised 30 specimens of archival primary ovarian cancer tissue received at the Pathology Department, Faculty of Medicine, Alexandria University in the period from October 2011 to October 2013. Examination of the specimens included tumor type, grade, and a set of clinicopathological parameters.
Immunohistochemical staining of paraffin embedded tissue sections for CD68 antibody [the pan-macrophage marker] was conducted applying the Avidin–Biotin-peroxidase method.
Next, semiquantitative scoring of TAMs counts was carried out. Statistical relations were explored between the different immunohistochemical and clinicopathological parameters. As negative control, PBS was added instead of primary antibody in 20 specimens were obtained from specimens performing total abdominal hysterectomy due to dysfunctional bleeding or fibroid uterus.
Results: The results of the present study revealed higher statistically significant values of TAMs in ovarian cancer specimens compared with normal ovarian specimens. Also, there was association between the densities of TAMs and the clinical stage and histological grade of the tumor being higher values of TAMs were encountered with the advanced stages and grades of the tumor.
Conclusion: TAMs are significantly elevated in malignant ovarian tumors. Their density increase toward advanced histological grading and staging of the tumor. TAMs are considered as one of the prognostic tools of ovarian cancer patients.