Clinicopathological Profile and Hormone Receptor Status of Malignant Surface Epithelial Tumours of the Ovary: A Prospective Retrospective Study from A Tertiary Military Centre

Abstract

Background. Surface epithelial tumours account for ~90 % of malignant ovarian neoplasms, yet data on the expression of oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2 neu) in Indian patients remain limited. This study characterises the clinicopathological spectrum of malignant surface epithelial ovarian tumours and evaluates ER, PR and HER2 neu expression in relation to established prognostic markers.

Methods. After institutional ethics approval, a combined prospective–retrospective observational study was performed in the Department of Pathology, Command Hospital (Northern Command). Fifty consecutive patients operated for ovarian tumours between May 2024 and May 2025 were screened; four were excluded because of scant tumour in deeper sections, yielding 46 analysable cases. Detailed clinical data were retrieved, tumours were classified per WHO 2020 and FIGO 2021 criteria, and immunohistochemistry for ER, PR (nuclear) and HER2 neu (membranous) was performed and scored independently by two pathologists. Associations were tested with χ²/ Fisher’s exact test, t test or one way ANOVA; p < 0.05 was considered significant.

Results. Median age was 52 years (range 26–74). High grade serous carcinoma predominated (71.7 %), followed by mucinous carcinoma (17.4 %). ER and PR positivity were seen in 65.2 % and 58.7 % respectively, while HER2 neu over expression (3+) occurred in 30.4 %. ER and PR correlated strongly with tumour grade (high > low; p < 0.001 each) but not with age or FIGO stage. HER2 neu positivity was significantly enriched in high grade tumours (p = 0.001) and in mucinous histology (50 %, p = 0.92). Triple positive phenotype (ER+ PR+ HER2+) comprised 10.9 % of cases—exclusively high grade—whereas triple negative tumours constituted 26.1 %. No significant correlation was found between receptor status and pre operative CA 125 levels.

Conclusion. ER and PR are expressed in nearly two thirds of malignant surface epithelial ovarian tumours, especially high grade lesions, underscoring the potential utility of endocrine therapy. HER2 neu over expression, although less common, clusters within high grade and mucinous carcinomas and may identify candidates for anti HER2 therapy. Routine assessment of these biomarkers could refine risk stratification and open avenues for targeted treatment in Indian ovarian cancer patients.