Original Article Endometriosis-associated ovarian carcinoma Differential expression of vascular endothelial growth factor and estrogen/progesterone receptors Marcela G. del Carmen, M.D. 1 *, Anne E. Smith Sehdev, M.D. 2, Amanda Nickles Fader, M.D. 3, Marianna L. Zahurak, M.D. 4, Michael Richardson, M.D. 5, John P. Fruehauf, M.D. 5, F. J. Montz, M.D., K.M. 1§, Robert E. Bristow, M.D. 1 1The Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics/Department of Oncology, The Johns Hopkins Hospital and Medical Institutions, Baltimore, Maryland 2Division of Gynecologic Pathology, Department of Gynecology and Obstetrics/Department of Pathology, The Johns Hopkins Hospital and Medical Institutions, Baltimore, Maryland 3Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Women's Hospital, Pittsburgh, Pennsylvania 4Department of Biostatistics, The Johns Hopkins Oncology Center, The Johns Hopkins Hospital and Medical Institutions, Baltimore, Maryland 5Oncotech Incorporated, Irvine, California email: Marcela G. del Carmen (mdelcar1@jhmi.edu) *Correspondence to Marcela G. del Carmen, Gynecologic Oncology Service, Gillette Center for Women's Cancers, Cox 5, 100 Blossom Street, Boston, MA 02114 John P. Fruehauf is chief scientific officer of Oncotech Incorporated (Irvine, California), the commercial reference lab that performed the immunohistochemical tests described in this article. Therefore, he has a related financial interest in this work. §Deceased. Abstract BACKGROUND Multiple epidemiologic and histologic studies have suggested that ovarian endometriosis can give rise to malignant ovarian tumors, primarily those of epithelial origin. The progression of endometriosis to endometriosis-associated ovarian carcinoma (EAOC) has not been investigated thoroughly and is poorly understood at best. Using immunohistochemical methods, we compared the differential expression patterns of various cytokines and growth factors in atypical endometriosis (AE) and EAOC. METHODS Using the Johns Hopkins Pathology Data Bank, tissue blocks from patients diagnosed with EAOC or AE were identified. Tissue blocks were stained for 4 markers: vascular endothelial growth factor (VEGF), Ki-67, estrogen receptor (ER), and progesterone receptor (PR). RESULTS Seventeen cases of EAOC and 8 cases of AE were identified. Staining for VEGF was documented in 16 of 17 (94%) EAOC tissue blocks and in only 1 of 8 (12.5%) AE tissue blocks (P < 0.0001). Only 4 of the 17 (23%) EAOC tissue blocks exhibited positive staining for ER, compared with 8 of 8 (100%) AE tissue blocks (P = 0.0005). Positive staining for PR was noted in only 6 of 17 (35%) EAOC samples but was present in 8 of 8 (100%) AE samples (P = 0.003). Seventy percent of EAOC samples exhibited positive staining for Ki-67, compared with 37.5% of AE samples (P = 0.19). CONCLUSIONS EAOC appears to be associated with overexpression of VEGF and reduced expression of both ER and PR. Variations in VEGF expression may be associated with the malignant transformation of endometriosis and may present both diagnostic and therapeutic options for the treatment of ovarian malignancies. Cancer 2003. Volume 98, Issue 8 , Pages 1658 - 1663 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.