Morphological and immunohistochemical study of ovarian and tubal dysplasia associated with tamoxifen

International audienceOvarian epithelial dysplasia was initially described in material from prophylactic oophorectomies for BRCA mutation. Similar histopathological abnormalities have been revealed after ovulation stimulation. Given that tamoxifen (TAM) has a clomid-like effect and is sometimes used to induce ovulation, we studied the morphological features and immunohistochemical expression patterns of neoplasia-associated markers in adnexec-tomies previously exposed to TAM for breast cancer. We blindly reviewed 173 histopatholog-ical slides of adnexectomies according to three groups-oophorectomies associated with TAM exposure (n=42), oophorectomies associated with Clomiphene exposure (n=15) and a spontaneously fertile non cancerous control group (n=116). Morphological features (with an ovarian and tubal dysplasia scoring system) and immunohistochemical expression patterns of Ki-67, p53 and Aldehyde dehydroge-nase 1 (ALDH1 is an enzyme significantly associated with early-stage ovarian cancer) were evaluated and correlated. Mean tubal dys-plasia score was significantly higher in the TAM group and Clomiphen group than in controls (respectively 7.8 vs 3.5, P<0.007 and 6.8 vs 3.5, P=0.008). There is no statistical difference for the ovarian score in TAM group in comparison with the control group whereas we found a significant score for Clomiphen group (6.5, P=0.009). Increased ALDH1 expression was observed in the two exposed group whereas expression patterns of Ki67 and p53 were moderate. Interestingly, ALDH1 expression was low in non-dysplastic epithelium, high in dysplasia, and constantly low in the two carci-noma. Furthemore, we confirm our previous results showing that ALDH1may be a useful tissue biomarker in the subtle histopathologi-cal diagnosis of tubo-ovarian dysplasia