الفهرس 
titleOnly 14 pages are availabe for public view
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Abstract
Ovarian tumors include different groups of tumors. They are classified into:
epithelial, germ cell, and sex cord stromal tumors. Epithelial tumors are further
subclassified into benign, borderline, and malignant tumors. Ovarian cancer is the seventh
cancer in women worldwide
Epithelial ovarian cancers are the most common type of ovarian cancers accounting
for 90% of all cases. Borderline ovarian tumors (BOT) constitute about 10%–15% of
ovarian tumors. The distinction of borderline ovarian tumors from malignant tumors can be
challenging in some cases.. Stratification of ovarian tumors into benign, borderline, or
malignant is critically important regarding the prognosis, outcome, the extension of
surgery and further follow up.
EMT is suggested to be a major process for the conversion of early stage ovarian
tumors to invasive and metastatic malignancies, due to the loss of epithelial characteristics
and acquisition of mesenchymal characteristics. EMT is generally induced by
developmental signalling pathways, leading to the molecular changes, including the loss of
epithelial markers, such as E-cadherin, and the upregulation of mesenchymal markers.
MDM2 is an oncogene related with various types of malignances, including the
occurrence of metastasis in several reports. MDM2 facilitates cell motility, invasivness and
EMT occurrence in ovarian cells by regulating E-cadherin ubiquitination and degradation
through the activation of TGF-b-Smads pathway.
E-cadherin is a member of the cadherin superfamily, a group of cell surface
glycoproteins that mediate cellular adhesion. E-cadherin allows the junction between the
cell and its cellular environment. Its deficiency allows the cells to detach from the tumor
site and give the cells an invasive phenotype. E-cadherin was considered a tumor
suppressor, since it was found to be downregulated in malignant epithelial tumors.
The present work aimed at determining the expression of murine double minute-2
(MDM2) and E-cadherin in epithelial ovarian tumors .In addition, evaluating their value in
differentiating borderline from malignant and benign epithelial ovarian tumors.
The present study included 70 paraffin blocks of ovarian tumors. That was recovered
retrospectively from the archive of the pathology department, Medical Research Institute,
Gamal Abd El Naser Hospital, and some private labs between the years 2015 to 2020.10
cases were of benign ovarian tumors, 30 cases of borderline ovarian tumors and 30 cases of
malignant epithelial ovarian tumors.
According to the result of the present study MDM2 was shown to be more frequently
expressed in malignant epithelial ovarian tumors than in borderline and benign tumors with
statistically significant difference.
Summary, conclusion & Recommendations
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On the other hands E-cadherin expression was more preserved in benign tumors with
homogenous staining pattern, while decreased expression was seen in borderline and
malignant epithelial ovarian tumors. Most of malignant ovarian tumors have heterogenous
staining pattern. The borderline ovarian tumors lie in between benign and malignant
groups as regards E-cadherin pattern.
According to E-cadherin intensity and pattern of expression EMT status was noted to
be more evident in borderline and malignant epithelial ovarian tumors than benign ones
with statistically significant difference.
Loss of E-cadherin expression was statistically significantly related to the presence
of omental deposits, high grade, and laterality in malignant ovarian tumors.
MDM2 was shown to be the most important marker to diagnose malignant from
borderline ovarian tumors.
The presence of (MDM2+/ E- cadherin -/ EMT status +) combination or (MDM2+/
EMT status +) even with preserved E-cadherin were shown to be reliable combinations
associated with borderline and malignant ovarian tumors in contrast to benign ovarian
tumors.