Keywords
Gastrointestinal-derived mucinous ovarian carcinoma
CLDN18.2
Immunohistochemistry
Differential diagnosis
Submitted : 2025-06-11
Accepted : 2025-06-26
Published : 2025-07-11
Abstract
Objective: Primary and metastatic mucinous ovarian carcinomas share similar morphologies but have significant differences in prognosis. This study aims to explore the immunophenotypic characteristics of primary and gastrointestinal-derived mucinous ovarian carcinomas. Methods: A total of 230 cases of primary and gastrointestinal-derived mucinous ovarian tumors surgically removed at Junnan County People’s Hospital and the Affiliated Hospital of Qingdao University from 2014 to 2024 were randomly selected. These included 67 cases of primary mucinous ovarian carcinoma, 56 cases of primary borderline mucinous ovarian tumor, 61 cases of colorectal-derived mucinous ovarian carcinoma (including 26 cases from the appendix and 35 cases from the colorectum), 26 cases of gastric-derived mucinous ovarian carcinoma, and 20 cases of mucinous cystadenoma of the ovary. All specimens were reviewed and confirmed by two experienced pathologists according to the 2020 WHO classification criteria. Immunohistochemistry was used to detect the expression differences of CLDN18.2 in primary mucinous ovarian tumors. Furthermore, the expressions of CLDN18.2, CDX2, SATB2, and PAX8 were jointly detected in primary and gastrointestinal metastatic mucinous ovarian tumors to explore the immunoexpression characteristics of multiple immune markers in primary ovarian and upper and lower gastrointestinal-derived ovarian metastatic mucinous carcinomas. Results: 1. CLDN18.2 showed varying degrees of expression in mucinous cystadenoma of the ovary, borderline mucinous ovarian tumor, and primary mucinous ovarian carcinoma, but was not expressed in normal ovarian and fallopian tube tissues. 2. In primary mucinous ovarian carcinoma, CLDN18.2 and PAX8 showed high expression, while CDX2 and SATB2 showed lower expression. In gastric-derived mucinous ovarian carcinoma, CLDN18.2 and CDX2 showed high expression, while SATB2 and PAX8 were almost not expressed. In colorectal-derived mucinous ovarian carcinoma, CDX2 and SATB2 showed high expression, while CLDN18.2 and PAX8 showed low expression. Conclusion: CLDN18.2 shows high expression in both primary and gastric-derived mucinous ovarian carcinomas and can be used as an auxiliary method for differentiating primary and gastrointestinal-derived mucinous ovarian carcinomas along with CDX2, SATB2, and PAX8.
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