Immunohistochemistry Expression of Chemokine Ligand 14, Periostin, and Suppressor of Mothers against Decapentaplegic 2 in High-grade Serous Carcinoma of Ovary and Its Potential Clinical Utility

Introduction: High-grade serous carcinoma of the ovary is the second most common cause of death from gynecological cancers. The debate about the sequence of treatment choice, between surgery and neoadjuvant chemotherapy (NACT) continues due to the lack of substantial evidence and biomarkers for determination of surgical outcome. The present study is conducted to evaluate chemokine (C-X-C motif) ligand14 (CXCL14), periostin (POSTN), and suppressor of mothers against decapentaplegic 2 (SMAD2) expression on immunohistochemistry (IHC) and to find out the association of these markers with the disease outcome. Materials and Methods: This was a retrospective and observational study of a total number of 57 patients of operated high-grade serous carcinoma of the ovary. IHC was performed on pre-NACT tissue samples including ascitic fluid cell blocks and core biopsies using Roche Ventana Benchmark XT autostainer. Results: Using the mean Q score as cutoff value, we found cutoff value for CXCL 14, POSTN, and SMAD2 expression as 155.44, 52.32, and 116.93, respectively. CXCL14 expression was found to be significantly associated with T staging ( P = 0.0187). POSTN expression was associated with short disease-free survival only after multivariate analysis ( P = 0.012). SMAD2 expression was significantly associated with the mesenteric deposit ( P = 0.0229). High CXCL14 expression was associated with short disease-free survival ( P = 0.020). Conclusion: CXCL14 expression can be used as a potential prognostic tool in High-grade serous carcinoma of the ovary. Evaluation of these surrogate IHC markers of inherent aggressive tumor biology did not show an association with surgical outcome in a limited sample size of tumors with suboptimal debulking and needs further evaluation to find out as a preoperative determinant of surgical outcome in clinical practice.