A Clinico – Pathological Correlation and Analysis of Ovarian Tumours with Study of Expression Pattern ofPankeratin.

Tumours Of The Ovary Are Common Forms Of Neoplasms In Women. The Pathology Of Ovarian Neoplsms Is One Of The Most Complex Areas Of Gyneacology, Because The Ovary Gives Rise To The Greater And Larger Variety Of Tumours Than Any Other Organ. While In Other Organs, Tissue Of Origin Is Usually Clear, Tissue From Which An Ovarian Tumour Arises Is Often Uncertain And Most Of The Development Of The Presumptive Tissue Is Often In Disparity. (46) Ovarian Tumours Account For A Considerable Proportion Of Clinically Important Problems In Females And They Are Dangerous Due To Their Silent Growth. Worldwide, Ovarian Tumuor Is The Sixth Most Common Tumor In Women. In The Western Countries, Ovarian Carcinoma Is The Fifth Most Common Malignancy And Ranks Fourth In Cancer Mortality. In U.S Women, Ovarian Cancer Accounts For 5% Of Cancer Deaths. In India, Breast Is The Leading Site Of Cancer, Followed By Cervix And Ovary. In Chennai, Ovarian Cancer Stands In The Fourth Position. (22,38,44) About Two Thirds Of Ovarian Tumours Occur In Women In The Reproductive Age Group. In General The Disease Is Most Common In Industrialized Countries Where Parity Is Lower But There Are Notable Exceptions Such As Japan Which Has Low Parity And Low Rates Of Ovarian Cancers. (8,22) Evidence Suggests That Reproductive Factors Are Important In Ovarian Cancer Risk. Increase In Parity And Oral Contraceptives Offer Protective Effect For Ovarian Cancer. Some Studies Have Demonstrated Early Menarche And Late Menopause As Significant Risk Factors. High Socioeconomic Status Contributes To Increased Ovarian Cancer Risk As A Result Of Lower Fertility Rates In Those Women. Several Risk Factors Have Been Identified, Such As Age At The Birth Of First Child, Breast Feeding, Weight, Diet, Talc, Smoking, Certain Types Of Viral Infections In Childhood And Ionizing Radiation. (22) Migration Studies Have Shown That Ovarian Cancer Rates Approach Those Place Of Immigration Rather Than The Place Of Emigration Suggesting A Significant Environmental Component To Ovarian Tumour Risk. Genetic Factors Are An Important Ovarian Cancer Risk. Hereditary Is Responsible For Approximately 10% Cases Due To The Markedly Increased Risk Conferred By The BRCA 1 And BRCA 2 Tumour Suppressor Genes. (22,44) Many Patients Present With Later Stages In Ovarian Cancer. This Is Because, Unlike Cervical Cancer, Effective Early Detective Screening Programmes Are Not Available For Ovarian Cancer. Nowadays, For Screening Purpose, Ultrasound And Serum CA 125 Level Are Used. Regarding Prevention Of Ovarian Cancer, Preventive Measures That Could Be Recommended On A Population Wide Basis, Such As Diet Modifications, Cessation Of Smoking And Prophylactic Oophorectomy Is Often Performed In Patients At High Risk Of Ovarian Cancer. (22) Cytokeratins Are A Family Of Water Insoluble, Intracellular Fibrous Proteins Present In Almost All Epithelia. Keratin Represents An Excellent Marker For Epithelial Differentiation Regardless Of Whether The Tumour Is Of Endodermal, Neuroectodermal, Mesenchymal Or Of Germ Cell Origin. (35,42) It Is A Useful Marker For Primary Ovarian Tumours And Various Types Of Metastatic Tumours In The Ovaries. Immunohistochemistry Is Done To Demonstrate Various Patterns Of Cytokeratin Expression In Epithelial And Non Epithelial Tumours. This Study Is Undertaken In View Of Evaluating The Actual Incidence Of Ovarian Neoplasms In A Semi Urban Area Like Thanjavur With Particular Attention To Age, Clinical Features, Histopathological And Immunohistochemical Features. In Addition, The Recent Literatures, Journals And Research Publications Regarding Ovarian Tumors Are Also Immensely Reviewed.