Study of Significance and Expression of BRCA1 in Epithelial Ovarian Cancers and Association with Clinico- Pathological Parameters

Abstract

Introduction: Epithelial ovarian carcinoma (EOC) remains the most fatal gynecological malignancy, largely due to late presentation and lack of effective screening markers. BRCA1, a tumor suppressor gene involved in homologous recombination repair, plays a crucial role in maintaining genomic stability. Loss of BRCA1 expression has been implicated in tumor aggressiveness, chemotherapy response, and prognostic stratification. Immunohistochemistry (IHC) offers a practical approach to assessing BRCA1 protein status, particularly in resourcelimited settings where molecular testing is not widely available. The aim is to evaluate BRCA1 expression in epithelial ovarian carcinomas and analyze its association with various clinicopathological parameters, including histological type, tumor grade, FIGO stage, and CA-125 levels. Material and Methods: This prospective observational study included 35 histologically confirmed cases of epithelial ovarian carcinomas received as surgically resected salpingooophorectomy specimens over an 18-month period (May 2023–October 2024). BRCA1 expression was determined using immunohistochemistry and categorized as positive or negative based on cytoplasmic staining. Statistical analysis was performed using SPSS v21, with p < 0.05 considered significant. Results: BRCA1 expression was negative in 54% and positive in 46% of cases. Serous carcinoma was the most common histological subtype (68.6%), and high-grade tumors accounted for 71.4%. A significant association was observed between BRCA1 loss and histological type (p = 0.003) and tumor grade (p = 0.010). Among serous carcinomas, high-grade tumors showed significant BRCA1 loss (p = 0.027). No significant correlation existed between BRCA1 expression and CA-125 levels (p = 0.7817) or FIGO stage (p = 0.2034). Conclusion: BRCA1 loss is strongly associated with serous and high-grade epithelial ovarian carcinomas, supporting its role as a prognostic biomarker. Larger multicenter studies are required to validate its diagnostic utility.