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HER2/neu and Ki-67 as prognostic factors in serous type ovarian carcinoma


Introduction: Serous type ovarian carcinoma occurs in about 59% of all ovary’s malignant tumors. The high incidence of advanced ovarian carcinoma at the time of diagnosis causes 5-year survival rate of only about 20%. Thus deep science in predictive biomarkers of prognosis is needed, which later could use in therapeutic considerations. Human epidermal growth factor receptor-2 (HER2/neu) is a proto-oncogene that is involved in cell proliferation, differentiation, and apoptosis. Ki-67 is a marker of proliferative activity that plays an essential role in tumor aggressiveness. This study aimed to prove that HER2/neu and Ki-67 have a role as a prognostic factor in serous type ovarian carcinoma.

Methods: The study design was an analytic cross-sectional study, with total sample were 36 samples from the patient’s surgery specimen of serous type ovarian carcinoma, examined at Anatomical Pathology Laboratory Faculty of Medicine, Universitas Udayana/Sanglah General Hospital, Denpasar. Histopathological diagnosis for the type of malignancy, grade, and pathological stage according to tumor size was determined on H & E stain. The expression of HER2/neu and Ki-67 was examined with immunohistochemical stain. The correlation between HER2/neu and Ki-67 expression with the degree of differentiation and tumor size was analyzed by the chi-square test, with p<0.05 was significant.

Result: The mean of the age was 49.6 ± 11.28, with range was between 26-64 years.  The most were in the age group 51-60 years (38.9%). No significant correlation was found between HER2/neu expression with the degree of differentiation (α =0.178) and tumor size (α =0.264). A significant correlation was found between Ki-67 expression with the degree of differentiation (α =0.019) and tumor size (α =0.039).

Conclusion: In this study, Ki-67 can be considered for its role as a prognostic factor, whereas HER2/neu requires further research, with a larger sample and followed by an examination of gene amplification.


  1. Reid BM, Permuth JB, Sellers TA. Epidemiology of ovarian cancer: a review. Cancer Biol Med. 2017 Feb; 14(1): 9–32.
  2. Demir L, Yigit S, Sadullahoglu C, Akyol M, Cokmert S, Kucukzeybek Y, Alacacioglu A, Cakalagaoglu F, Tarhan MO. Hormone receptor, HER2/NEU and EGFR expression in ovarian carcinoma--is here a prognostic phenotype? Asian Pac J Cancer Prev. 2014;15(22):9739-45. DOI:
  3. Marinas MC, Mogos G, Ciurea R, Mogos DG. EGFR, HER2/neu and Ki67 Immunoexpression in Serous Ovarian Tumors. Rom J Morphol Embryol. 2012;53(3):563-567.
  4. Luo H, Xu X, Ye M, Sheng B, Zhu X. The prognostic value of HER2 in ovarian cancer: A meta-analysis of observational studies. PLoS One. 2018;13(1):e0191972. Published 2018 Jan 30. doi:10.1371/journal.pone.0191972
  5. Mahadevappa A, Krishna SM, Vimala MG. Diagnostic and Prognostic Significance of Ki-67 Immunohistochemical Expression in Surface Epithelial Ovarian Carcinoma. J Clin Diagn Res. 2017 Feb; 11(2): EC08–EC12. doi: 10.7860/JCDR/2017/24350.9381.
  6. Momenimovahed Z, Tiznobaik A, Taheri S, Salehiniya H. Ovarian cancer in the world: epidemiology and risk factors. Int J Womens Health. 2019;11:287–299. doi: 10.2147/IJWH.S197604.
  7. Deng F, Xia Xu X, Mengmeng Lv, Ren B, Wang Y, Guo W, Feng J, Chen X. Age is associated with prognosis in serous ovarian carcinoma. J Ovarian Res. 2017;10:36. doi: 10.1186/s13048-017-0331-6.
  8. Lisio M-A, Fu L, Goyeneche A, Gao Z-H, Telleria C. High-Grade Serous Ovarian Cancer: Basic Sciences, Clinical and Therapeutic Standpoints. Int J Mol Sci. 2019 Feb;20(4):952. doi: 10.3390/ijms20040952.
  9. Kim J, Chang Y, Kim T-J, Lee J-W, Kim B-G, Bae D-S, Choi CH. Optimal cutoff age for predicting prognosis associated with serous epithelial ovarian cancer: what is the best age cutoff? J Gynecol Oncol. 2019 Jan;30(1):e11. doi: 10.3802/jgo.2019.30.e11.
  10. Tuefferd M, Couturier J, Penault-Llorca F, Vincent-Salomon A, Broët P, Guastalla JP, Allouache D, Combe M, Weber B, Pujade-Lauraine E, Camilleri-Broët S. HER2 Status in Ovarian Carcinomas: A Multicenter GINECO Study of 320 Patients. PLoS One. 2007;2(11):e1138. doi: 10.1371/journal.pone.0001138.
  11. Nielsen JS, Jakobsen E, Hølund B, Bertelsen K, Jakobsen A. Prognostic significance of p53, Her-2, and EGFR overexpression in borderline and epithelial ovarian cancer. Int J Gynecol Cancer. 2004, 14(6):1086–1096.
  12. Corkery DP, Le Page C, Meunier L, Provencher D, Mes-Masson AM, Dellaire G. PRP4K is a HER2-regulated modifier of taxane sensitivity. Cell Cycle. 2015;14(7):1059–1069. doi: 10.1080/15384101.2015.1007775.
  13. Matsuo K, Sheridan TB, Mabuchi S, Yoshino K, Hasegawa K, Studeman KD, et al. Estrogen receptor expression and increased risk of lymphovascular space invasion in high-grade serous ovarian carcinoma. Gynecol Oncol. 2014;133(3):473–479. doi: 10.1016/j.ygyno.2014.03.563.
  14. Chay WY, Chew SH, Ong WS, Busmanis I, Li X, Thung S, et al. HER2 amplification and clinicopathological characteristics in a large Asian cohort of ovarian cancer. PLoS One. 2013;8(4). doi: 10.1371/journal.pone.0061565.

How to Cite

Dewi, I. G. A. S. M., Susraini, A. A. A. N., & Ekawati, N. P. (2020). HER2/neu and Ki-67 as prognostic factors in serous type ovarian carcinoma. Bali Medical Journal, 9(2), 567–571.




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I Gusti Ayu Sri Mahendra Dewi
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Anak Agung Ayu Ngurah Susraini
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Ni Putu Ekawati
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