Potential Role of PTEN and AKT/PKB Proteins in the Pathogenesis of Ovarian Mature Teratomas

Abstract

Background/aim: Mature teratomas constitute over 95% of ovarian teratomas and account for more than 44% of all ovarian tumors and over 58% of benign ovarian lesions. The pathogenesis of these tumors is hypothesized to involve disruptions in primary germ cell development, with the PI3K/AKT signaling pathway potentially playing a crucial role. This study aimed to analyze the importance of the PTEN protein and its associated signalling pathway, particularly in relation to AKT kinase activation, in the pathogenesis of mature ovarian teratomas.

Materials and methods: Surgical specimens from 117 patients with mature ovarian teratomas and control tissues from contralateral ovaries were analyzed. Immunohistochemical analysis was conducted to evaluate the expression of PTEN and phosphorylated AKT (P-AKT/PKB), a key component of the PI3K/AKT pathway regulated by PTEN. Expression levels were assessed using the semi-quantitative Remmele Immunoreactive Score (IRS).

Results: An inverse pattern was observed in PTEN expression, with a higher overall IRS score in the study group despite a lower proportion of PTEN-positive cells. The expression of P-AKT protein was elevated in the studied group, both in terms of IRS score and the percentage of P-AKT reactive cells.

Conclusion: The study supports a potential role of the PI3K/AKT pathway in the pathogenesis of mature ovarian teratomas, as evidenced by increased P-AKT expression. The role of PTEN, however, remains unclear due to contradictory findings. Further research with larger control groups is warranted to clarify these observations.

Keywords: AKT/PKB; Ovarian mature teratoma; PI3K/AKT pathway; PTEN; Remmele immunoreactive score.