Aggressiveness evaluation of borderline serous ovarian tumors by analysis of Psammoma bodies present in cancer tissues using micro-FTIR spectroscopy

Borderline ovarian tumor is a type of tumor with generally low malignant potential. However, these tumors pose diagnostic challenges with benign and malignant epithelial ovarian tumors because the clinical symptoms are similar and investigation procedures for specific diagnosis are still debated. In addition, a small number of borderlines transform into high-grade serous ovarian carcinoma with a poor prognosis. Therefore, tools improving a better characterization of high-risk subtypes of borderline tumors to enable understanding of possible unfavorable evolution are essential for patients’ management. Psammoma bodies (PBs) are micro- calcifications found both in serous epithelial ovarian cancer and serous borderline tumors with possible corre- lation with disease progression. In this work, the chemical composition of PBs found in the tissues of borderline, high-grade and low-grade ovarian tumors was evaluated using micro-FTIR spectroscopy. Applying principal component analysis to spec- tral data, it was observed that among the borderline tumors analyzed (1-bl, 2-bl and 3-bl), the PBs of 3- bl showed a different chemical content from that of the PBs of the high-grade and low-grade tumors, while the PBs of 1-bl and 2-bl appeared to have similar chemical content to the PBs of high- and low-grade tumors. The discriminating wavenumbers were found to be those related to carbonate CO23− (1454, 1413 cm− 1 and 872 cm− 1) and phosphate PO34− (1018 cm− 1 and 960 cm− 1) present in microcalcifications. A higher ratio between peak intensities at 1413 cm− 1 and 1018 cm− 1 (I1413/I1018) was observed in the PBs of 3-bl compared with those of high- and low-grade ovarian carcinoma patients, which correlates with higher CO23− content. On the other hand, the PBs of 1-bl and 2-bl showed a CO23− level close to that of the PBs of high- and low-grade patients. Several studies on microcalcifications in breast carcinoma have reported that increased carbonate content is related to decreased tumor aggressiveness. Therefore, case bl-3 appeared to be the less aggressive. The results obtained from FTIR analysis were in agreement with histopathological tumor classification and molecular analysis for BRAFV600E. The FTIR technique could become a reliable tool for identifying borderline low- and high-risk tumors.