• α-smooth muscle actin
• BRCA
• tumor microenvironment
• high grade serous epithelial ovarian cancer
• p16
• Metalloproteinase-9

Epithelial ovarian cancer (EOC) is the most lethal gynecologic malignancy characterized by considerable biological, histological and molecular heterogeneity. Recent findings have already revealed that the tumor microenvironment (TME) plays an essential role in promoting cancer initiation, progression and metastasis. The TME consists of several different types of normal cells recruited and reprogrammed by the cancer cells to produce factors beneficial to tumor growth and spread. Cancer-associated fibroblasts (CAF)s are a major constituent of theTME and play a critical role in promoting many aspects of tumor function, but universal CAFs’ markers have not been identified. This project is a retrospective study on EOC: we collected the clinical and pathological data of women, undergoing primary debulking surgery (PDS) for high grade serous epithelial ovarian cancer (HGSC) between January 2019 and April 2020. The Formalin-fixed paraffin embedded (FFPE) tissue sample of primary HGSC of these previous patients were retrieved from the archives of the Division of Pathology, University of Pisa. We selected several biomarkers [α-smooth muscle actin (α-SMA), Metalloproteinase (MMP)-9 and p16] to investigate the molecular landscape in HGSC, trying to elucidate the stromal role in tumor initiation and progression. The biological variables have been related to the clinical, pathological, genetic features and the clinical outcome. This is a preliminary work: a deeper elucidation of the cellular/molecular structure and functions of the TME, as well as the relationships between epithelial and stromal compartments, will allow a better prognostic stratification and could bring to a tailored therapy.