The Expression And Clinical Significance Of Clusterin, Bcl-2, K-ras And S100A4 In Serous Borderline Ovarian Tumor

【Objective】To study the expression of clusterin,bcl-2,k-ras and S100A4 in serous borderline ovarian tumors(SBOT)and analyze the relationship between the expression of these markers and the clinicopathological parameters of SBOT,also combine the morphologic characters to find effective markers for diagnosis,in order to distinguish SBOT from malignant ovary tumor,further to predict its prognosis and adopt appropriate clinical managements.In order to research wheather SBOT is the precancerosis of the ovarian neoplasms,we investigated the role of K-ras mutation in tumorigenesis of ovarian neoplasms.【Methods】Immunohistochemistry was used to detect the expression and associativity of clusterin,bcl-2,K-ras,S100A4 in thirty cases of serous borderline ovarian tumors(SBOT).Moreover,their status were compared to 30 cases benign serous cyst adenoma and 30 cases serous cyst adenocarcinoma.Besides,DNA was extracted through the choosen samples fixed in 10%formalin and paraffin embedded.The mutation status of the K-ras gene were analyzed using Semi-nested polymerase chain reaction.All the data were analyzed by the chisquare test using SPSS13.0 software for windows.【Results】1.In SBOT,The expression of clusterin protein were higher than that in benign serous tumors and were lower than that in serous carcinoma.There were statistical significances between benign serous tumors and serous carcinoma,as well as between SBOT and serous carcinoma.Foremore,clusterin had a correlation with S100A4.2.The positive rate of bcl-2 protein in benign,borderline and malignant ovarian tumor was 80%,53.3%and 43.3%respectively.The expression of bcl-2 protein in SBOT were lower than that in benign serous tumors and were higher than that in serous carcinoma.There were statistical significances between benign serous tumors and serous carcinoma,as well as between serous cystic adenoma and SBOT.But there was no correlation between bcl-2 and the other three markers(clusterin,K-ras and S100A4).3.The positive rate of K-ras protein in serous cystic adenoma,SBOT and serous cystadenocarcinoma was 30%,53.3%and 80%respectively.There was no significant difference between serous cystic adenoma and SBOT,but the other two groups had statistical significances.Morever,K-ras had no correlations with the other markers.4.The expression of S100A4 protein in SBOT were higher than that in benign serous tumors and were lower than that in serous carcinoma.There was no statistical significance in between serous cystic adenoma and SBOT,but the other two groups had significant difference.So the correlation had been found in clusterin and S100A4.5.DNA was extracted through the choosen 59 samples fixed in paraffin embedded.The 54 samples were succeed to enlarge the K-ras gene piece.Using Semi-nested polymerase chain reaction,the K-ras gene 12th codon were not examined to have the mutation after BstNⅠthe enzyme cuts.【Conclusion】1.Clusterin overexpressed in ovary serous tumors,may inhibition apoptosis to have a critical role in the progression of ovarian serous tumorigenesis development.The expression of Clusterin have the significant differences in SBOT and serous carcinoma,and it may a supporting mark to distinguish serous carcinoma and SBOT.2.The S100A4 protein possibly is one marker with the invasion and metastases,and it will be useful to predict the illness development and to guide the clinic therapy.3.The K-ras gene expression elevated along with the pathological change aggravation, which has the certain practical value in the epithelial ovarian tumor's early diagnosis and the malignant degree's judgment.But K-ras gene the 12^thcode mutations may play a less important role in tumorigenesis of ovarian serous tumor.4.SBOT whether is serous cystadenocarcinoma precancerous lesion could not be verified.