Relationship Between Expression Of HA, CD44 And VEGF And Angiogenesis In Ovarian Adenocarcinoma

Objective: To study on the relationship between the expression of HA, CD44 and VEGF and tumor angiogenesis in ovarian adenocarcinoma and to demonstrate the prognostic of patients with ovarian adenocarcinoma.Method: HA, CD44 and VEGF immunohistochemical assays were performed in the histopathologic specimens of 55 cases with ovarian adenocarcinoma and 24 cases with ovarian adenoma. The relationship between the expression of the above marks, the microvascular densitymarked by CD34 and the prognostic of patients were then analyzed. Results: HA was mainly expressed in extracellular matrix. CD44 was mainly expressed in cellular membrane and /or cytoplasm in tumor cells, VEGF in cytoplasm in tumor cells and part of strom vasvular endothelial cell, CD34 in vasvular endothelial cell. It was showed that the positive expression of them in ovarian adenocarcinoma remarkably higher than that in ovarian adenoma(P<0.005). The MVD was singnificantly raisd when the overexpression of HA,CD44 and VEGF was taken place in ovarian adenocarcinoma (P<0.05)。In ovarian adenocarcinoma, the MVD was obviously correlated with the expression of HA, CD44 and VEGF. The strongest relationship between them and MVD was HA(r=0.459, P<0.001), the second was VEGF(r=0.381, P<0.005)and the weakest was CD44(r=0.315, P<0.05). The MVD was in higher level in patients with all positive expression of HA, CD44 and VEGF than that in those with other conditions (P<0.05). The logistic regression indicated that all the three makers had a significant effect on the MVD, and the whole effect of them was 72.20%.In addition there was remarkable interaction among the expression of HA, CD44 and VEGF(P<0.005). HA may play a critical role in tumor angiogenesis while CD44 and VEGF may be dependently corporative action in ovarian adenocarcinoma.Univariate survival analysis indicated that prognostic of the patients with ovarian adenocarcinoma was significantly correlated with histological grade, stage, volume of ascitic fluid , expression of stromal HA and VEGF as well as MVD(P<0.05). But the expression of CD44 have no relation with the outcome of the patients(P>0.05). Cox's proportional hazards model multivariate survival analysis showed that histological grade (B=1.288,RR=3.624,P=0.014)can be an independent prognostic marker of ovarian adenocarcinoma.Conclusion: The overexpression of HA, CD44 and VEGF in ovarian adenocarcinoma have a relation with tumor angiogenesis and they have a whole 72.20% effect to it. HA may play a critical role in tumor angiogenesis while CD44 and VEGF may be dependently corporative action in ovarian adenocarcinoma. Their overexpression may lead to tumor angiogenesis increasing greatly, cancer invasiving and metastasizing easily. Histological grade can be an independent prognostic marker of ovarian adenocarcinoma.