The Correlation Of Cellular Proliferation And Apoptosis Related Factors With Ovarian Borderline Tumors

Objective To study possible tumorigenic mechanism of ovarian tumors at molecular level by observation of the relationship between apoptosis and proliferation; moreover, to give some objective targets in order to divide ovarian borderline tumors into benign and malignant groups, predict prognosis and adopt appropriate clinical managements.Methods Immunohistochemistry and the TUNEL technique were used to detect the expression of cellular proliferation and apoptosis related factors(PCNA, hTERTbcl-2, caspase-3) in 41 cases of borderline epithelial ovarian rumors. Moreover, their status were compared to benign and malignant tumors. Result1. The expressions of cellular proliferation related factors ( PCNA, hTERT ) and antiapoptotic protein(bcl-2) showed an increased tendency from benign, borderline to malignant ovarian tumors, whereas it of caspase-3 showed a decreased tendency. The difference of above four proteins'positive rate between borderline and malignant cases was statistically significant(P<0.05), but there was not significant difference between borderline and benign groups(P>0.05).2. Of the borderline ovarian tumors, only bcl-2 was associated with the histologic type(P<0.05) ,of which the positive expression rate was significantly higher in the serous tumor than in the mucinous counterparts.3. Of the borderline ovarian tumors, apoptotic index(AI) was significantly higher than that in benign and malignant groups(P<0.05);while proliferative index(PI) was significantly lower than that in malignant groups(P<0.05),and there was notsignificant difference compared to benign groups(P>0.05). In addition,a positive correlation between AI and PI was observed in borderline ovarian tumors(r=0.599, P<3.05),as was a positive correlation between PI and PCNA(r=0.749, P<0.01) .4. Of the borderline ovarian tumors, as the number of detected factors added, the positive expression rate decreased progressively.If three factors were allowed to coexamination, PCNA, hTERT and caspase-3 were proposed.5.Of the borderline ovarian tumors, CA125 was associated with the histologic type(P<0.05) ,of which the positive expression rate was significantly higher in the serous tumor than in the mucinous counterparts.There was not significant correlation between the level of serum CA125 and the positive expression rate of protein CA125.Conclusion1. Borderline ovarian tumors generally behaved in a benign fashion, and still kept balance of the cell proliferation and the apoptosis. If the equilibrium was thrown into confusion , the malignant potential of tumors should increase and easily make progress to the cancer. Therefore,the tumorigenic mechanism of ovarian malignant tumors was maybe associated with "the selected proliferation of the cells" in the stage of the borderline ovarian tumors.2. Above data suggested that cellular proliferation related factors(PCNA , hTERT)and/or antiapoptotic protein(bcl-2)overexpression ,and/or caspase-3 low expression may contribute to enhancing the malignant potential of borderline ovarian tumors, these patients should be nearly follow-up .3. If immunohistochemistry technique was used to predict the malignant potential of borderline ovarian tumors, suitable antibody ought to be chosen on the basis of the histologic type difference.4. Joint examination of several oncoprotein might be helpful to assess the malignant potential of borderline ovarian tumors.4. Joint examination of several oncoprotein might be helpful to assess the malignant potential of borderline ovarian tumors.5. Examination of serum CA125 level was useful in the preoperative screening and following-up of ovarian malignant tumors, but it could not replace the immunohistochemistry technique to decide the histologic type after surgery.