Expression And Significance Of Maspin, Bcl-2 And Bax In Epithelial Ovarian Tumors

[Background And Objection]Ovarian carcinoma is one of the leading gynaecological maliganancies. Epithelial ovarian cancer takes the most part of the ovarian neoplasms,and has a high level of mortality.The lack of early diagnosis,as well as the severe side effects and resistance caused by long-termed chemotherapy,makes ovarian carcinoma become a huge and serious problem in the treatments of gynaecological tumors.Thus,it is necessary to find a effective way for the diagnosis,and then treat the cancers effectively in the early stage.Maspin(mammary serine protease inhibitor) is identified as a tumor suppressor protein playing an important role in the initiation and process of tumor.It inhibits tumor growth,invasion,angiogenesis and regulates apoptosis.Maspin expresses in many different kinds of tissue,and has been found to be downregulated during the progression of most cancers.However,Sood et al demonstrated that maspin protein over-expresses in the ovarian carcinoma,which means the mechanism of maspin in the ovarian cancer is much more complicated.The bcl-2 gene,a negative regulator of cell death,can prolong cell survival by avoidance of apoptosis and cause many kinds of neoplasms.The members of the Bcl-2 protein family interact with each other,participating the programme of cells apoptosis. Bcl-2/Bax is the most important pair in the Bcl-2 family.Thus,the research discusses the expression and relation of maspin,bcl-2 and bax,and wants to know the role of maspin in the epithelial ovarian cancer process and programmed cell death,and present the theories for the antioncogenic treatment.[Materials And Methods]1.Tissue and staining method:All the specimens were collected from the No.2 Hospital of Jilin University,without chemotherapy,radiotherapy and biotherapy before the surgeries.Epithelial oothecomas 24 cases(including 6 serous cystadenoma, 18 mucinous cystadenoma);epithelial ovarian cancers 40 cases(including 29 serous adenocarcinomas,6 mucinous adenocarcinomas,3 endometrioid adenocarcinomas,2 clear-cell carcinomas).All of the paraffin-embeded samples are stained with the immunohistochemical method to test the level of Maspin,Bcl-2 and Bax.2.Response definition:The apparent yellow particles both in nuclei or cytoplasms were interpreted positive.The percentage of positive cells was rated asfollows:0 point:0-5%;1 points:6-25%;2 points:26-50%;3 points:51-75%;4 points:＞75%positive cells.The staining intensity was rated as follows:1 point:weak intensity;2 points:moderate intensity;3 points:strong intensity.Points for intensity and percentage of positive cells were added.0-1 point:negative(-);2-6 point:low expression(+);8-12 point:high expression(++).Used(+),(++) as the responsing definitive results.3.Statistical analysis:The various parameters were compared by chi-square tests and Spearman Rank Correlation.Then,the results were performed using the SPSS for Windows version 13.0 software package.Statistical significance was defined as a probability value less than 0.05.[Result]1.The Maspin expression was observed in 25%of epithelial oothecomas,while 65%of epithelial ovarian carcinomas(P＜0.05).The expression of Maspin was higher in the StageⅠ-Ⅱthan in the StageⅢ-Ⅳbased on the surgery-pathology principle (P＜0.05).Meanwhile,the maspin protein was significantly lower in the ascites group than in the non-ascites group(P＜0.05).2.The Bcl-2 and Bax positive expression of epithelial ovarian carcinoma(52.5%, 67.5%) were higher than epithelial oothecomas(20.8%,33.3%)(P＜0.05).The Bcl-2 and Bax protein were expressed in 68.2%,86.4%of the patients with the StageⅢ-Ⅳ,compared with 33.3%,44.4%of the patients with the StageⅠ-Ⅱ(P＜0.05).3.Maspin expression is higher,as the Bax protein expression is(P＜0.05).However, there is no significant correlation between maspin and the Bcl-2,the Bcl-2 and the Bax(P＞0.05). [Conelusions]1.Maspin plays an important role in the suppression of the progression of ovarian carcinomas as a member of the tumor suppressor gene superfamily.These results suggest that Maspin can be a possible predictor of prognosis in the patients with advanced ovarian carcinoma,and it may become an new way for the oncotherapy.2.The relationship of bcl-2/bax can be used for the presumption of the differentiation of the epithelial ovarian cancer and the prognosis.3.It is possible to treat maspin as the molecular target of the antioncogenic therapy,based on the correlation of Maspin and Bax.The combining test of maspin and bax can speculate the condition and characters of the ovarian tumors and the progression of the epithelial ovarian carcinoma.4.The results can not confirm that we can test the blood of patient whose ovarian malignancy diagnosis does not reach.