The Expression And Clinical Value Of Oct4 And Oct-4A In Ovarian Germ Cell Tumor

Objective: Ovarian germ cell tumor accounts for approx. 20%-40% in the total amount of ovarian tumor, just inferior to ovarian epithelial tumor.In addition to mature teratoma, the rest are malignant and some are with extremely high malignant grade.For ovarian germ cell tumor is characterized by incidence of occult, early diagnosis is hard with complex clinical mechanism and pathological type and it tends to occur in children and young women. According to statistics, germ cell tumor accounts for approx. 60%-70% in ovarian tumor among patients aged under 20.The younger, the higher the risk of malignant tumor, and severe mental pressure and financial burden is brought to patients and their families.How to increase the early diagnosis rate and improve the long term treatment efficacy of advanced patient is the most important and difficult problem met in clinical application.Oct-4 gene is an extreme sensitive and specific marker for germ cell tumor with important significance in the diagnosis and differential diagnosis of germ cell tumor and its effect is specific. Oct-4A is the subtype of Oct-4, whether Oct-4A also has expression in ovarian germ cell tumor, whether it regulates the differentiation of ovarian germ cell tumor the same as Oct-4, how does it regulate the differentiation, and whether Oct-4A also has certain significant in tumor classification, early diagnosis and differential diagnosis? Understanding the regulation mechanism through the further research on the expression of Oct-4 and Oct-4A gene in ovarian germ cell tumor and Oct-4 gene function will provide a basis for early diagnosis, tumor classification, illness estimation, prognosis prediction and therapeutic target.Methods: Look up 36 ovarian malignant germ cell cases from Jun. 1984 to Jun. 2009 recorded in Medical Record Department in the Second Hospital of Hebei Medical University and select 5 ovarian germ cell tumor, i.e. ovarian mature teratoma cases from Sep. 2008 to Jun. 2009 treated in the Second Hospital of Hebei Medical University.Select the corresponding biopsies including HE staining sections and immunohistochemical sections preserving in the case department in the Second Hospital of Hebei Medical University after look up case histories and get the pathological numbers, and observe the HE staining sections under optical microscope, then conduct experiments with corresponding paraffin material chosen according to HE staining sections.Detect the expression level of Oct-4 and Oct-4A gene in ovarian germ cell tumor tissue with the adoption of SP immunohistochemistry, including 12 ovarian embryonal carcinomas, 7 dysgerminomas, 9 yolk-sac tumors, 1 choriocarcinoma, 7 immature teratomas and 5 mature teratomas.With the application of computerized pathological image analysis technology, its positioning is displayed.Compare the Oct-4 and Oct-4A gene positive expression in the 6 groups and seek the relationship between the positive expression rate of Oct-4 and Oct-4A gene in ovarian germ cell tumor tissue and different clinical pathologic feature.The selected data was statistically analyzed with the adoption of SPSS13.0 package analysis software.The experimental result was statistically analyzed using rank sum test and Spearman rank correlation analysis and trend X2 and P<0.05 was taken as significant difference.Result:(1)Expression of Oct4: Oct-4 has expression in almost all dysgerminoma and embryos; positive rate is 100% and it locates in nucleus.But it has no expression in other type of ovarian germ cell tumor. Increased or decrease expression of Oct-4 is not correlated with the same type of ovarian germ cell tumor(P=0.782>0.05). Oct-4 has significant difference expressing gin the different type of ovarian germ cell tumor (P=0.000<0.01).(2)Expression of Oct-4A: Oct-4A has expression in almost all dysgerminoma; positive rate is 100% and it locates in nucleus. It has no expression in other type of ovarian germ cell tumor except ovarian dysgerminoma. Oct-4A has significant difference expressing gin the different type of ovarian germ cell tumor (P=0.000<0.01).(3)Oct-4 has expression in almost all embryos and dysgerminoma, positive rate is 100%. The expression of Oct-4 in only 1 yolk-sac tumors has weak positive. Oct-4A has expression in almost all dysgerminoma; positive rate is 100%, It has no expression in other type of ovarian germ cell tumor except ovarian dysgerminoma. Oct-4 and Oct-4A have significant difference expressing and have relationship in ovarian germ cell tumor (P=0.003<0.01 r=0.446).Conclusion:(1) Oct-4 can be taken as a factor of tumor classification in ovarian germ cell tumors; it plays an important role in evaluating differentiation of ovarian germ cell tumor; thus it has important significance in correct tumor differentiation, proper evaluation of cell differentiation, making accurate treatment scheme and prognosis prediction.(2) Oct-4A only has no expression in ovarian dysgerminoma among all types of ovarian germ cell tumor, this has important significance in accurate judgment of dysgerminoma and nondysgerminomatous tumor, thus it provides important basis for early prognosis prediction.Foreign literature reports that Oct-4A plays an important role in maintaining multi-potential differentiation cell. However, till now there is no report in which phase of cell differentiation Oct-4A functions.The research result of this experiment supports the view that Oct-4A plays an important role in maintaining multi-potential differentiation cell.(3) Further research on Oct-4, Oct-4A and other subtypes of Oct-4 will not only provide powerful basis for early diagnosis, tumor classification, illness estimation, prognosis prediction and therapeutic target, but also brings decisive significance to stem cell study.