| Objective:1.To analyze the clinical-pathological characteristics and biological behavior of ovarian clear cell carcinoma2.The distribution and expression of GPC3 protein in ovarian clear cell carcinoma and human common malignant tumors and adjacent tissues3.Studty and discuss the expression of GPC3 protein and mRNA and its clinical significance in ovarian clear cell carcinomaMethods:1.Totally 45 patient with ovarian clear cell carcinoma and 52 patients with ovarian serous carcinoma were analyzed retrospectively,who were diagnosed and treated in The First Affiliated Hospital of Nanjing Medical University during In August 2009 to January 2014.The clinical-pathological characteristics,response to chemotherapy and prognosis were compared.2.The distribution and expression of GPC3 protein in ovarian clear cell carcinoma and human common malignant tumors and adjacent tissues was detected by immunohistochemistry.Analysis the difference expression level between them.3.The expression of GPC3 protein was detected in 83 cases of ovarian cancer including 45 clear cell carcinoma,20 serous carcinoma,18 mucinous carcinoma,20 cases of serous cystadenoma and 20 cases of normal ovary by immunohistochemistry.The expression of GPC3 mRNA was detected in 20 clear cell carcinoma,10 serous carcinoma,8 mucinous carcinoma,5 serous cystadenoma and 5 normal ovary tissues by real-time fluorescent quantitative polymerase chain reaction(RT-PCR).The correlation between GPC3 expression and relative clinical pathologic parameters was analysed.Result:1.The clinical-pathological characteristics,response to chemotherapy and prognosis were compared between ovarian clear cell carcinoma and ovarian serous carcinoma: the histopathologic features of ovarian clear cell carcinoma was different from serous carcinoma,the mean age of patients with clear cell carcinoma was(50.42±10.05)and patients with ovarian serous carcinoma(53.81±8.94),the average age of clear cell carcinoma was 3 years younger than serous carcinoma(P = 0.04).Ovarian clear cell carcinoma patients with early stage(FIGOI-II)62.22%(28/45)was significantly higher than that of ovarian serous carcinoma(15/52),28.84%(P = 0.000);Ovarian clear cell carcinoma cisplatin resistance was 37.78%(17/45),higher than that of serous carcinoma 11.54%(6/52),(P = 0.002).The difference had statistical significance(p < 0.05).Increased blood CA125 82.22%(37/45)and 82.69%(43/52),tumor diameter 10 cm 44.44%(20/45)and 26.92%(14/52),there was no statistically significant difference(p > 0.05).I-II ovarian clear cell carcinoma of the median survival time is 48 months,patients with I-II serous cancer was 57 months;the median survival time of III-IV clear cell carcinoma was 14 months.The median survival time of III-IV serous carcinoma was 28 months.Both I-II and III-IV,clear cell carcinoma patients time shorter than the serous carcinoma(p < 0.05).Kaplan Meier-survival curve log-rank test of ovarian clear cell carcinoma show that patients with stageI-II and III-IV survival rates are less than serous carcinoma(p < 0.05).Endometriosis in clear cell carcinoma was 28.89%(13/45)and serous carcinoma was7.69%(4/52),endometrial malignant transformation was 11.11%(5/45)and 0.00%(0/52)(p < 0.05),HE of ovarian clear cell carcinoma in 5 cases show the process of malignant transform of endometrium to clear cell carcinoma.This suggest that the ovarian clear cell carcinoma came from endometrial malignant.2.The distribution and expression of GPC3 protein in ovarian clear cell carcinoma and human common malignant tumors and adjacent tissues was detected by immunohistochemistry.Analysis the difference expression level between them.GPC3 protein expression in ovarian clear cell carcinoma was 90.91%(10/11),hepatocellular carcinoma was 30.77%(4/13),esophageal squamous cell carcinoma was 20%(1/5),prostatic cancer was 25%(1/4),vaginal squamous cell carcinoma was 20%(1/5),lung squamous cell carcinoma was 33.33%(2/6),gastric adenocarcinoma was 25%(1/4),nasopharyngeal carcinoma was 25%(1/4).The most of ovarian clear cell carcinoma was high expression,and lower expression in other cancer tissue,Fisher's exact test between them(P = 0.023).Only the difference between ovarian clear cell carcinoma and other tissue types have statistical significance(P < 0.05).The expression of GPC3 protein in human tumor tissues and tissue adjacent was not found.Such as lung carcinoma,bile duct carcinoma,pancreas carcinoma,breast carcinoma,renal clear cell carcinoma,lung,esophageal mucosa,gastric mucosa,intestinal mucosa,pancreas,liver,breast tissue were not found.But fetal liver,fetal spleen,fetal lung,fetal kidney,fetal adrenal gland,umbilical cord were weakly positive.3.In ovarian clear cell carcinoma,the positive rate of GPC3 protein and the mRNA expression(82.2%;1.3261±0.4936)were significantly higher than those in ovarian serous carcinoma(20%;0.4265±0.0294),mucinous carcinoma(5%;0.2652±0.1039),serous cystadenoma(0;0.1413±0.0113)and normal ovarian tissue(0;0.2914±0.0481)(P<0.01).Both the expression of GPC3 protein and the mRNA were relevant to the clinical stage of ovarian clear cell carcinoma.GPC3 expression in stage III or IV(100%;1.8081±0.2657)was significantly higher than that in stage I or II(71.4%;1.0458±0.4036),(P <0.01).Both the expression of GPC3 protein and mRNA were relevant to the status of cisplatin resistance.GPC3 expression in cisplatin-resistant patients(100%;1.8081±0.2657)was higher than that in cisplatin-sensitive patients(70.3%;0.9918±0.3303)(P <0.05).GPC3 protein expression was associated with survival of clear cell carcinoma,which was highter in patients with poor prognosis(p<0.05).GPC3 protein expression in ovarian clear cell carcinoma had no relavance with the lymph node metastasis or distant metastasis(P > 0.05).Kaplan-Meier analysis showed that GPC3 protein expression was a prognostic factor(P=0.048).Conclusion:1.Clinical-pathological characteristics and the biological behavior of ovarian clear cell carcinoma were different from ovarian serous carcinoma.Compared to serous carcinoma,ovarian clear cell carcinoma presented more early stage patients,more frequency early cases,higher resistance,lower survival time and rate survival,and they maybe comes from endometriosis progression.2.GPC3 protein is highly expressed in ovarian clear cell carcinoma,while low or no expression in several other tumor tissues.So the role of GPC3 in the development and progress of tumor are complex and worth further research.3.GPC3 has an important significance in the differential diagnosis.There was significant relationship between GPC3 expression and clinical stage and cisplatin resistance in ovarian clear cell carcinoma.GPC3 may play an important role in the development of ovarian clear cell carcinoma and might be used as a helpful prognostic marker and potential target. |
PDF Full Text Request