The Expression Of IMP3 In Primary Ovarian High-grade Serous Carcinoma And Its Clinical Significance

Backgrounds and ObjectivesOvarian cancer is one of the most common gynecologic malignant tumors,high-grade serous ovarian cancer accounted for about 70%[1].The early signs and symptoms of ovarian cancer are not obvious,and the lack of effective screening and diagnosis,more than 70%of patients have became to late when treated(phase Ⅲ-Ⅳ)[2].In advanced cases,there is a lack of effective treatment,and usually relapse after systematic treatment,with a very poor prognosis.The mortality rate ranks the first among gynecological malignancies,suggesting that the diagnosis and treatment of ovarian cancer are crucial to improve the prognosis of patients.Insulin-like growth factor Ⅱ mRNA binding protein 3(IMP3)is a member of IGF2BP family.IGFⅡ mRNA has been found to be highly expressed in high-grade serous ovarian carcinoma,and the changes in the expression of this gene can be used to monitor the development trend of malignant behavior.IMP3 can specific binding with IGFⅡ mRNA,which involved in regulating positioning,stable,reverse transcription and translation process of IGFⅡ mRNA.IMP3 plays a very important role in malignant tumor development,such as tumor cell proliferation and metastasis.This gene has important potential application value in early diagnosis,metastasis detection,effective treatment and prognosis of cancer,and likely to become a new tumor marker.The analysis of disease-related survival found that the survival time of IMP3-positive ovarian cancer patients was significantly shortened,while there were few studies on the expression of IMP3 and its relationship to the occurrence and development of high-grade serous ovarian cancer.In this study,we used IHC staining to detect the expression of IMP3 in tissue samples,aimed to investigate the relationship between IMP3 and the occurrence,development,recurrence and metastasis in high-grade serous ovarian cancer,and to evaluate the prognostic value of IMP3 in high-grade serous ovarian cancer.Material and Methods1、Clinical dataThe patients treated in Henan provincal people’s hospital in March 2013 to March 2016 with routine surgical treatment and postoperative chemotherapy,whose pathology were diagnosed as primary high-grade serous ovarian carcinoma.We collected the paraffin specimens of 54 cases as experimental group,at the same time selected ovarian serous cystic adenoma paraffin specimens from 30 cases as control group,and summarised all specimens corresponding patients clinical data.2、Expremental methodsAll the tissues were fixed in 10%formalin buffer,then treated with conventional paraffin embedding.The 5 microns thick sections were made for immunohistochemistry,and all hematoxylin-eosin(HE)staining sections were reviewed with by two experienced pathologists.IMP3 protein expression in 54 patients with primary ovarian high-grade serous carcinoma(experimental group)and 30 patients with serous cystadenoma(control group)were detected by SP immunohistochemistry.The experimental group was more divided into the recurrence group and the non-recurrence group,the distant metastasis group and the distant metastasis group according to the tumor recurrence and distant metastasis.3、Statistical analysisSPSS 22.0 statistical software was used for data analysis.Measurement data to mean±standard deviation in the form of(x±s)said,counting data in the form of percentage(%),said the group comparison between using analysis of variance,multiple sets of disordered count data set using correction is compared between χ2 test joint Fisher’s exact test,P<0.05 for the difference was statistically significant,use Log-Rank method for the single factor analysis,draw Kaplan Meier survival curve.Results1.There was no significant statistical difference in the age of each group,F=2.511,P=0.065>0.05.2.IMP3 expression in experimental group and control group:the positive expression rate of IMP3 in primary high-grade serous ovarian carcinoma group and ovarian serous cystic adenoma group were 73%(39/54)and 3%(1/30).The positive expression rate of IMP3 in high-grade serous ovarian carcinoma tissues was obviously higher than that of benign ovarian serous cystic adenoma group,and the difference was statistically significant(χ2=33.983,P=0.000<0.05).3.The expression of IMP3 in the high-grade serous ovarian carcinoma subgroup was divided into the distant metastasis group and the non-distant metastasis group according to the presence or absence of distant metastasis of tumors in the high-grade serous ovarian carcinoma.The positive rates of IMP3 were 100%(14/14)and 62.5%(25/40),respectively,with statistically significant differences(P=0.006<0.05).After systematic treatment,54 patients with ovarian cancer were followed up for 41 months.According to whether the tumor recurred or not,the IMP3 positive rate was 94%(16/17)and 62%(23/37),respectively,and the difference was statistically significant(χ2=4.443,P=0.035<0.05).4.The influence of IMP3 expression on the prognosis of high-grade serous ovarian carcinoma.According to the experimental results,54 patients with high-grade serous ovarian cancer were divided into IMP3 positive group(n=39)and IMP3 negative group(n=15).After systematic and standard treatment,all patients were followed up for 41 months,and their Progress Free Survival(PFS)and Overall Survival(OS)were calculated.The differences of PFS(χ2=4.750,P=0.029<0.05)and OS(χ2=5.400,P=0.020<0.05)were statistically significant.Conclusions1.IMP3 is highly expressed in ovarian high-grade serous carcinoma,especially in recurrent and metastatic tissues,suggesting that it is related to the occurrence,invasion and metastasis of ovarian high-grade serous carcinoma.2.IMP3 could be a new tumor biomarker for high grade serous ovarian carcinoma,which is expected to be an indicator of poor prognosis.