DAX-1 is a member of the
nuclear receptor superfamily and is thought to be involved in the regulation of steroidogenesis. Its expression has been detected primarily in endocrine
neoplasms such as adrenocortical as well as
pituitary tumors in human, but its
biological roles have not been examined well in sex
steroid-dependent
neoplasms. The aim of this study is to detect the expression of DAX-1 in common
epithelial ovarian carcinomas in order to evaluate its possible
biological significance. DAX-1 immunoreactivity was examined using immunohistochemistry. The correlation between the status of DAX-1 immunoreactivity and clinicopathological parameters and disease-free survival of the patients in a series of 60 cases of common
epithelial ovarian carcinoma was examined. The status of DAX-1 immunoreactivity was evaluated using H score. DAX-1 immunoreactivity was widely detected in the nuclei of common
epithelial ovarian carcinoma cells. There was a significant positive correlation between DAX-1 immunoreactivity and clinical staging (P = 0.0241),
tumor grade (P = 0.0115), the residual size of the
tumor (P = 0.0014) and Ki-67 labeling index (P = < 0.0001). In univariate survival analysis, a significant association was detected between DAX-1 immunoreactivity and shortened patient survival (P = 0.0157). Other significant prognostic parameters were clinical stage, residual size of
tumor and Ki-67. In multivariate analysis, DAX-1 immunoreactivity, clinical stage, residual size of
tumor and Ki-67 all turned out to be independent prognostic factors for shortened survival. In conclusion, DAX-1 immunoreactivity is considered to be a new independent marker of poor prognosis or adverse clinical outcome in patients with
epithelial ovarian carcinoma, possibly through altering in situ
steroids production.