It has been suggested that histologic subtype of
ovarian cancer is
a factor that determines the chemoresponsiveness of
tumor. In this study, we wanted to clarify the prognostic significance of histologic subtype and its correlation to expression of chemoresistance-related
proteins (CRPs) in
ovarian cancer. A total of 93 stage II-IV
ovarian cancers, where the proportion of serous, endometrioid, mucinous, and clear cell subtype was 61.3%, 14.0%, 7.5%, and 17.2%, respectively, were investigated for
glutathione S-transferase-pi (GST-pi), MDR (multidrug resistance)-1, and p53 expression using immunohistochemistry. GST-pi expression was detected in 62.4% of the
tumors and was not related to histologic subtype of
tumor. MDR-1 expression was observed in 12.9% of the
tumors tested and was more frequently detected in
clear cell adenocarcinomas than other histologic subtypes of
tumor (10/ 16 vs. 2 / 77, P < 0.001). P53 expression was found in 49.1% of serous, 53.8% of endometrioid, and 50% of
mucinous adenocarcinomas. In contrast, none of 16
clear cell adenocarcinomas showed positive p53 staining. In univariate analysis, no direct correlations were found between CRPs and overall survival. Histology of mucinous/clear cell
tumors (P = 0.0063), as well as FIGO stage III/IV (P = 0.0091) and
residual tumor >or= 2 cm (P = 0.0045), was found to have independent prognostic value in multivariate analysis. In conclusion, histologic subtype proved to be the significant independent prognostic factor in addition to FIGO stage and
residual tumor in stage II-IV
ovarian cancer. GST-pi, MDR-1, and p53 expression pattern is closely related to histologic subtype of
ovarian cancer, although they are not significant predictors of survival.