Annexin A4 study in
ovarian cancer has been primarily focused on clear cell
carcinoma, which exhibits strong resistance to
chemotherapy. The aim of this study was to examine the expression and cellular localization of
annexin A4 in serous ovarian
carcinomas. We evaluated the expression of
annexin A4 with real-time polymerase chain reaction in 40 ovarian serous
carcinoma tissues. Furthermore, the distribution of the
protein within the
tumor was studied by immunohistochemistry in 70
epithelial ovarian carcinoma tissues. The levels of
annexin A4 transcripts were higher in 14 chemoresistant
tumors than those in 26 chemosensitive
tumors (P = .013). Immunohistochemical expressions showed that nuclear expression was detected in 14 (20.0%) of 70 samples, and cytoplasmic expression was detected in 17 (24.3%) of 70 samples. The results showed that 35.7% of women with nuclear expression were resistant to
platinum-based
chemotherapy, whereas only 14.3% of women without expression were chemoresistant (P = .065). In addition, patients with nuclear staining had significantly shorter disease-free survival than did patients who showed negative staining. Multivariate proportional hazards model revealed that the stage and nuclear
annexin A4 expression were independent prognostic factors (hazard ratios, 6.34 [P = .001] and 2.85 [P = .011], respectively). This study showed that overexpression and nuclear localization of
annexin A4 are related to chemoresistance and poor survival in patients with serous papillary ovarian
carcinomas. Future studies are required to develop new
therapies targeting
annexin A4 in patients with ovarian epithelial
adenocarcinoma.