Clear cell carcinomas of the ovary: a multi-institutional study of 129 cases in Korea with prognostic significance of Emi1 and Galectin-3.

Abstract

Accurate diagnosis of ovarian clear cell carcinoma (CCC) is important because of its poor prognosis with chemoresistance and a high recurrent rate. The clinicopathologic characteristics and prognostic significance of the cell cycle regulator [early mitotic inhibitor-1 (Emi1)] and galactoside-binding protein (Galectin-3) were evaluated. Among 155 CCCs from 18 hospitals in Korea between 1995 and 2006, 129 pure CCCs were selected with consensus using immunohistochemical stains for hepatocyte nuclear factor-1β, Wilms' tumor protein, and estrogen receptor. The expressions of Emi1, Galectin-3, p53, and Ki-67 labeling index were analyzed with clinicopathologic parameters and the patient's survival. The mean age of the patients was 49.6 yr; the tumors were bilateral in 10.9%, and the average size was 12 cm. Adenofibromatous component was found in 7%, and endometriosis in 48.1% of the cases. Psammoma body was seen in 16.3%. Disease-free survival and overall survival rates were 78.3% and 79.1%, respectively. The International Federation of Obstetrics and Gynecology (FIGO) stage was the most important prognostic indicator. Emi1 expression (>5%) was seen in 23.3% of CCCs, and associated with high FIGO grades and poor overall survival (P<0.05). High Galectin-3 (≥80%) expression was seen in 59.7% of CCCs, and associated with FIGO stages III and IV, and high Ki-67 labeling index. High Ki-67 labeling index (≥50%) and p53 expression (≥50%) were seen in 27.1% and 18.6% of CCCs, respectively, but there was no clinicopathologic and prognostic significance. On the basis of the fact that the expression of Emi1 in CCC was correlated with a high histologic grade and worse overall survival, target therapy using inhibitors of Emi1 may be tried in the management of CCC patients with Emi1 expression.

• Authors: Kyueng-Whan Min, Moon Hyang Park, Sung Ran Hong, Heejung Lee, Sun Young Kwon, Sook Hee Hong, Hee Jae Joo, In Ae Park, Hee Jung An, Kwang Sun Suh, Hoon Kyu Oh, Chong Woo Yoo, Mi Jin Kim, Hee Kyung Chang, Sun Young Jun, Hye Kyoung Yoon, Eun Deok Chang, Dong Won Kim, Insun Kim, Gynecologic Pathology Study Group of the Korean Society of Pathologists
• Journal: International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists (Int J Gynecol Pathol) Vol. 32 Issue 1 Pg. 3-14 (Jan 2013) ISSN: 1538-7151 [Electronic] United States
• PMID: 23202783 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Biomarkers, Tumor
• Cell Cycle Proteins
• F-Box Proteins
• FBXO5 protein, human
• Galectin 3

Topics

• Adenocarcinoma, Clear Cell (metabolism, mortality, pathology)
• Adult
• Aged
• Biomarkers, Tumor (analysis)
• Cell Cycle Proteins (analysis, biosynthesis)
• Disease-Free Survival
• F-Box Proteins (analysis, biosynthesis)
• Female
• Galectin 3 (analysis, biosynthesis)
• Humans
• Immunohistochemistry
• Kaplan-Meier Estimate
• Korea
• Middle Aged
• Neoplasm Staging
• Ovarian Neoplasms (metabolism, mortality, pathology)
• Prognosis
• Proportional Hazards Models
• Tissue Array Analysis