Korean J Obstet Gynecol.  2010 Sep;53(9):804-815. 10.5468/kjog.2010.53.9.804.

The expression of clusterin, bax, p53, Ki-67, and apoptotic index in epithelial ovarian tumors

• Lee JY
• Na JY
• Kim IS
• Park MH
• Kang JS

• KMID: 2077998
• DOI: http://doi.org/10.5468/kjog.2010.53.9.804

Abstract

OBJECTIVE
The purpose of this study was (1) to evaluate the expressions of clusterin, bax, Ki-67, p53, and apoptotic index in epithelial ovarian tumors, borderline and malignant ovarian tumors, (2) to find out the correlation between their expressions and clinicopathological parameters, and (3) to evaluate the effect on the patient's survival according to their expressions.
METHODS
The histological and clinical findings of 22 cases of ovarian cystadenomas, 44 cases of borderline tumors and 96 cases of carcinomas were evaluated. Expressions of clusterin, bax, Ki-67, p53, and apoptotic index were studied on paraffin-embedded tissue sections by immunohistochemical methods.
RESULTS
The expressions of clusterin, p53, and Ki-67 were higher in ovarian carcinomas than borderline tumors. The overexpression of p53, and Ki-67 were frequent in high stage, poorly differentiated and bilateral ovarian carcinomas. The overexpressions of clusterin, bax, p53, and Ki-67 showed a statistically significant correlation with histologic type. Apoptotic index was higher in bax overexpression group, but there was no correlation with overexpression of clusterin or p53. Ki-67 was higher in p53 overexpression group, but there was no correlation with overexpression of clusterin or p53. There was no statistically significant correlation with each other between the overexpressions of clusterin, bax, p53, and Ki-67. The overexpressions of clusterin, Ki-67, p53 was associated with overall patient's survival in borderline significance.
CONCLUSION
The overexpression of p53, and Ki-67 were frequent in poorly differentiated ovarian carcinomas. So the overexpression of p53, and Ki-67 can be used as prognostic factor. The overexpression of clusterin was more in epithelial ovarian carcinomas than in borderline tumors but showed no significant correlation with the overall patient's survival. Further studies are required to clarify the possibility of using clusterin for target therapy in epithelial ovarian carcinomas.

Keyword

Epithelial ovarian tumors; Clusterin; Bax; Ki-67; p53

MeSH Terms

Clusterin
Cystadenoma
Clusterin

Figure

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  Figure 1 Immunohistochemical staining of clusterin, bax, p53 and Ki-67. (A) Clusterin overexpression in serous cystadenocarcinoma. (B) Bax overexpression in serous cystadenocarcinoma. (C) p53 overexpression (>50%) in serous cystadenocarcinoma. (D) The increased Ki-67 positive cells (>50%) in serous cystadenocarcinoma (×200).

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  Figure 2 Morphology of apoptosis. (A) Apoptoic bodies in serous adenocarcinoma (arrows) (TUNEL method, ×400). (B) Nuclear fragmentation known as apoptotic body in endometrioid adenocarcinoma (arrow head) (TUNEL method, ×600).

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  Figure 3 Kaplan-Meier analysis of overall survival of patients with epithelial ovarian carcinoma according to the overexpressions of (A) Clusterin (P=0.0574), (B) Bax (P=0.7568), (C) Ki-67 (P=0.0591), (D) p53 (P=0.0550), and (E) AI (P=0.8603) (log-rank test). FU: follow up, AI: apoptotic index.

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