J Gynecol Oncol.  2014 Oct;25(4):334-341. 10.3802/jgo.2014.25.4.334.

High expression of epidermal growth factor-like domain 7 is correlated with poor differentiation and poor prognosis in patients with epithelial ovarian cancer

• Oh J
• Park SH
• Lee TS
• Oh HK
• Choi JH
• Choi YS

• KMID: 2130123
• DOI: http://doi.org/10.3802/jgo.2014.25.4.334

Abstract

OBJECTIVE
The purpose of this study was to evaluate the expression of epidermal growth factor-like domain 7 (EGFL7) in epithelial ovarian cancer, and to assess its relevance to clinicopathological characteristics and patients' survival.
METHODS
A total of 177 patients with epithelial ovarian cancer were enrolled in the current study. For each patient, a retrospective review of medical records was conducted. Immunohistochemical staining for EGFL7 was performed using tissue microarrays made with paraffin-embedded tissue block. EGFL7 expression levels were graded on a grade of 0 to 3 based on the percentage of positive cancer cells. We analyzed the correlations between the expression of EGFL7 and various clinical parameters, and also analyzed the survival outcome according to the EGFL7 expression.
RESULTS
The expression of EGFL7 in ovarian cancer tissues was observed in 98 patients (55.4%). High expression of EGFL7 (grade 2 or 3) was significantly correlated with pathologic type, differentiation, stage, residual tumor after debulking surgery, lymphovascular space involvement, lymph node metastasis, high cancer antigen 125, peritoneal cytology, and ascites. Among these clinicopathologic factors, differentiation was significantly correlated with EGFL7 expression in multivariate analysis (p<0.05). Survival analysis showed that the patients with high EGFL7 expression had a poorer disease free survival than those with low EGFL7 expression (p=0.002).
CONCLUSION
Our data suggest that EGFL7 expression is a novel predictive factor for the clinical progression of epithelial ovarian cancer, and may constitute a therapeutic target for antiangiogenesis therapy in patients with epithelial ovarian cancer.

Keyword

Ascites; CA125-Antigen; Epidermal growth factor; Ovarian neoplasms; Paraffin; Survival Analysis

MeSH Terms

Adult
CA-125 Antigen/blood
Cell Differentiation/physiology
Endothelial Growth Factors/*metabolism
Female
Humans
Lymphatic Metastasis
Middle Aged
Neoplasm Proteins/metabolism
Neoplasm Staging
Neoplasm, Residual
Neoplasms, Glandular and Epithelial/*diagnosis/pathology/surgery
Ovarian Neoplasms/*diagnosis/pathology/surgery
Prognosis
Retrospective Studies
Survival Analysis
Tumor Markers, Biological/*metabolism
CA-125 Antigen
Endothelial Growth Factors
Neoplasm Proteins
Tumor Markers, Biological

Figure

• 

  Fig. 1 Representatives of epidermal growth factor-like domain 7 expression of each grade in immunohistochemical staining (×100). The staining was graded to using a 4-point scale according to the percentage of positive cancer cells: (A) grade 0 (≤10% positive); (B) grade 1 (11% to 25% positive); (C) grade 2 (26% to 50% positive); (D) grade 3 (≥51% positive).

• 

  Fig. 2 Survival analysis according to the epidermal growth factor-like domain 7 (EGFL7) expression (low EGFL7 expression [grade 0 or 1] vs. high EGFL7 expression [grade 2 or 3]). Kaplan-Meier analysis showed that the patients with high EGFL7 expression had a poorer disease-free survival than those with low EGFL7 expression.

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