Okuda T, Saito H, Sekizawa A, Shimizu Y, Akamatsu T, Kushima M, Yanaihara T, Okai T, Farina A
Department of Obstetrics and Gynecology, Showa University School of Medicine, Tokyo, Japan.
Gynecol Oncol. 2001 Sep;82(3):427-34. doi: 10.1006/gyno.2001.6322.
Steroid sulfatase (STS) is an important enzyme that converts biological inactive steroid sulfate to active free steroid. As estrogen is thought to play an important role in cell proliferation in gynecological cancer, the existence of STS may have particular significance in the prognosis of ovarian cancer. In the present study, we determined the STS expression of ovarian clear cell adenocarcinoma (OCCA), which has the poorest prognosis among various ovarian cancers, immunohistochemically to clarify the biological nature of OCCA and also to determine whether STS expression is one of the prognostic factors in OCCA.
Forty-five archival, formalin-fixed, paraffin-embedded tissues from patients with OCCA and other epithelial ovarian cancers who were first operated on from 1987 to 1998 were subjected to analysis. Twenty-eight of forty-five (60.9%) OCCA cases coexisted with endometriosis. They were subclassified into papillary, solid, and tubulocystic types with respect to architectural pattern. Immunohistochemical staining of STS was performed using anti-human STS polyclonal rabbit antibody that had been immunized with purified STS from human placenta.
STS was immunohistochemically stained positively in 70% (32/45) of OCCA, 33.3% of serous adenocarcinoma (6/18), and 50.0% of mucinous adenocarcinoma (4/8) specimens and was localized in the cytoplasm of neoplastic epithelial cells. No significant relationship was found between STS staining and FIGO staging. However, patients diagnosed as papillary type had a significantly lower survival rate and showed significantly more positive staining of STS (P < 0.05) than those with solid type. Stage, STS expression, and architectural type yielded a significant association with survival rate.
It was proven that STS is present in the cytoplasm of patients with OCCA by an immunohistochemical method. OCCA patients with papillary tumor with positive STS expression are considered to have a poor prognosis.
类固醇硫酸酯酶（STS）是一种将生物活性不高的硫酸类固醇转化为活性游离类固醇的重要酶。由于雌激素被认为在妇科癌症的细胞增殖中起重要作用，STS的存在可能对卵巢癌的预后具有特殊意义。在本研究中，我们采用免疫组织化学方法测定了在各种卵巢癌中预后最差的卵巢透明细胞腺癌（OCCA）的STS表达，以阐明OCCA的生物学特性，并确定STS表达是否为OCCA的预后因素之一。
对1987年至1998年首次接受手术的45例OCCA患者以及其他上皮性卵巢癌患者的存档福尔马林固定石蜡包埋组织进行分析。45例OCCA病例中有28例（60.9%）合并子宫内膜异位症。根据结构模式将它们分为乳头型、实体型和微管囊型。使用用人胎盘纯化的STS免疫的抗人STS多克隆兔抗体进行STS的免疫组织化学染色。
在OCCA标本中，70%（32/45）呈STS免疫组织化学阳性染色，浆液性腺癌标本中为33.3%（6/18），黏液性腺癌标本中为50.0%（4/8），且定位于肿瘤上皮细胞的细胞质中。STS染色与国际妇产科联盟（FIGO）分期之间未发现显著相关性。然而，诊断为乳头型的患者生存率显著较低，且STS阳性染色显著多于实体型患者（P<0.05）。分期、STS表达和结构类型与生存率有显著关联。
通过免疫组织化学方法证实STS存在于OCCA患者的细胞质中。STS表达阳性的乳头型OCCA患者预后较差。
