Institute of Pathology, Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Virchows Arch. 2012 Aug;461(2):109-16. doi: 10.1007/s00428-012-1273-4. Epub 2012 Jul 3.
Ovarian high-grade serous carcinoma (HGSC, type 2 ovarian carcinoma) is a poor prognosis cancer with limited therapeutic options. We aimed to investigate the expression pattern and prognostic potential of the metastasis-promoting protein anterior gradient 2 (AGR2) in primary HGSC. Immunohistochemistry was applied to a cohort of 124 primary HGSCs using tissue microarrays. Additionally, in 48 type 1 carcinomas (low-grade serous (LGSC), endometrioid (EC), clear cell (CCC), and mucinous carcinoma (MC)), AGR2 expression was investigated in an exploratory approach. A strong expression of AGR2 was seen in 15 HGSCs (12.1 %) and was significantly linked to shortened overall survival (OS, p = 0.011) and also for progression-free survival (PFS, p = 0.001) in the setting of adjuvant platinum-based chemotherapy (CTX). Multivariate survival analysis including age, stage, and residual tumor after surgery revealed that AGR2 expression was an independent prognostic marker for OS (p = 0.001) and PFS (p = 0.001) in HGSC. In type 1 carcinomas, AGR2 was significantly increased as compared to HGSC (p = 0.001) and was seen in subsets of all histological types, low-grade serous LGSC, EC, CCC, and MC. In particular, strong diffuse staining was seen in LGSC and MC. There was no association between AGR2 and estrogen receptor expression in ovarian type 1 or type 2 carcinomas. AGR2 expression identifies highly aggressive HGSC with a compromised prognosis for which novel therapeutic options are needed. Our data strongly support the further evaluation of AGR2 as a therapeutic target and a potential marker for response to platinum-based CTX in this tumor entity.
卵巢高级别浆液性癌(HGSC,2 型卵巢癌)是一种预后不良的癌症,治疗选择有限。我们旨在研究促进转移的蛋白前梯度 2(AGR2)在原发性 HGSC 中的表达模式和预后潜力。使用组织微阵列对 124 例原发性 HGSC 进行了免疫组织化学分析。此外,我们还在探索性方法中研究了 48 例 1 型癌(低级别浆液性(LGSC)、子宫内膜样(EC)、透明细胞(CCC)和黏液性癌(MC))中的 AGR2 表达。在 15 例 HGSC(12.1%)中观察到 AGR2 的强烈表达,并且与辅助铂类化疗(CTX)后的总生存期(OS)显著缩短(p=0.011)和无进展生存期(PFS)显著缩短相关(p=0.001)。包括年龄、分期和手术后残留肿瘤在内的多变量生存分析显示,AGR2 表达是 HGSC 患者 OS(p=0.001)和 PFS(p=0.001)的独立预后标志物。在 1 型癌中,与 HGSC 相比,AGR2 显著增加(p=0.001),并且在所有组织学类型中都可见到低级别浆液性 LGSC、EC、CCC 和 MC 的亚组。特别是,在 LGSC 和 MC 中可见强烈弥漫性染色。在卵巢 1 型或 2 型癌中,AGR2 与雌激素受体表达之间没有关联。AGR2 表达可识别高度侵袭性的 HGSC,预后较差,需要新的治疗选择。我们的数据强烈支持进一步评估 AGR2 作为该肿瘤实体中铂类 CTX 治疗反应的潜在标志物和治疗靶点。
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