Clinicopathological insights and prognostic implications of DEK in association with apoptosis-regulating factors in ovarian cancer.

PURPOSE

Ovarian cancer is one of the most common gynecologic malignancies of the present era. Dysregulation of apoptosis is considered as one of the most important factors for malignant transformation. DEK is a ubiquitous protein, and its downregulation induces apoptosis by altering BCL-2, BAX, and CASPASE-3 expressions. This study illuminates the cumulative clinical usefulness of DEK and related apoptotic proteins.

METHODS

A total of 119 patients were enrolled during 2021-2023. Demographic and clinicopathological data were recorded at presentation, and the follow-up was done till August 2024. Tissue samples were analyzed using immunohistochemistry and real-time PCR. A paired t test assessed gene expression between normal and malignant tissues of different treatment strategies. The crosstab was performed to find the association of DEK, BCL-2, BAX, and CASPASE-3 with clinicopathological features. Pearson's correlation was used to predict the association of DEK with other apoptotic factors. Survival and hazard risk were evaluated using log-rank and Cox regression.

RESULTS

The mean age of OC patients was 47.61 ± 12.5 years, presented with advanced stage (90.7%) and grade (85.3%). Most of them were post-menopausal (68.08%) and had unhygienic (76.5%) regular menstrual cycles (89.1%), and also experienced early pregnancy (61.8%). Some of these factors are related to a hazard risk (HR > 1). DEK and apoptotic proteins were upregulated in OC than in normal (p ≤ 0.01). DEK was positively correlated with BCL-2, BAX, and CASPASE-3, at both mRNA and protein levels, and only BAX showed significance in both (p ≤ 0.05). All the selected genes are independent risk factors for survival of OC (HR > 1), but only DEK and CASPASE-3 were significantly associated with poor survival (p ≤ 0.05).

CONCLUSIONS

Dysregulation of DEK, CASPASE-3, and BAX/BCL-2 is associated with poor overall survival. Further, this study highlights the correlation between DEK and key apoptotic regulators, emphasizing the critical role of DEK in OC prognosis.