Mast cell density, angiogenesis, blood clotting, and prognosis in women with advanced ovarian cancer.
OBJECTIVE
To determine clinical or biological associations between mast cell density, blood clotting, angiogenesis, and survival of patients with advanced ovarian cancer.


METHODS
Tumor tissue sections were assessed for mast cell density by staining for mast cell tryptase, blood clotting by staining of thrombosed blood vessels, and angiogenesis by CD34 expression. Chi-square, Kaplan-Meier, and Cox proportional hazard statistical analyses were used.


RESULTS
44 women with stage III-IV ovarian cancers had tumor blocks available for immunohistochemical analysis. Higher mean vessel density (MVD) (>11 vessels/400x field) predicted for better survival than lower MVD (< or =11 vessels/400x field) (P = 0.004). Women whose tumors had low levels of peri-tumoral mast cell infiltration had a mean survival of 40.6 months compared to 50.6 months in those whose tumors had high levels (P = 0.47). Tumors with higher MVD and high peri-tumoral mast cell infiltration had a mean survival of 80.3 months compared to 37.8 months in those with low mast cell density or low MVD (P = 0.015). Patients with tumors showing a low degree of blood clotting had a mean survival of 45.5 compared to 45.1 months in those with tumors showing a high degree of blood clotting (P = 0.91). There was no significant association between angiogenesis and mast cell density (P = 0.123). In multivariate analysis, higher MVD remained as a significant prognostic factor for improved survival after adjusting for clotting and mast cell density.


CONCLUSIONS
Our data suggest that peri-tumoral mast cell infiltration in tumors with high MVD predicts for improved survival in women with advanced epithelial ovarian cancer.
Chan
John K
JK
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Stanford University School of Medicine, 300 Pasteur Dr. HH333, Stanford, CA 94305-5317, USA. johnchan@stanford.edu
Magistris
Alessandra
A
Loizzi
Vera
V
Lin
Fritz
F
Rutgers
Joanne
J
Osann
Kathryn
K
DiSaia
Philip J
PJ
Samoszuk
Michael
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001777:Blood Coagulation; D002452:Cell Count; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008407:Mast Cells / Q000473:pathology*; D008875:Middle Aged; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000097:blood / Q000473:pathology; D010051:Ovarian Neoplasms / Q000097:blood / Q000098:blood supply* / Q000473:pathology*; D011379:Prognosis