title: Multidrug resistance-related phenotype and apoptosis-related protein expression in ovarian serous carcinomas.
abstract: OBJECTIVE
  Multidrug resistance (MDR) to chemotherapy is a major obstacle in attempts to improve the clinical outcome of ovarian carcinoma patients. The MDR-related phenotype is associated with over-expression of certain drug transporters, such as P-glycoprotein (P-gp), multidrug resistance protein 1 (MRP1), and lung resistance protein (LRP). The aim of this study was to evaluate the extent and prognostic significance of MDR-related protein expression in ovarian serous carcinomas. In addition, we correlated expression of these proteins with the apoptosis-related proteins p53, bcl-2, and bax.
  
  
  METHODS
  Consecutive sections from 60 cases of ovarian serous carcinoma were assessed immunohistochemically for expression of P-gp, MRP1, LRP, p53, bcl-2, and bax. The level of protein expression was scored based on staining intensity and extent.
  
  
  RESULTS
  Strong P-gp expression was observed in 12 (20%), MRP1 in 39 (65%), LRP in 27 (45%), p53 in 45 (75%), bcl-2 in 25 (41.7%), and bax in 30 (50%) of the 60 tumors. MRP1 expression was associated with both p53 and bcl-2 expressions (P = 0.01 and P = 0.03, respectively). Univariate analysis of survival revealed a significant inverse correlation between P-gp expression and patient survival (P = 0.015). Moreover, P-gp expression was significantly increased in tumors of patients unresponsive to chemotherapy (P = 0.009). Multivariate analysis revealed that only FIGO stage and P-gp expression were useful negative independent predictors of survival (P = 0.035 and P = 0.045, respectively).
  
  
  CONCLUSIONS
  Our pilot study demonstrates that P-gp expression may be a reliable independent prognostic factor of survival in patients with ovarian serous carcinoma. Moreover, P-gp immunostaining may be useful for dividing ovarian carcinoma patients into chemoresponsive and chemoresistant groups.
authors.affiliation: Department of Pathology, Carmel Medical Center and Rappaport Faculty of Medicine, Technion University, Haifa, Israel. eyakirevich@lifespan.org
authors.forename: Evgeny
authors.initials: E
authors.lastname: Yakirevich
authors.forename: Edmond
authors.initials: E
authors.lastname: Sabo
authors.forename: Inna
authors.initials: I
authors.lastname: Naroditsky
authors.forename: Yanina
authors.initials: Y
authors.lastname: Sova
authors.forename: Ofer
authors.initials: O
authors.lastname: Lavie
authors.forename: Murray B
authors.initials: MB
authors.lastname: Resnick
mesh_terms: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000096:biosynthesis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D051017:Apoptosis Regulatory Proteins / Q000096:biosynthesis*; D018284:Cystadenocarcinoma, Serous / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D018432:Drug Resistance, Multiple / Q000502:physiology*; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000096:biosynthesis; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000096:biosynthesis; D016159:Tumor Suppressor Protein p53 / Q000096:biosynthesis; D020394:Vault Ribonucleoprotein Particles / Q000096:biosynthesis; D051028:bcl-2-Associated X Protein / Q000096:biosynthesis; D000099187:Major Vault Protein
chemical_list: D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D051017:Apoptosis Regulatory Proteins; D009363:Neoplasm Proteins; D019253:Proto-Oncogene Proteins c-bcl-2; D016159:Tumor Suppressor Protein p53; D020394:Vault Ribonucleoprotein Particles; D051028:bcl-2-Associated X Protein; D000099187:Major Vault Protein; C495901:TP53 protein, human