title: Tissue AP-2gamma and Oct-3/4, and serum CA 125 as diagnostic and prognostic markers of malignant ovarian germ cell tumors.
abstract: Histology, clinical stage and treatment response are used to define the prognosis of malignant ovarian germ cell tumors (MOGCTs). However, additional biological tools to guide treatment in MOGCTs would be desirable. We evaluated the prognostic value of several serum and tissue markers in MOGCTs. Medical charts of 30 women were reviewed as regards preoperative and treatment-related factors, with a mean follow-up time of 92 months (range 2-205). Serum levels of alpha-fetoprotein, human chorionic gonadotropin and CA 125 were determined, and immunohistochemistry for CA 125 as well as the pluripotent stem cell markers AP-2gamma and Oct-3/4 was performed in tumor specimens and the NCC-IT human germinoma cell line. Overall survival was 73%. Elevated preoperative levels of serum CA 125 were prognostic of progressive disease (p<0.05). Immunohistochemical evaluation revealed that in most cases the elevated CA 125 levels originated from the tumor tissue. Most dysgerminomas as well as the germinoma cell line were positive for AP-2gamma and Oct-3/4, whereas the majority of yolk sac tumors and immature teratomas were negative. Taken together, increased preoperative serum CA 125 levels indicate poor prognosis of MOGCTs. Tissue AP-2gamma and Oct-3/4 are associated with dysgerminomas and can thus be used as additional differential diagnostic tools in MOGCTs.
authors.affiliation: Children's Hospital and Program for Women's Health, Biomedicum Helsinki, University of Helsinki, Helsinki, Finland.
authors.forename: Jonna
authors.initials: J
authors.lastname: Salonen
authors.forename: Arto
authors.initials: A
authors.lastname: Leminen
authors.forename: Ulf-Håkan
authors.initials: UH
authors.lastname: Stenman
authors.forename: Ralf
authors.initials: R
authors.lastname: Butzow
authors.forename: Markku
authors.initials: M
authors.lastname: Heikinheimo
authors.forename: Oskari
authors.initials: O
authors.lastname: Heikinheimo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood / Q000378:metabolism*; D018394:CA-125 Antigen / Q000097:blood*; D002648:Child; D006063:Chorionic Gonadotropin / Q000097:blood; D005260:Female; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000097:blood / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D050814:Octamer Transcription Factor-3 / Q000378:metabolism*; D010051:Ovarian Neoplasms / Q000097:blood / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D011379:Prognosis; D050656:Transcription Factor AP-2 / Q000378:metabolism*; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D006063:Chorionic Gonadotropin; D050814:Octamer Transcription Factor-3; D050656:Transcription Factor AP-2; D000509:alpha-Fetoproteins