title: Expression of the Ets transcription factor EHF in serous ovarian carcinoma effusions is a marker of poor survival.
abstract: The EHF (Ets homologous factor) gene was previously shown to be overexpressed in ovarian/primary peritoneal serous carcinoma compared to malignant mesothelioma using gene expression arrays. The objective of this study was to validate this finding at the mRNA level in a larger series. We analyzed the diagnostic role of EHF in 98 ovarian serous carcinoma effusions, 23 malignant mesothelioma specimens (20 effusions, 3 surgical specimens), and 28 primary ovarian serous carcinomas using quantitative real-time polymerase chain reaction. Expression levels of EHF in ovarian carcinoma were additionally investigated for association with clinicopathologic parameters and survival. Quantitative real-time polymerase chain reaction analysis showed significantly higher expression of EHF mRNA in ovarian carcinoma effusions and in primary ovarian carcinoma compared to malignant mesothelioma effusions (P < .001 for both). EHF mRNA expression was additionally higher in primary ovarian carcinomas compared to effusions of this cancer (P < .001). In univariate analysis for all patients with effusions, higher EHF mRNA levels were associated with a trend for shorter progression-free survival (P = .066), which became significant in analysis of 45 patients with primary diagnosis pre-chemotherapy effusions (P = .01). In Cox multivariate analysis, EHF mRNA expression was an independent predictor of poor progression-free survival for all patients and patients with primary diagnosis pre-chemotherapy effusions (P = .033 and P = .009, respectively). EHF mRNA levels differentiate ovarian carcinoma from malignant mesothelioma and may thus be of diagnostic value in this setting. EHF may be a novel prognostic marker in ovarian carcinoma.
authors.affiliation: Division of Pathology, Norwegian Radium Hospital, Oslo University Hospital, N-0424 Oslo, Norway.
authors.forename: Kjersti
authors.initials: K
authors.lastname: Brenne
authors.forename: Dag André
authors.initials: DA
authors.lastname: Nymoen
authors.forename: Thea Eline
authors.initials: TE
authors.lastname: Hetland
authors.forename: Claes G
authors.initials: CG
authors.lastname: Trope'
authors.forename: Ben
authors.initials: B
authors.lastname: Davidson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001202:Ascitic Fluid / Q000473:pathology; D014408:Biomarkers, Tumor / Q000235:genetics; D015331:Cohort Studies; D018284:Cystadenocarcinoma, Serous / Q000235:genetics / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008654:Mesothelioma / Q000235:genetics / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000235:genetics / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D016066:Pleural Effusion, Malignant / Q000473:pathology; D011379:Prognosis; D012333:RNA, Messenger / Q000235:genetics; D012334:RNA, Neoplasm / Q000235:genetics; D015996:Survival Rate; D014157:Transcription Factors / Q000235:genetics*
chemical_list: D014408:Biomarkers, Tumor; C403306:EHF protein, human; D012333:RNA, Messenger; D012334:RNA, Neoplasm; D014157:Transcription Factors