title: Clear cell carcinomas of the ovary: a multi-institutional study of 129 cases in Korea with prognostic significance of Emi1 and Galectin-3.
abstract: Accurate diagnosis of ovarian clear cell carcinoma (CCC) is important because of its poor prognosis with chemoresistance and a high recurrent rate. The clinicopathologic characteristics and prognostic significance of the cell cycle regulator [early mitotic inhibitor-1 (Emi1)] and galactoside-binding protein (Galectin-3) were evaluated. Among 155 CCCs from 18 hospitals in Korea between 1995 and 2006, 129 pure CCCs were selected with consensus using immunohistochemical stains for hepatocyte nuclear factor-1β, Wilms' tumor protein, and estrogen receptor. The expressions of Emi1, Galectin-3, p53, and Ki-67 labeling index were analyzed with clinicopathologic parameters and the patient's survival. The mean age of the patients was 49.6 yr; the tumors were bilateral in 10.9%, and the average size was 12 cm. Adenofibromatous component was found in 7%, and endometriosis in 48.1% of the cases. Psammoma body was seen in 16.3%. Disease-free survival and overall survival rates were 78.3% and 79.1%, respectively. The International Federation of Obstetrics and Gynecology (FIGO) stage was the most important prognostic indicator. Emi1 expression (>5%) was seen in 23.3% of CCCs, and associated with high FIGO grades and poor overall survival (P<0.05). High Galectin-3 (≥80%) expression was seen in 59.7% of CCCs, and associated with FIGO stages III and IV, and high Ki-67 labeling index. High Ki-67 labeling index (≥50%) and p53 expression (≥50%) were seen in 27.1% and 18.6% of CCCs, respectively, but there was no clinicopathologic and prognostic significance. On the basis of the fact that the expression of Emi1 in CCC was correlated with a high histologic grade and worse overall survival, target therapy using inhibitors of Emi1 may be tried in the management of CCC patients with Emi1 expression.
authors.affiliation: Department of Pathology, Hanyang University, Seoul, Korea.
authors.forename: Kyueng-Whan
authors.initials: KW
authors.lastname: Min
authors.forename: Moon Hyang
authors.initials: MH
authors.lastname: Park
authors.forename: Sung Ran
authors.initials: SR
authors.lastname: Hong
authors.forename: Heejung
authors.initials: H
authors.lastname: Lee
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Kwon
authors.forename: Sook Hee
authors.initials: SH
authors.lastname: Hong
authors.forename: Hee Jae
authors.initials: HJ
authors.lastname: Joo
authors.forename: In Ae
authors.initials: IA
authors.lastname: Park
authors.forename: Hee Jung
authors.initials: HJ
authors.lastname: An
authors.forename: Kwang Sun
authors.initials: KS
authors.lastname: Suh
authors.forename: Hoon Kyu
authors.initials: HK
authors.lastname: Oh
authors.forename: Chong Woo
authors.initials: CW
authors.lastname: Yoo
authors.forename: Mi Jin
authors.initials: MJ
authors.lastname: Kim
authors.forename: Hee Kyung
authors.initials: HK
authors.lastname: Chang
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Jun
authors.forename: Hye Kyoung
authors.initials: HK
authors.lastname: Yoon
authors.forename: Eun Deok
authors.initials: ED
authors.lastname: Chang
authors.forename: Dong Won
authors.initials: DW
authors.lastname: Kim
authors.forename: Insun
authors.initials: I
authors.lastname: Kim
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D018797:Cell Cycle Proteins / Q000032:analysis / Q000096:biosynthesis*; D018572:Disease-Free Survival; D044783:F-Box Proteins / Q000032:analysis / Q000096:biosynthesis*; D005260:Female; D037502:Galectin 3 / Q000032:analysis / Q000096:biosynthesis*; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D007723:Korea; D008875:Middle Aged; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology; D011379:Prognosis; D016016:Proportional Hazards Models; D046888:Tissue Array Analysis
chemical_list: D014408:Biomarkers, Tumor; D018797:Cell Cycle Proteins; D044783:F-Box Proteins; C498960:FBXO5 protein, human; D037502:Galectin 3