title: Interferon-gamma in ascites could be a predictive biomarker of outcome in ovarian carcinoma.
abstract: OBJECTIVE
  The ovarian cancer-associated ascites is an ideal material for evaluating the interaction between the host immune system and cancer cells in the tumor micro-environment. The aim of this study was to investigate whether the selected target cytokine expression levels in ascites could serve as an immune biomarker for predicting outcomes in ovarian cancer.
  
  
  METHODS
  Eighty-eight specimens of ovarian cancer-associated ascites were evaluated to select the target cytokine by a cytokine profiling kit. The 144 total samples were subsequently analyzed for this target cytokine. The correlation between the target cytokine and clinical characteristics was analyzed.
  
  
  RESULTS
  Interferon-gamma (IFN-γ) was identified as the target cytokine. Higher levels of IFN-γ in the ascites of the tumor micro-environment were associated with advanced disease (p=0.012), higher tumor histological grading (p=0.004), and sub-optimal surgical status (p=0.040). By multivariate analysis, the adjusted hazard ratios (HRs) were 2.74 (95% confidence interval (CI) 1.85-4.05, p<0.001) for disease-free survival (DFS) and 1.72 (95% CI 1.01-2.93, p=0.048) for overall survival (OS) for a 10-fold increase in IFN-γ concentration in the ascites. An inverse dose-response relationship between IFN-γ level and survival was also noted (Ptrend<0.001 for DFS and Ptrend<0.042 for OS).
  
  
  CONCLUSIONS
  Patients with ovarian cancer and higher IFN-γ expression levels in cancer-associated ascites will have shorter DFS and OS. IFN-γ levels in the ascites may be a prognostic marker and a potential reference for immunotherapy targeting IFN-γ.
authors.affiliation: Graduate Institute of Anatomy and Cell Biology, College of Medicine, National Taiwan University, Taipei, Taiwan; Gynecologic Cancer Center, Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Yu-Li
authors.initials: YL
authors.lastname: Chen
authors.forename: Wen-Fang
authors.initials: WF
authors.lastname: Cheng
authors.forename: Ming-Cheng
authors.initials: MC
authors.lastname: Chang
authors.forename: Han-Wei
authors.initials: HW
authors.lastname: Lin
authors.forename: Ching-Ting
authors.initials: CT
authors.lastname: Huang
authors.forename: Chung-Liang
authors.initials: CL
authors.lastname: Chien
authors.forename: Chi-An
authors.initials: CA
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D001201:Ascites / Q000209:etiology / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D002277:Carcinoma / Q000150:complications / Q000276:immunology* / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000378:metabolism*; D008875:Middle Aged; D060787:Neoplasm Grading; D010051:Ovarian Neoplasms / Q000150:complications / Q000276:immunology* / Q000473:pathology*; D016016:Proportional Hazards Models
chemical_list: D014408:Biomarkers, Tumor; D007371:Interferon-gamma
keywords: Ascites; Cytokine; Interferon-gamma; Ovarian carcinoma; Tumor immunology