title: Expression and prognostic significance of the polymeric immunoglobulin receptor in epithelial ovarian cancer.
abstract: BACKGROUND
  High expression of the polymeric immunoglobulin receptor (PIGR) has previously been associated with a favourable prognosis in a few cancer forms, but its expression and relationship with clinical outcome in epithelial ovarian cancer (EOC) has not yet been reported. The aim of this study was therefore to examine the clinicopathological correlates and prognostic significance of PIGR expression in EOC.
  
  
  METHODS
  After an initial screening in the Human Protein Atlas portal, a validated antibody was selected for extended analysis of immunohistochemical PIGR expression in tissue microarrays with tumours from 154 incident cases of EOC from two pooled prospective population-based cohorts. Subsets of corresponding benign-appearing fallopian tubes (n = 38) and omental metastases (n = 33) were also analysed. Kaplan-Meier analysis and Cox regression analysis were applied to examine the impact of PIGR expression on overall survival (OS) and ovarian cancer-specific survival (OCSS).
  
  
  RESULTS
  PIGR expression was significantly higher in fallopian tubes compared to primary tumours and metastases (p < 0.001) and lower in carcinoma of the serous subtype compared to other carcinomas (p < 0.001). PIGR expression was significantly associated with lower grade (p = 0.001), mucinous histological subtype (p = 0.002), positive progesterone receptor expression (p = 0.009) and negative or low Ki-67 expression (p = 0.003). Kaplan-Meier analysis revealed a significantly improved OS (p = 0.013) and OCSS (p = 0.009) for patients with tumours displaying high expression of PIGR. These associations were confirmed in unadjusted Cox regression analysis (HR = 0.48; 95% CI 0.26-0.87; p = 0.015 for OS and HR = 0.43, 95% CI 0.22-0.82; p = 0.011 for OCSS) but did not remain significant after adjustment for age, grade and clinical stage.
  
  
  CONCLUSIONS
  This study provides a first demonstration of PIGR expression in human fallopian tubes, primary EOC tumours and metastases. High tumour-specific expression of PIGR was found to be associated with a favourable prognosis in unadjusted, but not in adjusted, analysis. These findings are novel and merit further investigation.
authors.forename: Jonna
authors.initials: J
authors.lastname: Berntsson
authors.forename: Sebastian
authors.initials: S
authors.lastname: Lundgren
authors.forename: Björn
authors.initials: B
authors.lastname: Nodin
authors.forename: Mathias
authors.initials: M
authors.lastname: Uhlén
authors.forename: Alexander
authors.initials: A
authors.lastname: Gaber
authors.affiliation: Department of Clinical Sciences, Division of Pathology, Lund University, 221 85 Lund, Sweden. karin.jirstrom@med.lu.se.
authors.forename: Karin
authors.initials: K
authors.lastname: Jirström
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D000077216:Carcinoma, Ovarian Epithelial; D018572:Disease-Free Survival; D005187:Fallopian Tubes / Q000737:chemistry* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D009375:Neoplasms, Glandular and Epithelial / Q000737:chemistry* / Q000401:mortality / Q000556:secondary; D009852:Omentum / Q000737:chemistry* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000473:pathology; D010534:Peritoneal Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000556:secondary; D016016:Proportional Hazards Models; D011446:Prospective Studies; D019056:Receptors, Polymeric Immunoglobulin / Q000032:analysis*; D013997:Time Factors; D046888:Tissue Array Analysis; D015854:Up-Regulation
chemical_list: D014408:Biomarkers, Tumor; D019056:Receptors, Polymeric Immunoglobulin