title: Elevated growth differentiation factor 15 expression predicts poor prognosis in epithelial ovarian cancer patients.
abstract: The purpose of this study was to determine the expression of growth differentiation factor 15 (GDF15) and explore its clinical significance in epithelial ovarian cancer (EOC) patients. The expression of GDF15 in EOC tissues and serum samples was evaluated using immunohistochemistry and enzyme-linked immunosorbent assay (ELISA), respectively. The association of GDF15 expression with clinicopathologic parameters was analyzed. Survival time was assessed using the Kaplan-Meier technique and Cox regression model. Both in EOC tissues and serum, high GDF15 levels were obviously related with advanced International Federation of Gynecology and Obstetrics (FIGO) stage, lymph node metastasis, ascites, and chemoresistance. Kaplan-Meier analysis indicated that EOC patients with high GDF15 expression showed poorer progression-free survival (PFS) and overall survival (OS). Multivariate analysis demonstrated that GDF15 expression was an independent predictor of PFS in EOC patients. Our study shows that elevated GDF15 expression was associated with poor prognosis in EOC patients. We suggest that GDF15 is a novel biomarker for the early detection of EOC, prediction of the response to chemotherapy, and screening for recurrence in EOC patients.
authors.affiliation: The State Key Laboratory of Cancer Biology, Biotechnology Center, School of Pharmacy, The Fourth Military Medical University, 17 Changle West Road, 710032, Xi'an, Shaanxi, China.|Department of Gynecology and Obstetrics, The People's Liberation Army 323 Hospital, Xi'an, Shaanxi, 710045, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: State Key Laboratory of Tumor Biology, Department of Pathology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, 710033, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Hua
authors.affiliation: Department of Gynecology and Obstetrics, The People's Liberation Army 323 Hospital, Xi'an, Shaanxi, 710045, China.
authors.forename: Li-Chun
authors.initials: LC
authors.lastname: Niu
authors.affiliation: Department of Gynecology and Obstetrics, The People's Liberation Army 323 Hospital, Xi'an, Shaanxi, 710045, China.
authors.forename: Shi-Mei
authors.initials: SM
authors.lastname: Li
authors.affiliation: State Key Laboratory of Tumor Biology, Department of Pathology, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi, 710033, China.
authors.forename: Ying-Mei
authors.initials: YM
authors.lastname: Wang
authors.affiliation: Department of Health Service, School of Public Health, Fourth Military Medical University, Xi'an, Shaanxi, 710033, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Shang
authors.affiliation: The State Key Laboratory of Cancer Biology, Biotechnology Center, School of Pharmacy, The Fourth Military Medical University, 17 Changle West Road, 710032, Xi'an, Shaanxi, China.
authors.forename: Cun
authors.initials: C
authors.lastname: Zhang
authors.affiliation: The State Key Laboratory of Cancer Biology, Biotechnology Center, School of Pharmacy, The Fourth Military Medical University, 17 Changle West Road, 710032, Xi'an, Shaanxi, China.
authors.forename: Wei-Na
authors.initials: WN
authors.lastname: Li
authors.affiliation: Department of Health Service, School of Public Health, Fourth Military Medical University, Xi'an, Shaanxi, 710033, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Gynecology and Obstetrics, Xijing Hospital, Fourth Military Medical University, 169 Changle West Road, 710033, Xi'an, Shaanxi, China.
authors.forename: Bi-Liang
authors.initials: BL
authors.lastname: Chen
authors.affiliation: Department of Gynecology and Obstetrics, Xijing Hospital, Fourth Military Medical University, 169 Changle West Road, 710033, Xi'an, Shaanxi, China.
authors.forename: Xiao-Yan
authors.initials: XY
authors.lastname: Xin
authors.affiliation: The State Key Laboratory of Cancer Biology, Biotechnology Center, School of Pharmacy, The Fourth Military Medical University, 17 Changle West Road, 710032, Xi'an, Shaanxi, China. zhangyingqi710032@163.com.
authors.forename: Ying-Qi
authors.initials: YQ
authors.lastname: Zhang
authors.affiliation: Department of Gynecology and Obstetrics, Xijing Hospital, Fourth Military Medical University, 169 Changle West Road, 710033, Xi'an, Shaanxi, China. wangjian710032@163.com.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D016022:Case-Control Studies; D018284:Cystadenocarcinoma, Serous / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D016889:Endometrial Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D055436:Growth Differentiation Factor 15 / Q000378:metabolism*; D006801:Humans; D007124:Immunoenzyme Techniques; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D011379:Prognosis; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; C526140:GDF15 protein, human; D055436:Growth Differentiation Factor 15
keywords: Biomarker; Chemotherapy; Epithelial ovarian cancer; Growth differentiation factor 15; Prognosis