Clinicopathological correlation of endocan expression and survival in epithelial ovarian cancer

• Published in: Archives of gynecology and obstetrics Vol. 288; no. 6; pp. 1371 - 1376
• Main Authors: El Behery, Manal M., Seksaka, Mahmoud A., Ibrahiem, Moustafa A., Saleh, Hend S., El Alfy, Yehya
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-12-2013; Springer Nature B.V
• Subjects: Adult; Aged; Carcinoma, Ovarian Epithelial; Egypt - epidemiology; Endocrinology; Endothelium; Female; Fibroids; Gynecologic Oncology; Gynecology; Human Genetics; Humans; Immunohistochemistry; Male; Medical prognosis; Medicine; Medicine & Public Health; Middle Aged; Multivariate Analysis; Neoplasm Proteins - metabolism; Neoplasms, Glandular and Epithelial - mortality; Neoplasms, Glandular and Epithelial - pathology; Neovascularization, Pathologic; Obstetrics/Perinatology/Midwifery; Ovarian cancer; Ovarian Neoplasms - mortality; Ovarian Neoplasms - pathology; Prognosis; Prospective Studies; Proteoglycans - metabolism; Survival Analysis; Vascular endothelial growth factor; Vascular Endothelial Growth Factor A - metabolism; Egypt; Immunohistochemistry; Endocan; Epithelial ovarian cancer; VEGF; ECM-1; ECM-MVD; Survival
• ISSN: 0932-0067; 1432-0711
• DOI: 10.1007/s00404-013-2863-3

Introduction
Endothelial-cell-specific molecule-1 or endocan is a proteoglycan with tumorigenic activity through both its glycan and protein cores. Endocan mRNA is identified as one of the most significant molecular signatures defining a poor prognosis in lung, breast, kidney, and hepatocellular cancer.
Objective
To assess the clinical value of endocan expression in ovarian cancer tissues in association with other prognostic factors and its impact on overall survival.
Setting
Oncology unit of Zagazig University Hospitals, Egypt.
Study design
Prospective observational cohort.
Patients and methods
One hundred primary ovarian cancer patients were recruited as study group, another 100 patients undergoing hysterectomy and oophorectomy due to uterine fibroid were the control group. Angiogenesis was determined by immunohistochemical staining, using anti-endocan, and anti vascular endothelial growth factor (VEGF) monoclonal antibodies.
Results
Endocan was expressed in endothelium of ovarian cancer tissue specimens in all patients with no expression in endothelium of normal ovarian tissue in the control group. VEGF was also expressed in endothelium of all specimens of ovarian cancer tissue, compared with 70 % expression in normal ovarian tissue specimens in the control group. A significant association was found between endocan-microvessel density (MVD) and tumor histology, tumor size, staging, and grading. No significant association was found between VEGF expression and any of the clinicopathological variables. Overall survival of patients was inversely associated with endocan-MVD (
P
 < 0.01). Multivariate analysis showed that endocan-MVD was an independent prognostic marker for overall survival of epithelial ovarian cancer (
P
 < 0.01).
Conclusion
Endocan could be a reliable marker to predict the survival in epithelial ovarian cancer patients.