Periostin in ovarian carcinoma: from heterogeneity to prognostic value

INTRODUCTION

Periostin (POSTN), an extracellular matrix protein, is involved in tumor-associated extracellular matrix (ECM) remodeling. However, its potential value as a prognostic and/or predictive factor has not yet been confirmed. The present study aims to assess POSTN expression separately in tumor cells and stroma of different ovarian carcinoma (OC) histological types, and its relationship with clinicopathological features.

MATERIAL AND METHODS

102 cases of different histological OC subtypes were immunohistochemically investigated, for POSTN expression assessment in both epithelial tumor cells and tumor stroma. Statistical analysis was performed to correlate POSTN profile with clinicopathological characteristics, therapeutic response, and survival.

RESULTS

POSTN expression in epithelial tumor cells was significantly correlated with POSTN expression in tumor stroma. The expression of POSTN in tumor cells was associated with histological type, tumor type (type I and II), tumor recurrence, progression-free survival (PFS), and overall survival (OS), whereas stromal POSTN expression was significantly correlated with age, histological type, tumor type, grade, and stage, residual disease, tumor recurrence, response to chemotherapy, and OS. Survival analysis revealed significant differences of PFS and OS in patients with high POSTN expression in tumor cells and negative stromal POSTN expression compared to patients with low POSTN expression in tumor cells and positive stromal POSTN expression (PFS: hazard ratio (HR) = 2.11, 95% confidence interval (CI): 1.33-3.37, P = 0.002; OS: HR = 1.78, 95% CI: 1.09-2.89, P = 0.019).

CONCLUSIONS

The comparative assessment of POSTN immunoexpression in two tumor compartments: in tumor cells and stroma, by use of different scoring systems revealed that higher stromal POSTN levels are evidently correlated with unfavorable clinical features and poorer prognosis, while POSTN expression in tumor cells seems to be associated with a better patient outcome.

BMI-1 Expression Heterogeneity in Endometriosis-Related and Non-Endometriotic Ovarian Carcinoma

BMI-1 is a key component of stem cells, which are essential for normal organ development and cell phenotype maintenance. BMI-1 expression is deregulated in cancer, resulting in the alteration of chromatin and gene transcription repression. The cellular signaling pathway that governs BMI-1 action in the ovarian carcinogenesis sequences is incompletely deciphered. In this study, we set out to analyze the immunohistochemical (IHC) BMI-1 expression in two different groups: endometriosis-related ovarian carcinoma (EOC) and non-endometriotic ovarian carcinoma (NEOC), aiming to identify the differences in its tissue profile. Methods: BMI-1 IHC expression has been individually quantified in epithelial and in stromal components by using adapted scores systems. Statistical analysis was performed to analyze the relationship between BMI-1 epithelial and stromal profile in each group and between groups and its correlation with classical clinicopathological characteristics. Results: BMI-1 expression in epithelial tumor cells was mostly low or negative in the EOC group, and predominantly positive in the NEOC group. Moreover, the stromal BMI-1 expression was variable in the EOC group, whereas in the NEOC group, stromal BMI-1 expression was mainly strong. We noted statistically significant differences between the epithelial and stromal BMI-1 profiles in each group and between the two ovarian carcinoma (OC) groups. Conclusions: Our study provides solid evidence for a different BMI-1 expression in EOC and NEOC, corresponding to the differences in their etiopathogeny. The reported differences in the BMI-1 expression of EOC and NEOC need to be further validated in a larger and homogenous cohort of study.

Macrophage-colony stimulating factor (CSF1) predicts breast cancer progression and mortality

BACKGROUND

Macrophage colony-stimulating factor (CSF1), also known as colony-stimulating factor-1 (CSF1), and its receptor CSF1R have been correlated with poor prognosis in many cancer types including breast cancer. Herein, we investigated the prognostic impact of CSF1 and CSF1R expression in tumor epithelial and stromal compartments in primary breast cancer and axillary lymph node metastases. In addition, the density of CD68+ tumor-associated macrophages (TAMs) and CD3+ T-lymphocytes was examined.

MATERIALS AND METHODS

Tumor tissue was obtained at the time of primary surgery from 68 prior treatment breast cancer patients, 38 with axillary lymph node metastases and 30 patients without metastases. Digital video analysis was performed on immunohistochemically stained slides.

RESULTS

The expression of CSF1, CSF1R and the density of TAMs and CD3+ T-lymphocytes were then correlated to metastases and disease-specific mortality. Metastasized primary cancers had higher tumor epithelial and stromal expressions of CSF1 (p<0.001 and p=0.002, respectively) and CSF1R (both p=0.03) compared to non-metastatic cancers. Similar findings were made for the density of CD68+ (p=0.003) and CD3+ cells in the tumor epithelium (p<0.001). In multivariate analysis, a high tumor epithelial expression of CSF1 in primary breast cancer predicted mortality (hazard ratio (HR)=8.6, p=0.039).

CONCLUSION

High expression of CSF1 and CSF1R and high density of TAMs and CD3+ T-lymphocytes were related to breast cancer progression. CSF1 expression in tumor epithelium predicted breast cancer mortality.