Reduced bikunin gene expression as a factor of poor prognosis in ovarian carcinoma

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Abstract
BACKGROUND In previous studies, the authors showed that various types of cultured tumor cells treated with exogenous bikunin protein or ovarian carcinoma cells transfected with bikunin cDNA have low invasiveness and diminished metastatic potential. This study was carried out to clarify the relation between the expression of individual bikunin mRNA and tumor progression. METHODS Forty-one newly diagnosed ovarian carcinomas were investigated using a semiquantitative reverse transcriptase-polymerase chain reaction. RESULTS The authors found that 24 patients had tumors that overexpressed bikunin and that gene expression was reduced in the tumors of the remaining 17 individuals. Bikunin mRNA expression was independent of age, surgical stage, tumor size, degree of differentiation, histologic subtype, and serum CA 125 levels. There was a significant correlation between low expression of bikunin mRNA and lymph node status (P = 0.035) or peritoneal status (P = 0.042). Multivariate analysis indicated that bikunin was an independent prognostic marker (P = 0.013; hazard ratio, 2.30; 95 % confidence interval, 1.13–4.19), even after controlling for lymph node metastasis and the degree of peritoneal dissemination. In addition, low expression was a significant predictor for poor prognosis compared with high expression (2-year survival rate; 75.0 % vs. 47.1 %, respectively; P < 0.05). CONCLUSIONS The data suggest that low bikunin mRNA expression by ovarian cacinoma cells may be associated with poor prognosis. It is conceivable that testing for bikunin mRNA may identify patients with ovarian carcinoma who are at high risk for early disease recurrence and a poor prognosis. Cancer 2003;98:424–30. © 2003 American Cancer Society. DOI 10.1002/cncr.11506