Abstract
BackgroundEndometrioid ovarian carcinoma and clear cell ovarian carcinoma are both classified as endometriosis-associated ovarian cancers (EAOCs). Despite the high rates of recurrence and mortality of EAOC, only a few prognostic biomarkers have been reported. Mitochondrial superoxide dismutase (SOD2) plays an important role in maintaining mitochondrial function through oxidative stress tolerance and contributes to chemotherapeutic resistance.MethodsTo clarify the clinical significance of SOD2 in EAOC, SOD2 expression was semi-quantitatively investigated by immunohistochemical analysis in 61 primary EAOC cases, and the correlations between SOD2 expression and clinicopathological data and survival were analyzed.ResultsForty-six (75%) cases expressed high levels of SOD2. High SOD2 expression was associated with a poor prognosis on both univariate and multivariate analyses after adjusting for variables such as age, International Federation of Gynecology and Obstetrics (FIGO) stage, blood markers, histological type, and completion of treatment. There were 14 fatalities from 15 recurrences among 46 cases with high SOD2 expression. In contrast, only one recurrence and no fatalities were seen among 15 cases with low SOD2 expression.ConclusionIncreased SOD2 expression is a predictive biomarker for worse prognosis in EAOC. The therapeutic efficacy of the current standard therapeutic protocol for EAOC is limited; thus, mitochondrial SOD2 should be a therapeutic target for SOD2-abundant EAOC.
Highlights
Endometrioid ovarian carcinoma and clear cell ovarian carcinoma are both classified as endometriosisassociated ovarian cancers (EAOCs)
We investigated the correlation between Mitochondrial superoxide dismutase (SOD2) expression and prognosis in a cohort of EAOC cases based on immunohistochemical staining of SOD2 and compared the results with clinicopathological data
Abundant SOD2 expression in EAOC and the correlation with clinicopathological characteristics SOD2 expression was semi-quantitatively evaluated in 61 primary tumors of EAOC
Summary
Endometrioid ovarian carcinoma and clear cell ovarian carcinoma are both classified as endometriosisassociated ovarian cancers (EAOCs). Mitochondrial superoxide dismutase (SOD2) plays an important role in maintaining mitochondrial function through oxidative stress tolerance and contributes to chemotherapeutic resistance. Inflammation and oxidative stress induced by heme and iron seem to be important triggers in the malignant transformation of endometriosis into EAOC [8]. Mitochondrial superoxide dismutase (SOD2) is an enzyme that metabolizes superoxide in mitochondria and plays an important role in maintaining mitochondrial function through oxidative stress tolerance. In ovarian cancer, especially in EAOC, the correlation between SOD2 expression and prognosis remains unknown. It is unclear whether overexpression of SOD2 is strongly involved in ROS resistance and related to prognosis in EAOC. We investigated the correlation between SOD2 expression and prognosis in a cohort of EAOC cases based on immunohistochemical staining of SOD2 and compared the results with clinicopathological data
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