| Summary: | 碩士 === 臺灣大學 === 臨床醫學研究所 === 95 === Objective: Ovarian cancer is one of the leading cause of death among all gynecologic malignancies. The standard treatment of epithelial ovarian cancer (EOC) includes maximally debulking surgery followed by adjuvant chemotherapy. However, resistance to chemotherapy is an important issue while managing patients with EOC. Mesothelin, a secreted glycoprotein, was originally identified on mesothelial cells, mesotheliomas and ovarian cancers. The definite function of mesothelin is still to be clarified. This study is to investigate if the expression levels of mesothelin would correlate with chemotherapeutic response of patients with EOC.
Methods: Ninety eight patients with EOC received operation and postoperative adjuvant chemotherapy were enrolled. Patients with progressive disease or with recurrence within 6 months after completion of chemotherapy were defined as resistant group. Patients without recurrence or with recurrence more than 6 months after completion of chemotherapy were defined as sensitive group. Their clinical and pathologic items were recorded. Expression of mesothelin in ovarian cancer tissue was measured by quantitative competitive RT-PCR (QC RT-PCR) and real-time quantitative PCR (RQ-PCR) methods. The results were correlated to clinical data and outcome of these patients.
Results: The expression of mesothelin in ovarian cancer tissue was significantly higher in patients of resistant group than in sensitive group (p<0.05). In addition, high grade tumors also expressed higher level of mesothelin than those with low grade tumors (p<0.05 ). Patients with mesothelin over-expression had significantly shorter disease free survival than those with normal expression of mesothelin (10.8 months v.s.20.2 months; p<0.05). Patients with over-expression of mesothelin had a poorer overall survival than those with normal expression of mesothelin in serous type of EOC (Log Rank Test: p<0.01).
Conclusions: The expression level of mesothelin in ovarian cancer tissue might be a predictor for the possibility of chemotherapy resistance for patients of EOC.
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