| Objective:1.To analyze the relationship between the expression of cancer stem cell markers CD133 and CD44 in serous ovarian cancer(SOC)and clinicopathological characteristics.2.To explore the expression of CD133,CD44 and the neutrophils lymphocyte ratio(NLR),mononuclear lymphocyte ratio(MLR),platelet lymphocyte ratio(PLR),neutrophils ratio * monocytes/lymphocyte(index of systemic inflammation,SIRI)immune inflammation parameters,such as relationship with the effect of chemotherapy.3.To investigate the correlation between the expression of CD133 and CD44 and immunoinflammatory parameters.4.The evaluation value of CD133,CD44 and immunoinflammatory parameters for the prognosis of SOC was analyzed.Methods: From January 2012 to December 2015,131 tissue specimens diagnosed as SOC in Sheng Jing Hospital affiliated to China Medical University were selected.A total of 15 cases of normal ovarian,fallopian tube,benign and borderline ovarian serous tumors were selected.The expression of CD133 and CD44 was detected by SP immunohistochemical staining.To analyze the relationship between the expression of CD133 and CD44 and clinicopathological characteristics,and to test whether they are correlated.Clinicopathological data were collected and NLR,PLR,MLR and SIRI were calculated.Survival state was used as the state variable to draw the receiver operating characteristic(ROC)curve,and the critical values of NLR,PLR,MLR and SIRI were determined.According to the critical values,they were respectively divided into high level group and low level group.According to NCCN guidelines,the patients were divided into chemotherapy-sensitive group and chemotherapy-resistant group.The expression of CD133 and CD44,as well as the levels of NLR,PLR,MLR and SIRI were analyzed in relation to the response to chemotherapy.The correlation of CD133,CD44 expression with NLR,PLR,MLR and SIRI was examined.Based on clinicopathological data and follow-up results,the positive expression of CD133 and CD44,the level of NLR,PLR,MLR,SIRI and the prognosis of SOC were analyzed.Results: 1.Immunohistochemical staining showed negative expression of CD133 and CD44 in normal ovarian,fallopian tube,benign and borderline ovarian serous tumors.The positive rates of CD133 and CD44 were 38.9%(51/131)and 26.7%(35/131)in 131 SOC specimens,which were significantly higher than those in normal ovarian,fallopian tube,benign and borderline ovarian serous tumors,and the difference was statistically significant(P=0.003,0.022).2.The expression of CD133 positive was associated with FIGO(Ⅲ-Ⅳ)(P = 0.009);CD44 positive expression was associated with lymph node metastasis(P=0.023).3.The chemotherapy resistance rate of CD133 positive group was 47.1%,and that of CD133 negative group was 21.3%;CD44 positive group chemotherapy drug resistance rate was 54.3%,CD44 negative group chemotherapy drug resistance rate was 22.9%;The chemotherapy drug resistance rate of MLR > 0.21 group was 37.1%,and that of MLR≤0.21 group was 14.7%.SIRI > 0.79 group chemotherapy drug resistance rate was 40.2%,and that of SIRI≤0.79 group chemotherapy drug resistance rate was 10.3%.SOC chemotherapy resistance was correlated with the positive expression of CD133 and CD44,high level of MLR and SIRI,and the difference was statistically significant(P < 0.05).4.K-M survival analysis showed that positive CD133,CD44,PLR > 229.88,MLR >0.21,and SIRI>0.79 were associated with poorer progression-free survival(PFS)(P < 0.05),while positive CD44,NLR>1.69,PLR>229.88,MLR >0.21 and SIRI>0.79 were associated with poorer overall survival(OS)(P < 0.05).5.Cox multivariate regression model was used to analyze the risk factors,and CD44 was an independent risk factor for PFS in serous ovarian cancer.Conclusion: 1.The expression of cancer stem cell markers CD133,CD44 in serous ovarian cancer was significantly higher than that in normal ovarian,fallopian tube,benign and borderline ovarian serous tumors.CD133 positive expression was associated with FIGO(Ⅲ-Ⅳ period),CD44 positive expression was associated with lymph node metastasis.These results suggest that CD133 and CD44 play an important role in the progression of serous ovarian cancer.2.The chemotherapy resistance of serous ovarian cancer is associated with the positive expression of CD133,CD44 and high level of MLR and SIRI.CD133,CD44,MLR and SIRI may be a new indicator to evaluate the efficacy of chemotherapy.3.CD44,as an independent risk factor affecting the progression-free survival of serous ovarian cancer,may become a new indicator for predicting the prognosis of serous ovarian cancer. |
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