Expression Of GSDME In Epithelial Ovarian Cancer And Its Correlation With Chemotherapy Resistance And Prognosis

Objective:Assessing the expression of GSDME protein in normal ovarian,benign,borderline and malignant ovarian tumors by immunohistochemistry.Analyzing the relationship between GSDME protein expression and clinic pathological features,chemotherapy resistance and prognosis of ovarian cancer based on clinical data,in order to explore a new indicator related to the development and progression of ovarian cancer,provide a new starting point for solving the problem of chemotherapy resistance of ovarian cancer and provide new ideas for searching for prognostic indicators of ovarian cancer.Methods:Paraffin specimens of patients stored in the Pathology Department of Shanxi Provincial People’s Hospital from January 2018 to December 2020 were collected,including 90 cases of epithelial ovarian cancer,30 cases of borderline epithelial ovarian tumors,30 cases of epithelial ovarian benign tumors and 30 cases of normal ovarian paraffin specimens.Immunohistochemistry was used to detect the expression of GSDME protein in different ovarian tissues.Meanwhile,clinical data of ovarian cancer patients were collected and followed up to analyze statistically whether there were differences in the expression of GSDME protein in different ovarian tissues and the correlation between GSDME protein expression and clinicopathologic characteristics,chemotherapy resistance and prognosis of ovarian cancer patients.Results:1.The expression of GSDME protein decreased successively in normal ovarian tissue,benign epithelial ovarian tumor,borderline epithelial ovarian tumor and epithelial ovarian cancer,and the positive rates were 100%,96.67%,73.33% and40.00%,respectively.The difference among the four groups was statistically significant(P< 0.001).2.The expression of GSDME protein was correlated with age(P=0.027),differentiation degree(P=0.012),FIGO stage(P=0.025)and lymph node metastasis(P=0.024).The positive rate of ≤50 years old(54.29%)was higher than that of ≥50 years old(30.90%).The positive rate of middle and high differentiation(55.26%)was higher than that of low differentiation(28.85%).The positive rate of FIGO stage Ⅰ-Ⅱ(52.38%)was higher than that of Ⅲ-Ⅳ(29.17%).The positive rate without lymph node metastasis(47.62%)was higher than that with lymph node metastasis(22.22%).3.The expression of GSDME protein was correlated with chemotherapy resistance of ovarian cancer(P=0.004),and the positive rate in chemotherapy sensitive group(52.94%)was higher than that in drug resistant group(23.08%).4.Univariate analysis suggested that differentiation degree(P=0.040),FIGO stage(P<0.001),lymph node metastasis(P=0.001),platinum reaction(P=0.003)and GSDME expression(P<0.001)affected the prognosis of ovarian cancer.Multivariate analysis suggested that GSDME expression affected the prognosis of ovarian cancer(P=0.011),and the lower the expression,the worse the prognosis.Conclusion:1.The expression of GSDME protein is down-regulated in epithelial ovarian cancer,which is related to the age,differentiation degree,FIGO stage and lymph node metastasis of patients with epithelial ovarian cancer,and may be involved in the occurrence and development of epithelial ovarian cancer as a tumor suppressor.2.The lower the expression of GSDME protein,the more likely it is to produce drug resistance.3.GSDME is expected to be a new indicator of chemotherapy resistance of ovarian cancer.Low expression of GSDME is an independent risk factor for ovarian cancer prognosis.