| Objective: To observe the expression of Shh and Foxm1 protein in epithelial ovarian tumor and its clinical significance.Methods: Immunohistochemical staining(IHC) was used to detect the expression pattern of Shh protein and Foxm1 protein in 74 ovarian tissue specimens including 38 cases of epithelial ovarian carcinoma,18 cases of benign ovarian tumor, 18 cases of normal ovary tissue. Then we analyzed the relationship between this two factors and epithelial ovarian cancer clinical stage, pathological grading, pathological types, lymph node metastasis, and explored its clinical significance.Results:1 Shh protein showed negative expression in all normal ovarian tissues, while showed positive expression in benign ovarian tumor and epithelial ovarian carcinoma, the positive expression rate of which were respectively 22.22%(4/18) and 81.6%(31/38).The positive expression of Shh protein in epithelial ovarian carcinoma was significantly higher than that in benign ovarian tumor with statistically significant(P<0.05). Foxm1 protein showed weak positive expression in all normal ovarian tissues, while showed positive expression in benign ovarian tumor and epithelial ovarian carcinoma, the positive expression rate of which were respectively 11.11%(2/18), 44.44%(8/18) and 84.2%(32/38). The rate of Foxm1 Protein positive expression in epithelial ovarian carcinoma was significantly higher than that in benign ovarian tumor and normal ovarian tissues. The rate of Foxm1 Protein positive expression in benign ovarian tumor was significantly higher than that in normal ovarian tissues,by means of comparison methods, which were statistically significant(P<0.05).2 The Shh protein showed positive expression in different clinical stages of epithelial ovarian carcinoma tissues, 61.5%(8/13) in the early stage(stage I, II), 92.0%(23/25) in the late phase(stage III, IV) which had statistical significance(P<0.05); the Foxm1 protein also showed positive expression in different clinical Stages, 61.5%(8/13) in the early stage(stage I, II), 96.0%(24/25) in the late phase(stage III, IV) which had statistical significance(P<0.05).3 In epithelial ovarian carcinoma tissue of different pathological grading, the rate of positive expression of Shh protein was 56.3%(9/16) in moderately to highly differentiated group, while was 100%(22/22) in low differentiation group(P<0.05). The rate of positive expression of Foxm1 protein was 62.5%(10/16) in moderately to highly differentiated epithelial ovarian carcinoma tissue, while was 100%(22/22) in low differentiation group(P<0.05). All the differences were statistically significant.4 In epithelial ovarian carcinoma tissue with lymph node metastasis, the rate of positive expression of Shh protein in no lymph node metastasis group was 60.0%(9/15), while 95.7%(22/23) in lymph node metastasis group, which had significant differences(P<0.05). The rate of positive expression of Foxm1 protein in no lymph node metastasis group was 66.7%(10/15), while 95.7%(22/23) in lymph node metastasis group, which had significant differences(P<0.05).5 In different pathological types of epithelial ovarian cancer, the Shh protein and Foxm1 protein were expressed as follows: 86.4%(19/22) and 86.4%(19/22) in 22 cases of serous Carcinoma, 83.3%(10/12) and 75%(9/12) in 12 cases of mucinous carcinoma, 50%(1/2) and 100%(2/2) in 2 cases of endometrioid carcinoma, 50%(1/2) and 100%(2/2) in 2 cases of clear cell carcinoma. There was no significant difference of Shh protein and Foxm1 protein in different pathological types of epithelial ovarian cancer tissue.6 In epithelial ovarian carcinoma, the expression of Shh protein is positively correlated with that of Foxm1 protein, r=0.539, P<0.05.Conclusions:1 Shh protein showed negative expression in all normal ovarian tissues, while showed positive expression in benign ovarian tumor and epithelial ovarian carcinoma. The positive expression of Shh protein in epithelial ovarian carcinoma was significantly higher than that in benign ovarian tumor.2 The rate of positive expression of Shh protein in epithelial ovarian cancer was closely related to tumor staging, the cancer differentiation degree and lymph node metastasis. the later clinical stage,the lower differentiation of tumor and the metastatic lymphonode, the higher rate was the positive expression of Shh protein. The expression of Shh protein has nothing to do with pathological types of cancer tissue.3 Foxm1 protein expressed weakly positive in normal ovarian tissue, positive in benign ovarian tumor and epithelial ovarian cancer tissue. In three tissues positive expression levels gradually increased.4 The rate of positive expression of Foxm1 protein in epithelial ovarian cancer was closely related to tumor staging, the cancer differentiation degree and lymph node metastasis. The later clinical stage,the lower differentiation of tumor and the metastatic lymphonode, the higher rate was the positive expression of Foxm1 protein. The expression of Foxm1 protein has nothing to do with pathological types of cancer tissue.5 In epithelial ovarian carcinoma, the expression of Shh protein is positively correlated with that of Foxm1 protein. This shows that the two in ovarian cancer development plays a synergistic effect.In conclusion, this study has found that Shh and Foxm1 protein showed high expression in epithelial ovarian tumor(benign and malignant).The two were positively related to tumor staging, pathological grade and lymph node metastasis. Shh and its downstream target gene Foxm1 plays an important role in the ovary epithelial cell cancer development, invasion and metastasis process, its mechanism of action remains to be further studied. |
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