Clinical Value Of Peripheral Blood SCF In The Prediction Of Chemoresistance Of C-kit Positive Ovarian Cancer

Gynecological tumor is a common tumor of female reproductive system,and it is also a multiple tumor in human body.According to the statistics of the incidence and mortality of malignant tumors in 2009,the incidence of malignant tumors in female reproductive system is the top ten,which is more higher than that of male.Epithelial ovarian cancer(Epithelial ovarian cancer,EOC)grows in a hidden way,leading to difficult in early detection and diagnosis,there are about 70% patients who are diagnosed advanced cancer.So the ovarian malignant tumor mortality in gynecological malignant tumor,has become a serious threat to women's lives and health.At present,the main treatment of patients with Epithelial ovarian cancer depends on surgery and chemotherapy,most patients with Epithelial ovarian cancer have a higher response rate to chemotherapy based on platinum,combined chemotherapy based on platinum is recommended as the first-line chemotherapy for ovarian cancer.However,about 50% of patients recur and resist to chemotherapy.And the reatment of recurrent ovarian cancer with chemotherapy resistance has been clinically intractable.Recent studies have found that c-kit and SCF co-expressed on ovarian cancer,small cell lung cancer and intrahepatic cholangiocarcinoma,and plays an important role in the development of these malignant tumors.And high expression of c-kit suggests poor prognosis in many tumors.The abnormal expression of free SCF concentration of blood or abnormal SCF and c-kit protein in tumor cells,both can lead to abnormal tyrosine kinase signal transduction,disrupting the growth regulation,leading to tumor formation,has a great influence on the tumor resistance to chemotherapeutic drugs especially platinum drugs.Objective:To monitor the changes in the concentration of free stem cell factor(SCF)in peripheral blood and the expression of c-kit protein in ovarian cancer tissues,and to investigate the clinical value of early prediction of c-kit(+)in Epithelial ovarian cancer(EOC)resistance to platinum-based chemotherapy by monitoring SCF in peripheral blood.Methods:Expressions of c-kit and SCF were retrospectively studied with QDs double-labeling immunofluorescence technology in paraffin–embeded tissue specimens from 106 cases of EOC.The plasma concentration of the SCF were measured with enzyme linked immuno-sorbent assay(ELISA)from 46 EOC.To investigate the difference of SCF value in peripheral serum and c-kit expression of EOC patients who were sensitive and resistant to platinum-based chemotherapy.Results:In Epithelial ovarian cancer(EOC),the positive expression rate of c-kit in the chemoresistance group was 29.27%,it was statistically higher than chemosensitive group(10.8%)(p<0.05).The positive expression of c-kit in EOC was closely corralated with advanced FIGO clinical stages and chemotherapy-sensitivity.The positive rate increased in advanced stage(I-II 8.7%,III-IV 25%)(p<0.05).The mean plasma concentration of the SCF in the chemoresistance group was statistically higher than the chemosensitive group of EOC(p<0.05).The plasma concentration of the SCF in the Chemoresistance group was up-regulated after platinum-based chemotherapy.The mean value of the SCF in c-kit(+)group was higher than that in c-kit(-)group in Epithelial ovarian cancer(p=0.018),the plasma concentration of the SCF in c-kit(+)group was up-regulated after platinum-based chemotherapy.Conclusion:The abnormal expression of c-kit protein may play an important role in the progression and chemoresistance of EOC.The positive expression of c-kit protein in ovarian cancer stromal cell indicated poor clinical outcome.Monitoring of SCF in peripheral blood during platinum-based chemotherapy,the elevation of serum SCF may be one of the early prediction of chemotherapy resistance in the c-kit(+)EOC.