The Prognostic Value of Syndecan-1 in Ovarian Cancer Patients with Long-Term Follow up

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Introduction:Syndecan-1 plays a role in the cell regulation through cell-extracellular matrix adhesion, cell-cell adhesion, migration, and morphogenesis. It functions as a co-receptor for several growth factors, modulating the affinity of the growth-factor receptor interactions. Syndecan-1 has been investigated as a prognostic factor for several malignant cancer types, but its role still seems unclear. The purpose of the present study was to investigate the possible role of syndecan-1 as a prognostic factor in ovarian cancer.Methods:The expression of syndecan-1 was examined in ovarian cancer specimens from 164 patients who were enrolled in a Danish protocol after primary surgery in the period from 1991 to 1994. Immunohistochemistry and tissue microarrays (TMAs) were used for the detection of syndecan-1 in both tumor epithelial and stromal cells.Results:The median duration of follow-up for those still alive was 18 years. Positive tumor epithelial syndecan-1 staining was found in 18% of the patients, whereas positive stromal syndecan-1 immunoreactivity was seen in 50% of the patients. Positive expression of syndecan-1 in epithelial cells was observed less frequently in serous adenocarcinoma, whereas positive stromal expression was found more frequently in poorly differentiated tumors. Positive epithelial syndecan-1 expression was associated with unfavorable overall survival (OS) in univariate analysis (P = 0.02), which, however, was not confirmed in multivariate analysis, although there was a tendency (P = 0.12) and a hazard ratio of 1.52.Conclusion:Syndecan-1 is present in a subset of ovarian carcinomas and may be an indicator of survival, but further investigations are required.

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