抄録
Objective: Clear cell adenocarcinoma of the
ovary is more resistant to chemotherapy and has a
worse prognosis than other ovarian carcinomas. In
order to clarify the factors that contribute to the
poor prognosis of clear cell adenocarcinomas, we
examined the expression of proliferation- and
apoptosis-related factors. In addition, we attempted
to discover correlations between the structure of
clear cell adenocarcinomas and prognosis.
Material and Methods: We evaluated clinicopathological
data on 39 patients with ovarian clear cell
adenocarcinoma who underwent resection at the
Tokyo Medical and Dental University Hospital. The
tumors were examined for the expression of proliferation-
related factors (mitotic index, Ki-67 labeling
index) and apoptosis-related factors (apoptotic
index, bcl-2 and p53). In addition, we investigated
correlations between the expression of these factors
and the cell types and structure of the
tumors. Results: High bcl-2 expression and low
apoptotic index were associated with a reduced
survival rate. The survival rate of patients with
tumors of the hobnail cell type was shorter than
that of patients with clear cell type, and expression
of bcl-2 was significantly associated with the hobnail
cell type. Tumors with a papillary structure
showed lower apoptotic index and the patients had
a lower survival rate than those with a tubulocystic
structure. Conclusion: The results of the current
study suggest that a low apoptotic activity controlled
by bcl-2 correlated with shorter survival in
patients with ovarian clear cell adenocarcinoma.
The cases with poorer prognosis, associated with
higher expression of bcl-2 and lower expression of
apoptosis-related factors, may be discerned by
morphological characteristics of routinely sampled
specimens.
