Background
Materials and methods
Patients
Immunohistochemical staining
Statistical analysis
Results
CN is downregulated in later-stage tumors in unique subtype of ovarian cancer
The upregulation of CN expression is associated with a poor prognosis in unique subtype of ovarian cancer
Clinical parameters | CN expression | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Total type | Clear-cell carcinoma | Serous carcinoma | Papillary serous cystadenocarcinoma | |||||||||
N | Mean ± SD | p-value | N | Mean ± SD | p-value | N | Mean ± SD | p-value | N | Mean ± SD | p-value | |
Age (years) | ||||||||||||
< 50 | 20 | 38.25 ± 35.81 | 0.14 | 9 | 51.11 ± 38.87 | 0.63 | 3 | 26.67 ± 25.17 | 0.38 | 8 | 28.13 ± 34.43 | 0.15 |
≧50 | 21 | 53.33 ± 30.39 | 8 | 60.00 ± 31.17 | 6 | 48.33 ± 35.50 | 7 | 50.00 ± 28.28 | ||||
Pathological stage | ||||||||||||
I~II | 22 | 31.00 ± 22.73 | 0.16 | 8 | 45.00 ± 21.86 | 0.10 | 4 | 18.00 ± 22.50 | 0.03* | 10 | 25.00 ± 31.23 | 0.25 |
III~IV | 18 | 60.28 ± 33.72 | 8 | 71.25 ± 22.48 | 5 | 58.00 ± 21.50 | 5 | 45.00 ± 32.75 | ||||
Tumor size (mm3) | ||||||||||||
< 395 | 20 | 35.25 ± 35.67 | 0.04* | 5 | 36.00 ± 39.12 | 0.20 | 6 | 36.67 ± 28.30 | 0.35 | 9 | 33.89 ± 36.55 | 0.39 |
≧395 | 21 | 56.19 ± 28.72 | 12 | 63.33 ± 30.85 | 3 | 50.00 ± 20.00 | 6 | 45.00 ± 27.39 | ||||
LN metastasis | ||||||||||||
No | 24 | 31.25 ± 31.53 | 0.26 | 10 | 46.00 ± 32.04 | 0.12 | 4 | 20.00 ± 24.50 | 0.11 | 10 | 25.00 ± 31.23 | 0.25 |
Yes | 17 | 52.65 ± 36.23 | 7 | 68.57 ± 36.25 | 5 | 58.00 ± 29.50 | 5 | 45.00 ± 32.75 | ||||
Distant metastasis | ||||||||||||
No | 40 | 40.13 ± 34.02 | 0.89 | 16 | 40.25 ± 35.57 | 0.68 | 9 | 41.11 ± 32.58 | ─ | 15 | 38.33 ± 32.61 | ─ |
Yes | 1 | 40 ± 0 | 1 | 60 ± 0 | 0 | ─ | 0 | ─ | ||||
Ascites | ||||||||||||
No | 21 | 45.24 ± 33.11 | 0.88 | 10 | 52.00 ± 34.90 | 0.66 | 6 | 36.67 ± 38.30 | 0.55 | 5 | 42.00 ± 25.88 | 0.68 |
Yes | 20 | 46.75 ± 34.95 | 7 | 60.00 ± 36.52 | 3 | 50.00 ± 20.00 | 10 | 36.50 ± 36.67 | ||||
Chemotherapeutic response | ||||||||||||
No | 2 | 50.00 ± 56.57 | 0.91 | 1 | 90.00 ± 0 | 0.32 | 0 | ─ | ─ | 1 | 10 ± 0 | 0.62 |
Yes | 32 | 47.34 ± 33.41 | 13 | 53.85 ± 35.72 | 7 | 50.00 ± 31.09 | 12 | 38.75 ± 33.04 | ||||
Chemotherapeutic resistance | ||||||||||||
No | 18 | 35.83 ± 30.01 | 0.49 | 5 | 46.00 ± 28.81 | 0.81 | 2 | 15.00 ± 21.21 | ─ | 11 | 35.00 ± 31.86 | 0.49 |
Yes | 8 | 45.00 ± 33.81 | 4 | 42.50 ± 35.00 | 0 | ─ | 4 | 47.50 ± 37.75 | ||||
CA125 (U/ml) | ||||||||||||
< 324 | 22 | 48.86 ± 34.22 | 0.66 | 11 | 51.82 ± 37.10 | 0.04* | 3 | 50.00 ± 20.00 | 0.55 | 8 | 44.38 ± 37.36 | 0.61 |
≧324 | 18 | 44.44 ± 33.47 | 5 | 72.00 ± 21.68 | 6 | 36.67 ± 38.30 | 7 | 31.43 ± 27.34 | ||||
CA19–9 (U/ml) | ||||||||||||
< 21.55 | 21 | 50.00 ± 37.68 | 0.69 | 8 | 65.00 ± 34.23 | 0.90 | 6 | 41.67 ± 39.71 | 1.00 | 7 | 40.00 ± 39.58 | 0.71 |
≧21.55 | 17 | 44.71 ± 28.75 | 7 | 50.00 ± 36.52 | 3 | 40.00 ± 17.32 | 7 | 41.43 ± 26.73 | ||||
CA72–4 (U/ml) | ||||||||||||
< 7.89 | 19 | 47.89 ± 37.94 | 0.98 | 8 | 58.75 ± 39.80 | 0.83 | 3 | 23.33 ± 40.42 | 0.38 | 8 | 46.25 ± 35.43 | 0.39 |
≧7.89 | 21 | 45.95 ± 29.90 | 8 | 57.50 ± 29.16 | 6 | 50.00 ± 27.57 | 7 | 29.29 ± 28.93 | ||||
AFP (ng/mL) | ||||||||||||
< 2.9 | 22 | 28.86 ± 20.08 | 0.24 | 7 | 57.14 ± 27.52 | 0.63 | 3 | 40.00 ± 36.06 | 0.91 | 12 | 6.67 ± 5.77 | 0.03* |
≧2.9 | 18 | 44.44 ± 28.08 | 9 | 58.88 ± 39.51 | 6 | 41.67 ± 34.30 | 3 | 46.25 ± 31.70 | ||||
CEA (ng/mL) | ||||||||||||
< 1.48 | 17 | 48.82 ± 27.36 | 0.83 | 8 | 45.00 ± 34.23 | 0.14 | 4 | 47.50 ± 320.62 | 0.56 | 5 | 56.00 ± 23.02 | 0.15 |
≧1.48 | 22 | 47.05 ± 38.07 | 8 | 71.25 ± 29.49 | 5 | 36.00 ± 41.59 | 9 | 31.67 ± 35.36 |
Clinical parameters | Disease-free survival (months) | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Total type | Clear-cell carcinoma | Serous carcinoma | Papillary serous cystadenocarcinoma | |||||||||||||
N | Mean | 95% CI | p-value | N | Mean | 95% CI | p-value | N | Mean | 95% CI | p-value | N | Mean | 95% CI | p-value | |
CN expression | ||||||||||||||||
≦50 | 24 | 97.67 | 73.67, 121.66 | 0.41 | 7 | 77.70 | 60.20, 95.20 | 0.27 | 7 | 143.33 | 92.76, 191.53 | 0.43 | 10 | 62.80 | 42.71, 82.89 | 0.89 |
>50 | 17 | 87.15 | 72.12, 102.19 | 10 | 56.29 | 26.30, 86.27 | 2 | 116.39 | 95.55, 160.14 | 5 | 64.60 | 46.88, 82.32 | ||||
Age (years) | ||||||||||||||||
<50 | 26 | 181.38 | 157.41, 205.34 | < 0.01* | 10 | 83.33 | 69.17, 97.50 | 0.07 | 7 | 188.30 | 163.97, 212.63 | 0.04* | 9 | 66.71 | 46.30, 87.12 | 0.50 |
≧50 | 24 | 82.12 | 59.05, 105.19 | 9 | 51.60 | 26.31, 76.87 | 8 | 98.49 | 77.65, 142.24 | 7 | 57.33 | 36.48, 78.19 | ||||
Pathological stage | ||||||||||||||||
I~II | 29 | 167.83 | 141.87, 193.79 | 0.09 | 9 | 76.78 | 57.89, 95.67 | 0.52 | 10 | 168.30 | 123.97, 212.63 | 0.99 | 10 | 73.40 | 60.50, 86.30 | 0.04* |
III~IV | 20 | 68.24 | 48.96, 87.52 | 9 | 64.22 | 39.29, 89.16 | 5 | 86.80 | 56.65, 116.95 | 6 | 40.17 | 14.87, 65.46 | ||||
Tumor size (mm3) | ||||||||||||||||
< 395 | 26 | 132.37 | 97.50, 167.24 | 0.19 | 5 | 75.60 | 59.41, 91.78 | 0.06 | 12 | 154.33 | 103.76, 202.53 | 0.36 | 9 | 65.29 | 43.36, 87.21 | 0.08 |
≧395 | 24 | 86.30 | 72.20, 100.40 | 14 | 42.40 | 7.14, 77.66 | 3 | 96.39 | 75.55, 140.14 | 7 | 58.44 | 38.35, 78.54 | ||||
LN metastasis | ||||||||||||||||
No | 31 | 163.70 | 137.35, 190.06 | 0.08 | 11 | 72.64 | 54.13, 91.15 | 0.55 | 10 | 168.30 | 123.97, 212.63 | 0.99 | 10 | 73.40 | 60.50, 86.30 | 0.04* |
Yes | 19 | 65.44 | 45.02, 85.86 | 8 | 58.75 | 29.89, 87.61 | 5 | 86.80 | 56.65, 116.95 | 6 | 40.17 | 14.87, 65.46 | ||||
Distant metastasis | ||||||||||||||||
No | 48 | 153.55 | 130.07, 177.03 | 0.02* | 18 | 69.19 | 52.48, 85.89 | 0.17 | 15 | 167.80 | 131.11, 204.49 | ─ | 15 | 64.20 | 49.30, 79.10 | 0.15 |
Yes | 2 | 21.00 | 19.04, 22.96 | 1 | 22.00 | 22.00, 22.00 | 0 | ─ | ─ | 1 | 20.00 | 20.00, 20.00 | ||||
Ascites | ||||||||||||||||
No | 26 | 153.63 | 121.72, 185.54 | 0.63 | 10 | 66.00 | 43.09, 88.91 | 0.98 | 11 | 164.33 | 113.76, 212.53 | 0.27 | 5 | 77.80 | 66.93, 88.67 | 0.29 |
Yes | 24 | 75.63 | 59.23, 92.02 | 9 | 67.44 | 44.19, 90.70 | 4 | 97.49 | 76.65, 141.24 | 11 | 54.00 | 34.39, 73.61 | ||||
Chemotherapeutic response | ||||||||||||||||
No | 2 | 51.00 | 0, 105.05 | 0.60 | 1 | 82.00 | 82.00, 82.00 | 0.48 | 0 | ─ | ─ | ─ | 1 | 20.00 | 20.00, 20.00 | 0.07 |
Yes | 37 | 95.81 | 77.57, 114.05 | 15 | 64.06 | 41.89, 86.23 | 10 | 102.80 | 70.29, 135.31 | 12 | 65.25 | 49.35, 81.15 | ||||
Chemotherapeutic resistance | ||||||||||||||||
No | 21 | 126.95 | 109.94, 143.96 | < 0.01* | 5 | 73.20 | 50.76, 95.64 | 0.12 | 5 | 141.30 | 70.29, 212.31 | 0.02* | 11 | 75.09 | 63.04, 87.15 | < 0.01* |
Yes | 11 | 31.95 | 16.56, 47.33 | 5 | 32.60 | 8.37, 56.83 | 1 | 32.00 | 32.00, 32.00 | 5 | 30.20 | 8.41, 51.99 | ||||
CA125 (U/ml) | ||||||||||||||||
< 324 | 24 | 133.50 | 97.04, 169.96 | 0.18 | 11 | 78.46 | 62.08, 94.83 | 0.27 | 5 | 162.44 | 111.65, 213.24 | 0.85 | 8 | 71.13 | 54.12, 88.13 | 0.28 |
≧324 | 24 | 88.03 | 75.20, 100.86 | 7 | 56.00 | 26.65, 85.35 | 9 | 90.20 | 66.01, 114.39 | 8 | 51.75 | 29.15, 74.35 | ||||
CA19–9 (U/ml) | ||||||||||||||||
< 21.55 | 24 | 147.26 | 112.14, 182.39 | 0.86 | 8 | 71.38 | 47.59, 95.16 | 0.71 | 8 | 153.29 | 93.79, 212.78 | 0.51 | 8 | 55.38 | 35.44, 75.31 | 0.55 |
≧21.55 | 23 | 105.67 | 84.02, 127.31 | 7 | 66.06 | 42.89, 89.23 | 7 | 124.50 | 96.08, 152.92 | 7 | 64.00 | 40.54, 87.46 | ||||
CA72–4 (U/ml) | ||||||||||||||||
< 7.89 | 25 | 174.20 | 147.38, 201.03 | 0.04* | 8 | 80.00 | 59.83, 100.17 | 0.21 | 9 | 164.33 | 115.76, 212.91 | 0.80 | 8 | 74.75 | 59.62, 89.88 | 0.05* |
≧7.89 | 24 | 69.33 | 52.59, 86.08 | 10 | 60.74 | 38.11, 83.37 | 6 | 89.67 | 64.02, 115.31 | 8 | 47.25 | 25.78, 76.36 | ||||
AFP (ng/mL) | ||||||||||||||||
< 2.9 | 25 | 148.04 | 113.12, 182.97 | 0.82 | 7 | 79.00 | 66.73, 91.27 | 0.31 | 6 | 183.33 | 145.14, 221.52 | 0.30 | 12 | 65.25 | 49.35, 81.15 | 0.49 |
≧2.9 | 24 | 105.84 | 86.19, 125.49 | 11 | 61.10 | 37.54, 84.64 | 9 | 99.83 | 57.55, 142.12 | 4 | 50.00 | 16.57, 83. 44 | ||||
CEA (ng/mL) | ||||||||||||||||
< 1.48 | 24 | 180.33 | 155.28, 205.39 | 0.03* | 10 | 81.49 | 69.17, 97.50 | 0.02* | 8 | 177.14 | 128.41, 225.88 | 0.67 | 6 | 58.67 | 37.69, 79.65 | 0.39 |
≧1.48 | 24 | 89.07 | 66.13, 112.02 | 8 | 31.60 | 16.31, 56.87 | 7 | 109.38 | 76.09, 142.66 | 9 | 68.44 | 49.41, 87.48 |
Clinical parameters | Overall survival (months) | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Total type | Clear-cell carcinoma | Serous carcinoma | Papillary serous cystadenocarcinoma | |||||||||||||
N | Mean | 95%CI | p-value | N | Mean | 95%CI | p-value | N | Mean | 95%CI | p-value | N | Mean | 95%CI | p-value | |
CN | ||||||||||||||||
≦50 | 24 | 96.73 | 76.00, 117.46 | 0.53 | 7 | 73.57 | 53.15, 93.99 | 0.73 | 7 | 69.29 | 34.03, 104.54 | 0.03* | 10 | 73.33 | 59.06, 87.61 | 0.27 |
>50 | 17 | 63.24 | 49.45, 77.02 | 10 | 69.8 | 52.34, 87.26 | 2 | 22.00 | 10.24, 33.76 | 5 | 59.4 | 39.98, 78.82 | ||||
Age (years) | ||||||||||||||||
< 50 | 26 | 140.79 | 106.30, 175.28 | 0.30 | 10 | 79.56 | 65.43, 93.69 | 0.18 | 7 | 118.88 | 52.82, 184.93 | 0.63 | 9 | 73.44 | 60.56, 86.33 | 0.91 |
≧50 | 24 | 86.20 | 67.27, 105.12 | 9 | 60.40 | 40.08, 80.72 | 8 | 72.71 | 40.43, 105.00 | 7 | 63.00 | 44.19, 81.86 | ||||
Pathological stage | ||||||||||||||||
I~II | 29 | 160.80 | 133.60, 188.00 | < 0.01* | 9 | 87.56 | 81.19, 93.92 | 0.03* | 10 | 143.50 | 91.66, 195.34 | < 0.01* | 10 | 70.20 | 56.49, 83.91 | 0.26 |
III~IV | 20 | 53.05 | 40.27, 65.83 | 9 | 55.67 | 34.21, 77.12 | 5 | 31.80 | 24.86, 38.74 | 6 | 65.17 | 46.86, 83.47 | ||||
Tumor size (mm3) | ||||||||||||||||
< 395 | 26 | 123.50 | 91.08, 155.92 | 0.71 | 5 | 66.60 | 40.40, 92.80 | 0.81 | 12 | 110.33 | 61.84, 158.82 | 0.67 | 9 | 71.33 | 57.58, 85.09 | 0.98 |
≧395 | 24 | 68.00 | 56.19, 79.81 | 14 | 70.50 | 55.05, 85.95 | 3 | 48.00 | 22.28, 73.72 | 7 | 65.71 | 47.24, 84.19 | ||||
LN metastasis | ||||||||||||||||
No | 31 | 158.09 | 131.28, 184.90 | < 0.01* | 11 | 82.91 | 72.21, 93.61 | 0.02* | 10 | 143.50 | 91.66, 195.34 | < 0.01* | 10 | 70.20 | 56.49, 83.91 | 0.26 |
Yes | 19 | 50.95 | 38.08, 63.82 | 8 | 51.00 | 28.58, 73.43 | 5 | 31.80 | 24.86, 38.74 | 6 | 65.17 | 46.86, 83.47 | ||||
Distant metastasis | ||||||||||||||||
No | 48 | 127.95 | 103.85, 152.05 | 0.88 | 18 | 82.46 | 76.09, 88.82 | 0.49 | 15 | 106.27 | 63.19, 149.34 | ─ | 15 | 69.53 | 57.31, 81.76 | 0.39 |
Yes | 2 | 75.00 | 66.68, 83.32 | 1 | 81.00 | 81.00, 81.00 | 0 | ─ | ─ | 1 | 69.00 | 69.00, 69.00 | ||||
Ascites | ||||||||||||||||
No | 26 | 134.35 | 101.53, 167.16 | 0.59 | 10 | 65.50 | 49.72, 81.28 | 0.84 | 11 | 113.46 | 60.45, 166.46 | 0.65 | 5 | 80.40 | 74.09, 86.71 | 0.19 |
Yes | 24 | 66.34 | 54.61, 78.06 | 9 | 70.56 | 50.00, 91.11 | 4 | 55.00 | 32.34, 77.66 | 11 | 63.64 | 48.48, 78.79 | ||||
Chemotherapeutic response | ||||||||||||||||
No | 2 | 66.00 | 38.28, 93.72 | 0.99 | 1 | 46.00 | 46.00, 46.00 | 0.27 | 0 | ─ | ─ | ─ | 1 | 86.00 | 86.00, 86.00 | 0.47 |
Yes | 37 | 91.51 | 75.18, 107.84 | 15 | 70.60 | 55.21, 85.99 | 10 | 66.40 | 37.16, 95.64 | 12 | 85.75 | 78.54, 92.96 | ||||
Chemotherapeutic resistance | ||||||||||||||||
No | 21 | 125.89 | 110.57, 141.23 | < 0.01* | 5 | 88.56 | 82.19, 94.92 | 0.01* | 5 | 123.00 | 87.94, 158.06 | 0.24 | 11 | 77.12 | 68.46, 85.77 | 0.02* |
Yes | 11 | 52.27 | 37.78, 66.76 | 5 | 49.00 | 26.58, 71.43 | 1 | 59.00 | 59.00, 59.00 | 5 | 49.60 | 27.15, 72.05 | ||||
CA125 (U/ml) | ||||||||||||||||
< 324 | 24 | 120.68 | 85.63, 155.73 | 0.49 | 11 | 77.27 | 63.36, 91.19 | 0.41 | 5 | 113.89 | 55.42, 172.36 | 0.43 | 8 | 74.18 | 59.48, 88.87 | 0.56 |
≧324 | 24 | 71.67 | 61.36, 81.87 | 7 | 59.86 | 36.36, 83.36 | 9 | 50.40 | 29.89, 70.90 | 8 | 63.88 | 47.47, 80.28 | ||||
CA19–9 (U/ml) | ||||||||||||||||
< 21.55 | 24 | 130.61 | 94.49, 166.73 | 0.75 | 8 | 81.25 | 63.37, 99.13 | 0.21 | 8 | 134.29 | 64.96, 203.61 | 0.22 | 8 | 76.88 | 67.98, 85.77 | 0.60 |
≧21.55 | 23 | 99.98 | 80.42, 119.54 | 9 | 64.56 | 47.29, 81.82 | 7 | 65.75 | 34.39, 97.11 | 7 | 59.00 | 37.42, 80.58 | ||||
CA72–4 (U/ml) | ||||||||||||||||
< 7.89 | 25 | 164.61 | 134.70, 194.52 | < 0.01* | 8 | 86.56 | 80.19, 92.92 | 0.01* | 9 | 134.56 | 76.93, 192.18 | 0.10 | 8 | 69.13 | 52.32, 85.93 | 0.26 |
≧7.89 | 24 | 56.17 | 45.78, 66.56 | 10 | 53.67 | 32.21, 75.12 | 6 | 42.83 | 29.35, 56.31 | 8 | 67.88 | 53.35, 82.40 | ||||
AFP (ng/mL) | ||||||||||||||||
< 2.9 | 25 | 142.27 | 108.32, 176.22 | 0.32 | 7 | 73.00 | 55.03, 90.97 | 0.60 | 6 | 115.00 | 57.28, 172.72 | 0.54 | 12 | 81.75 | 74.54, 88.96 | 0.37 |
≧2.9 | 24 | 87.09 | 67.74, 106.44 | 11 | 66.57 | 48.66, 84.48 | 9 | 70.83 | 32.42, 109.25 | 4 | 64.01 | 50.29, 77.73 | ||||
CEA (ng/mL) | ||||||||||||||||
< 1.48 | 24 | 141.13 | 106.79, 175.46 | 0.28 | 10 | 78.13 | 62.51, 93.74 | 0.45 | 8 | 132.43 | 61.69, 203.16 | 0.28 | 6 | 72.33 | 62.58, 82.09 | 0.95 |
≧1.48 | 24 | 85.70 | 65.99, 105.41 | 8 | 62.80 | 44.44, 81.16 | 7 | 66.63 | 36.26, 96.99 | 9 | 63.56 | 45.83, 81.28 |