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European Journal of Gynaecological Oncology  2021, Vol. 42 Issue (4): 782-787    DOI: 10.31083/j.ejgo4204118
Special Issue: Immunology in Gynecological Cancer
Original Research Previous articles | Next articles
Association of cancer-associated fibroblasts and survival in malignant ovarian neoplasms
Ana Carolinne da Silva1, Millena Prata Jammal1, Renata Margarida Etchebehere2, Eddie Fernando Candido Murta1, Rosekeila Simões Nomelini1, *()
1Department of Gynecology and Obstetrics/Research Institute of Oncology (IPON), Federal University of Triângulo Mineiro, 38025-440 Uberaba-MG, Brazil
2Surgical Pathology Service, Federal University of Triângulo Mineiro, 38025-440 Uberaba-MG, Brazil
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Abstract  
Objective: The aims of the study were to compare the stromal immunostaining of smooth muscle alpha-actin (α-SMA) and fibroblast activation protein-α (FAP) between borderline ovarian tumors and epithelial ovarian cancer, and to evaluate their association in overall survival (OS) and disease-free survival (DFS) in patients with ovarian cancer. Methods: Patients diagnosed with malignant (n = 28) and borderline ovarian tumors (n = 18) were evaluated. Immunohistochemical study of stromal α-SMA and FAP was carried out. The comparison of immunostaining between borderline and malignant ovarian tumors was performed using Fisher's exact test. Survival was assessed by the Kaplan-Meier method and the log-rank test. Multivariate analysis was performed by Cox regression. The differences were considered significant for p < 0.05. Results: Evaluating stromal FAP, stronger immunostaining (2 and 3) was more often found in epithelial ovarian cancer than in borderline ovarian tumors (p = 0.0331). There was no statistical significance in the assessment of α-SMA. Evaluating only patients with epithelial ovarian cancer, there was a higher OS in patients with stromal α-SMA immunostaining 3 (p = 0.017). There was no statistical significance when evaluating OS and DFS in patients with stromal FAP immunostaining, nor evaluating DFS in patients with α-SMA stromal immunostaining 3. After multivariate analysis, patients with stromal α-SMA immunostaining 3 had higher OS compared to immunostaining 0, 1 or 2 [OR (95% CI) = 0.107 (0.018–0.649), p = 0.015]. Conclusion: Stronger FAP immunostaining was more often found in epithelial ovarian cancer than in borderline ovarian tumors. In epithelial ovarian cancer, there was a higher OS in patients with stromal α-SMA immunostaining 3.
Key words:  Epithelial ovarian cancer      Borderline ovarian tumors      Smooth muscle alpha-actin      Fibroblast activation protein-α      Tumor microenvironment      Overall survival     
Submitted:  18 April 2021      Revised:  01 June 2021      Accepted:  21 June 2021      Published:  15 August 2021     
Fund: 
AREMG (Associação de Apoio à Residência Médica—Minas Gerais)
CNPq (Conselho Nacional de De-senvolvimento Científico e Tecnológico)
FUNEPU (Fun-dação de Ensino e Pesquisa de Uberaba)
FAPEMIG (Fun-dação de Amparo à Pesquisa do Estado de Minas Gerais)
CAPES (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil)
*Corresponding Author(s):  rosekeila@terra.com.br; rosekeila.nomelini@pesquisador.cnpq.br (Rosekeila Simões Nomelini)   

Cite this article: 

Ana Carolinne da Silva, Millena Prata Jammal, Renata Margarida Etchebehere, Eddie Fernando Candido Murta, Rosekeila Simões Nomelini. Association of cancer-associated fibroblasts and survival in malignant ovarian neoplasms. European Journal of Gynaecological Oncology, 2021, 42(4): 782-787.

URL: 

https://ejgo.imrpress.com/EN/10.31083/j.ejgo4204118     OR     https://ejgo.imrpress.com/EN/Y2021/V42/I4/782

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