Cumulative alterations of p27Kip1‐related cell‐cycle regulators in the development of endometriosis‐associated ovarian clear cell adenocarcinoma

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This study found that alterations in p27(Kip1)-interacting cell-cycle regulators, including increased Skp2, Cks1, cyclin A, cyclin E, and decreased p27(Kip1), correlate with increased proliferation and progression from endometriosis to clear cell adenocarcinoma.

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Abstract

AIMS: To identify the key cell-cycle dysregulations in the development of endometriosis-associated ovarian clear cell adenocarcinoma (CCA). METHODS AND RESULTS: Expression of p27(Kip1)-interacting cell-cycle regulators, such as p27(Kip1) itself, Skp2, cyclin-dependent kinase subunit 1 (Cks1), cyclin A and cyclin E, and Ki67 labelling index (LI), were analysed by immunohistochemistry in 23 CCAs with 36 endometriotic or atypical endometriotic lesions adjacent to CCA from a cohort of 23 patients, and in 31 cases of solitary endometriosis. The cell-cycle regulators examined were overexpressed (Skp2, Cks1, cyclin A and cyclin E; P < 0.01, each) or down-regulated (p27(Kip1), P = 0.044) significantly more frequently in the CCAs than in the adjacent endometriosis. The frequency of Skp2 overexpression was significantly higher in atypical endometriosis than in endometriosis, and the frequency of Skp2 and cyclin A overexpression was significantly higher in CCA than in atypical endometriosis (P < 0.01, each). Mean Ki67 LI increased from endometriosis (8.4%) through atypical endometriosis (21.4%) to CCA (46.9%), with statistical significance between each component (P < 0.01, each). The frequency of cell-cycle regulator expression and mean Ki67 LIs were not significantly different between solitary endometriosis and endometriosis adjacent to CCA. CONCLUSIONS: Alteration of the p27(Kip1)-interacting cell-cycle regulators appeared strongly involved in the progression of endometriosis-associated ovarian clear cell carcinogenesis through increasing cell proliferative activity.

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Condition tags

endometriosis

MeSH descriptors

Adenocarcinoma, Clear Cell Cell Cycle Proteins Endometriosis Intracellular Signaling Peptides and Proteins Ovarian Neoplasms Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Carrier Proteins Carrier Proteins CDC2-CDC28 Kinases Cell Cycle Proteins Cyclin A Cyclin A Cyclin-Dependent Kinase Inhibitor p27 Cyclin-Dependent Kinases Cyclin-Dependent Kinases Down-Regulation Endometriosis Endometriosis

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