[Identification and prognostic value of differentially expressed proteins of patients with platinum resistance epithelial ovarian cancer in serum].

OBJECTIVE: To identified differentially expressed proteins associated with platinum resistance in platinum resistance epithelial oarian cancer(EOC)patients in serum and investigate their clinical value.

METHODS: A total of 106 patients withoverian tumor in affiliated tumor hospital of Guangxi Medical University from August 1998 to September 2013 were enrolled in this study, which include 52 cases od platinum-sensitive(PTS), 44 cases of platinum-resistant(PTR)and 10 cases of benign ovarian cyst(BOC). Thirty-three cases of normal women proceeded physical examination in our hospital in 2008 were chosen as control group(NC). Four groups of patients serum samples of 4 groups were collected and preserved.(1)Differentially express level of serum proteins of 10 cases of every group(PTS & PTR vs NC, PTS & PTR vs BOC, PTS vs PTR)were identified with isobaric tags for relative and absolute quantitative(iTRAQ)based quantitative proteomic approach and then was subjected to bioinformatics analysis.(2)Proteins that played a important role in multidrug resistance were validated by western blot(WB)and ELISA in 44 PTR patients, 52 PRS patients and 33 NC women.(3)Pearson correlation analysis was used to explain the relationship between proteins and clinical pathological parameters of PTR individuals. Kaplan-Meier method was supposed to explore serum biomarkers associated with clinical prognosis data. Receiver operating characteristic(ROC)curves were used to determine the diagnostic value of the markers.

RESULTS: (1)Based on the result of bioinformatics analysis, 56 proteins, 39 proteins and 62 proteins were identified respectively among PTS & PTR vs NC, PTS & PTR vs BOC, PTS vs PTR. It showed that C6 and CNTN1 have a positive seletion effect among Asians and BCHE among Europeans through searching Haplotter database. CRP, FN1, S100A9, TF, ALB, VWF, APOC2, APOE, CD44, F2, GPX3 and ACTB proein were further verified related with platinum resistance by taking intersection analysis in the COREMINE database and TCGA.(2)The expression level of SERPINA1 protein in serum of PTR group, PTS group and NC groupwere 41.7±9.2, 32.8±6.6 and 14.2±3.6 respectively using WB assay, and(816±246),(686±205)and(756 ± 244)μg/μl respectively using ELISA; the expression level of ORM1 protein in PTR, PTS and NC serum were 37.9±7.0, 27.0±22.5 and 21.7±2.6 respectively using WB assay, and(221±35),(174±23)and(157±18)μg/μl respectively using ELISA; the expression level of FN1 protein in PTR, PTS and NC serum were 30.3±11.4, 18.2±5.2, 23.7±3.9 respectively by WB assay, and(71±13),(62±13),(69±13)ng/μl respectively by ELISA; the expression level of GPX3 protein in PTR, PTS and NC serum were 1.2±0.3, 2.2± 0.3, 1.6±0.3 respectively WB assay. The expression of each protein by using western blot method and ELISA method had the same trend as that using iTRAQ technology.(3)Pearson correlation analysis showed, the expression of SERPINA1, FN1 and ORM1 had a positive correlation with recurrence and death of PTR patients(P <0.01, P <0.05), but was negatively correlated with progress free survival of PTR patients(P <0.05). Kaplan-Meier analysis indicated that clinical stage, initial treatment outcomes, the express level of SERPINA1, FN1 and ORM1 were significantly related with progression-free survival(P <0.05), the initial treatment outcomes was related with overall survival(P=0.027). The overall predictive accuracy of each protein was reflected by the area under the ROC curve(AUC), FN1 ORM1 and SERPINA with ROC areas of 0.679, 0.910 and 0.666 respectively. The diagnosis value of ORM1 protein in ovarian cancer patients with platinum resistance performance is significantly higher than that of FN1 and SERPINA1 protein(P=0.000) CONCLUSIONS: The differentially express level of FN1, SERPINA1 and ORM1 between PTS and PTR play a essential role in measuring subtle changes in response to platinum-based chemotherapy and may be involved in biological processes of platinum resistance. ORM1 has higher diagnostic efficiency of platinum resistance in ovarian cancer patients. It may be a promising candidate biomarker for screening and diagnosis of ovarian cancer patients with platinum resistance.