Objective: To evaluate the correlation of drug resistance proteins LRP (Lung Resistance Protein), Pgp (P-glycoprotein), MRP1 (Multidrug Related Protein, Multidrug Resistance-Associated Protein), MRP3 a MRP5 with clinical - pathological factors and to find the clinical outcome of these data in ovarian cancer patients.
Design: Prospective study.
Setting: Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine and University Hospital Hradec Kralove.
Methods: 111 patients with epithelial ovarian cancer who underwent primary surgery from 2006-2010 had specimens stained with imunohistochemistry for LRP, Pgp, MRP1, MRP3, MRP5.
Results: The histological subtype of epithelial ovarian cancer correlated to the LRP, Pgp, MRP1 and MRP3 expression. Patients with late ovarian cancer had a higher MRP1 compared to early stage ovarian cancer (I+II 71.6% (CI 60-100), III+IV 83.6% (CI 100-100),p = 0.03). Correlation of MRP1 with grading was found(G1 60.83% (CI 10-100), G2 36.80% (CI 20-100),G3 88.87% (CI 100-100), p = 0.039). Patients with high Pgp, MRP1 and MRP3 expression had significantly shorter progression-free survival. (Kaplan-Meier test - PFS, Pgp < 85% Med PFS 23 months (CI 8-37) vs > 85% Med PFS 11 months (CI 7-17), p = 0.054), (MRP1 < 85% Med PFS 33 months (CI 11-49) vs > 85% Med PFS 11 months(CI 7-16), p = 0.046).
Conclusion: We found clinical significance of LRP, Pgp, MRP1 and MRP3 expression in ovarian cancer patients. MRP5 expression did not correlate with neither histo-pathological parameters nor progression free survival. MRP1 have some additional predictive and prognostic value for the clinical outcome of patients with ovarian carcinoma.