Prognostic importance of survivin, Ki-67, and topoisomerase IIα in ovarian carcinoma

Stage, tumor grade and histological subtype determine the clinical behavior in ovarian tumors. Some additional factors are related to tumor cell biology and are the useful predictors for identifying the patients with poor prognosis. The aim of this study is to evaluate the prognostic significance of survivin, Ki-67 and Topoisomerase II alpha (TOPO II alpha) in epithelial ovarian cancer (EOC). Seventy-three patients with EOC were included in this study. Survivin, Ki-67 and TOPO II alpha expressions were studied by immunohistochemistry on formalin-fixed, paraffin-embedded tissue sections. Nuclear staining for all antibodies was scored on a three-tiered system and more than 10 % staining was accepted as expression. The relationship between the expressions of survivin, Ki-67, TOPO II alpha and clinicopathological parameters including age, stage, grade, platinum resistance and survival was evaluated. Survivin, Ki-67 and TOPO II alpha expressions were found in 20, 82 and 86 % of the tumors, respectively. Ki-67 and TOPO II alpha expressions were found to be related to poor overall survival (p = 0.005, 0.004, respectively), while survivin expression was not associated with overall survival. There was no association between TOPO II alpha and Ki-67 expressions and histological subtype, stage or grade. However, we found an important relationship between TOPO II alpha expression and platinum resistance (p = 0.044). Platinum resistance was found to be an independent prognostic factor in EOC. Ki-67 and TOPO II alpha expressions were found to be related to poor overall survival, and TOPO II alpha expression was found to be associated with platinum resistance.