Role of integrins in the metastatic spread of high-grade serous ovarian cancer

Purpose Integrins may be involved in the metastatic spread of high-grade serous ovarian cancer (HGSOC) which determines the therapeutical approach and prognosis. We investigated the integrin expression in primary tumor and metastases of advanced HGSOC. Methods The expression of integrin alpha 2, alpha 4, alpha 5, alpha 6, and beta 1 was assessed by immunostaining in tumor samples of the ovary, omentum, and peritoneum of each patient. Differences in integrin expression among tumor localizations and their association with clinicopathological parameters were examined by Fisher's exact test. The impact of integrin expression on progression-free survival (PFS) and overall survival (OS) was examined by Cox regression and Kaplan-Meier analyses. Results Hundred and thirteen tumor samples of 40 HGSOC patients were examined. The expression of the integrins did not differ between the three tumor localizations (all p values > 0.05) with the exception of high expression of integrin alpha 4 in primary tumor and omentum (52.5% versus 47.5%, p = 0.008) and primary tumor and peritoneum (52.5% versus 47.5%, p = 0.050). High expression of integrin alpha 4 in peritoneum was associated with poorer PFS (HR 2.02 95% CI 1.01-4.05, p = 0.047), younger age (p = 0.047), and death (p = 0.046). Median PFS in patients with high expression of integrin alpha 4 was 13.00 months, whereas median PFS in patients without high expression of integrin alpha 4 was 21.00 months (p = 0.040). Expression of other integrins did not correlate with PFS or OS. Conclusion Expression of integrin alpha 4 may be altered during the metastatic spread of HGSOC and affect prognosis, whereas expression of integrin alpha 2, alpha 5, alpha 6, and beta 1 did not reveal any prognostic value.