The expression of Fibulin-3 in ovarian cancer and its relationship with prognosis

BACKGROUND: Despite the significant advancements made in the treatment of ovarian cancer (OC), poor prognosis remains a major concern because this disease is frequently diagnosed at an advanced stage. Tumor recurrence and metastasis have been implicated in the poor clinical outcomes of OC. Although Fibulin-3 has been shown to be closely related to the development of various tumors, its relationship with OC has not been widely examined. Hence, this study was conducted to investigate the expression of Fibulin-3 in epithelial ovarian cancer (EOC), determine its relationship with EOC prognosis, and correlate its expression with that of the epithelial-mesenchymal transition markers (Snail, E-cadherin, and N-cadherin). METHODS: Immunohistochemistry analysis was performed to detect the expression of Fibulin-3 protein in 84 OC samples, 10 benign ovarian tumor samples, and eight borderline ovarian tumor samples. RESULTS: The positive rates of Fibulin-3 protein expression in OC, benign ovarian tumors, and borderline ovarian tumors were 45.24%, 20%, and 0%, respectively, showing significant differences (P<0.05). Fibulin-3 expression was found to be correlated with the FIGO stage of EOC, with tumors in higher stages (FIGO III + IV) showing higher expression. Additionally, at the protein level, Fibulin-3 was negatively correlated with E-cadherin protein (r=–0.252, P<0.05), and positively correlated with Snail and N-cadherin protein (r=0.644, 0.451, P<0.01).Overexpression of Fibulin-3 and the FIGO stage (III + IV) were related to the poor prognosis of patients (P<0.05). High expression of Fibulin-3 was an independent prognostic factor of EOC (P<0.05) The survival curve analysis showed that patients overexpressing Fibulin-3 had significantly shorter survival than those with low expression (P<0.05). CONCLUSIONS: Increased expression of Fibulin-3 was found to be related to the invasion, metastasis, and prognosis of ovarian tumors, suggesting that it is an important indicator for evaluating the clinical prognosis of patients with EOC.