Wnt/β-catenin pathway as a potential prognostic and predictive marker in patients with advanced ovarian cancer

Background: beta-catenin is the key protein in the WNT signalling pathway and it forms adherent junctions together with E-cadherin. In ovarian carcinoma, abnormal expression of beta-catenin, E-cadherin and WNT-1 was observed, but their prognostic and predictive role is unclear. The aim of this study was to clarify the prognostic and predictive role of E-cadherin, beta-catenin and WNT-1 in advanced epithelial ovarian carcinoma (AEOC). Methods: The expression of E-cadherin, beta-catenin and WNT-1 was determined by immunohistochemistry in AEOC. The correlation between expression of these proteins and progression-free survival (PFS) and overall survival (OS) was evaluated. Statistical analyses included Kaplan-Meier estimation, log-rank test, Spearman correlation and Cox proportional-hazards model. Results: In ovarian cancer, intense expression of E-cadherin, beta-catenin and WNT-1 was found. In multivariate analysis, strong membrane beta-catenin expression was an independent unfavourable predictor for PFS (HR 2.19, 95% CI 1.09-4.39; p = 0.028), while in univariate analysis, strong membrane beta-catenin expression was a prognostic factor for OS in patients with AOC (p = 0.039). In multivariate analysis, only resistance to first-line chemotherapy was an adverse independent prognostic factor for OS (HR 16.84; 95% CI 5.07-55.98; p < 0.0001). Additionally, strong membranous beta-catenin expression was associated with resistance to platinum-based chemotherapy (p = 0.027). Conclusions: These findings support that WNT/beta-catenin pathway and E-cadherin are important factors in advanced epithelial ovarian cancer.