CRABP1-reduced expression is associated with poorer prognosis in serous and clear cell ovarian adenocarcinoma

CRABP1 is a modulator of retinoic acid function. The aim of the present study was to investigate CRABP1 expression and its clinical significance in ovarian carcinoma. Expression of CRABP1 protein was investigated by immunohistochemical analysis in 100 ovarian carcinomas of various histological sub-types, including serous and clear cell adenocarcinomas. Relationship of CRABP1 expression to clinical features, including prognosis, was analyzed. Reduced expression of CRABP1 protein was detected especially frequently in the serous and clear cell adenocarcinomas sub-types, 50% (20 of 40) and 38% (10 of 26) of cases, respectively. We found that in both serous and clear cell adenocarcinomas overall survival was significantly poorer in the cases with reduced CRABP1 expression compared to similar cases where expression was maintained, irrespective of the disease stage (P = 0.0073 and 0.049, respectively). Disease-free survival of the serous and clear cell adenocarcinoma cases with reduced CRABP1 expression was significantly poorer, compared to the cases whose CRABP1 expression was maintained (P = 0.024). Multivariate analysis showed that reduced expression of CRABP1 was a significantly important prognostic factor (adjusted hazard ratio: 8.189 (95% CI, 2.186-30.672, P = 0.0019)). The present study is the first to demonstrate that the reduced expression of CRABP1 has a potential as a prognostic marker for serous adenocarcinoma which is the most frequent histological ovarian tumor type and also for clear cell carcinoma that often exhibits chemo-resistance. Further study is necessary to clarify how CRABP1 protein expression was altered and how CRABP1 affects ovarian carcinoma cells.