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FGF18 as a prognostic and therapeutic biomarker in ovarian cancer
Wei Wei, … , Gayatry Mohapatra, Michael J. Birrer
Wei Wei, … , Gayatry Mohapatra, Michael J. Birrer
Published September 9, 2013
Citation Information: J Clin Invest. 2013;123(10):4435-4448. https://doi.org/10.1172/JCI70625.
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Research Article Oncology

FGF18 as a prognostic and therapeutic biomarker in ovarian cancer

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Abstract

High-throughput genomic technologies have identified biomarkers and potential therapeutic targets for ovarian cancer. Comprehensive functional validation studies of the biological and clinical implications of these biomarkers are needed to advance them toward clinical use. Amplification of chromosomal region 5q31–5q35.3 has been used to predict poor prognosis in patients with advanced stage, high-grade serous ovarian cancer. In this study, we further dissected this large amplicon and identified the overexpression of FGF18 as an independent predictive marker for poor clinical outcome in this patient population. Using cell culture and xenograft models, we show that FGF18 signaling promoted tumor progression by modulating the ovarian tumor aggressiveness and microenvironment. FGF18 controlled migration, invasion, and tumorigenicity of ovarian cancer cells through NF-κB activation, which increased the production of oncogenic cytokines and chemokines. This resulted in a tumor microenvironment characterized by enhanced angiogenesis and augmented tumor-associated macrophage infiltration and M2 polarization. Tumors from ovarian cancer patients had increased FGF18 expression levels with microvessel density and M2 macrophage infiltration, confirming our in vitro results. These findings demonstrate that FGF18 is important for a subset of ovarian cancers and may serve as a therapeutic target.

Authors

Wei Wei, Samuel C. Mok, Esther Oliva, Sung-hoon Kim, Gayatry Mohapatra, Michael J. Birrer

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Figure 2

Validation of the prognostic significance of FGF18 in high-grade, advanced stage serous ovarian cancers through an independent tissue microarray (TMA).

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Validation of the prognostic significance of FGF18 in high-grade, advanc...
(A–E) Independent TMA validation of FGF18 expression in 47 benign ovarian cysts and 209 high-grade, late-stage serous ovarian cancers. A membrane and cytoplasmic staining pattern was observed for FGF18. Semiquantitative staining intensity evaluation indicated significant upregulation of FGF18 in high-grade serous ovarian tumors (C and D) compared with benign ovarian cysts (A and B). Scale bars: 100 μm. Arrowheads indicate the epithelial layer of the benign ovarian cyst; T and S designate tumor and stromal portions respectively. (F) The impact of FGF18 on overall patient survival in the 209 high-grade advanced-stage serous ovarian cancers on the validation TMA. Kaplan-Meier analysis was employed with the score of 6 (the highest score of FGF18 in benign ovarian cysts) out of 12 accepted as the cut-off. A statistically significant difference was observed indicating a correlation between FGF18 expression and poor prognosis. Black lines, samples with low FGF18; red broken lines, samples with high FGF18; +, censored samples.

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ISSN: 0021-9738 (print), 1558-8238 (online)

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