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The autophagy protein LC3A correlates with hypoxia and is a prognostic marker of patient survival in clear cell ovarian cancer
- Source :
- The Journal of pathology. 228(4)
- Publication Year :
- 2012
-
Abstract
- Clear cell ovarian cancer histotypes exhibit metabolic features associated with resistance to hypoxia and glucose deprivation-induced cell death. This metabolic characteristic suggests that clear cell ovarian cancers activate survival mechanisms not typical of other epithelial ovarian cancers. Here we demonstrate that microtubule-associated protein 1 light chain 3A (LC3A), a marker of autophagy, is related to hypoxia and poor prognosis in clear cell ovarian cancer. In 485 ovarian tumours, we found that LC3A was significantly associated with poor progression-free (p = 0.0232), disease-specific (p = 0.0011) and overall patient survival (p = 0.0013) in clear cell ovarian cancer patients, but not in other subtypes examined. LC3A was an independent prognostic marker of reduced disease-specific [hazard ratio (HR): 2.55 (95% CI 1.21-5.37); p = 0.014] and overall survival [HR: 1.95 (95% CI 1.00-3.77); p = 0.049] in patients with clear cell ovarian carcinoma. We also found a strong link between autophagy and hypoxia as LC3A staining revealed a significant positive association with the hypoxia-related proteins carbonic anhydrase-IX and HIF-1α. The functional link between hypoxia and autophagy was demonstrated using clear cell and high-grade serous cell lines that were subjected to hypoxia or hypoxia + glucose deprivation. Clear cell carcinoma lines displayed greater autophagy induction and were subsequently more sensitive to inhibition of autophagy under hypoxia compared to the high-grade serous lines. Together, our findings indicate that hypoxia-induced autophagy may be crucial to the clinical pathology of clear cell ovarian cancer and is a potential explanation for histological subtype differences in patient disease progression and outcomes.
- Subjects :
- Adult
Aged, 80 and over
Ovarian Neoplasms
Apoptosis
Kaplan-Meier Estimate
Middle Aged
Hypoxia-Inducible Factor 1, alpha Subunit
Prognosis
Immunohistochemistry
Cell Hypoxia
Cell Line, Tumor
Multivariate Analysis
Autophagy
Humans
Female
Microtubule-Associated Proteins
Biomarkers
Adenocarcinoma, Clear Cell
Aged
Carbonic Anhydrases
Retrospective Studies
Subjects
Details
- ISSN :
- 10969896
- Volume :
- 228
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- The Journal of pathology
- Accession number :
- edsair.pmid..........f816444e64d7917e59cfd81b460b2337