Nuclear maspin expression as a good prognostic factor in human epithelial ovarian carcinoma

Maspin, a protein belonging to the serpin superfamily, seems to exert tumour-suppressive activity. Its significance in ovarian cancer prognosis is currently under investigation. In the present work, immunocytochemical maspin expression in 132 invasive epithelial ovarian carcinomas was assessed independently in the nucleus and cytoplasm, in correlation with histopathological and clinical data. Positive maspin expression was found in 117 cases: nuclear/cytoplasmatic in 71, exclusive nuclear in 29, and only cytoplasmatic in 17 cases. Cytoplasmatic maspin expression was positively correlated with tumour grade (p = 0.000), FIGO stage (p = 0.002), and distant metastases (p = 0.000) but exhibited no significant correlation with tumour type (p = 0.078). Nuclear maspin expression showed negative correlation with tumour grade (p = 0.025), FIGO stage (p = 0.05), distant metastases (p = 0.001), and cancer remission (p = 0.000) but showed no significant relationship with the patients' age (p = 0.948) or cancer subtype (p = 0.261). Kaplan-Meier survival analysis showed that strong cytoplasmatic maspin expression was correlated with shorter disease-free survival (p = 0.000) whereas strong nuclear expression was correlated with longer survival (p = 0.000). In Cox regression analysis, low nuclear maspin expression (score 2 and 3) remained a significant independent prognostic factor (p = 0.001) with a relative death risk of 5.337. The obtained results suggest that maspin expression may be a significant marker in epithelial ovarian carcinoma prognosis with its nuclear expression being a good prognostic factor.