Transforming growth factor-beta and nitrates in epithelial ovarian cancer

The role of transforming growth factor-beta (TGF-beta) and nitric oxide (NO ) in ovarian neoplasia is still not clear. We studied the expression of TGF -beta by enzyme immunoassay, and nitrates las a stable end product of NO) i n 127 ovarian tissues (36 normal, 37 benign, and 54 malignant). Ploidy stat us and synthetic phase fraction (SPF) were also assessed by flow cytometry. Mean ranks of TGF-beta, nitrate, and SPF were significant among different groups (X-2 = 12.01, P = 0.0025, X-2 = 67.42, P = 0.000, X-2 = 9.06, P = 0. 011 respectively). Nitrate mean ranks were significant among different FIGO stages of the disease (X-2 = 17.6, P=0.000). A significant correlation was shown between TGF-beta, and nitrate levels in all tissues (r=0.24, P=0.01) , as well as in malignant tissues (r = 0.3, P = 0.026). Cutoff values were determined for both TGF-beta (290 pg/mg protein), and nitrates (310 nmole/m g non protein nitrogenous substances). At these cut-offs, nitrates showed a sensitivity of 93% and 84% specificity for malignant versus normal cases, while TGF-beta had 76% sensitivity, and 82.4% specificity for poor versus g ood outcome. Patients with epithelial ovarian cancer were followed up for a total of 40 months. Survival analysis showed that patients with TGF-beta a bove the cut-off had worse prognosis (X-2 = 12.69, P=0.004). The present re sults suggest that malignant transformation of ovarian tissues is associate d with increased TGF-beta and NO production. NO level is related to the dev elopment and progression of epithelial ovarian cancer, while high levels of TGF-beta could be of prognostic significance.