Expression of thymidine phosphorylase in epithelial ovarian cancer: Correlation with angiogenesis, apoptosis, and ultrasound-derived peak systolic velocity

Objective. The objective of this study was to determine whether the express ion of thymidine phosphorylase (TP) by epithelial ovarian cancer cells corr elates with the density of microvessels within the tumor, apoptotic index ( AI) within the tumor cells, and ultrasound-derived blood flow. Methods. Color Doppler imaging and pulsed Doppler spectral analysis ultraso nography were used to scan 44 patients with an overt ovarian mass immediate ly before laparotomy. Sections of malignant tumors were analyzed for the ce llular expression of TP and the intratumoral density of microvessels by imm unohistochemistry using antibodies to TP and factor-VIII-related antigen, r espectively. Moreover, AI was evaluated by the terminal deoxynucleotidyl tr ansferase-mediated dUTP-biotin nick end labeling methods. Results. Forty-four epithelial ovarian cancers were studied (6 low malignan t potential, 15 serous cystadenocarcinoma, 9 mucinous cystadenocarcinoma, 8 endometrioid adenocarcinoma, 4 clear cell carcinoma, and 2 malignant Brenn er tumors); 19 were Stage I, 6 Stage II, 15 Stage III, and 4 Stage IV. Four teen tumors (32%) were classified as being TP positive. The proportion of S tage I tumors that was TP positive (16%) was significantly lower (P = 0.022 ) that the corresponding value for Stages II-IV (44%), although the values for microvessel count, AI, and peak systolic velocity (PSV) were similar. A I was significantly lower in TP-positive tumors than in TP-negative tumors (P = 0.015). The PSV was significantly higher in TP-positive tumors (P = 0. 02). There was a significant correlation between the microvessel count and the PSV (r = 0.34, P = 0.024). Moreover, AI was significantly inversely rel ated to the PSV (r = 0.35, P = 0.023). The PSV in a subgroup with a high mi crovessel count and low AI was significantly higher than that in a subgroup with a low microvessel count and high AI (P = 0.0006). These findings sign ificantly associated with TP expression (P = 0.024). Conclusions. The intratumoral PSV, as determined by color Doppler imaging a nd spectral analysis, might reflect the coordination of angiogenesis and ap optosis associated with TP expression in epithelial ovarian cancer, (C) 200 0 Academic Press.