Expression of the adrenomedullin gene in epithelial ovarian cancer

Adrenomedullin (AM) gene expression was analysed in 60 cases of epithelial ovarian cancer, (29 serous, 14 mucinous, 13 endometrioid, three clear cell, and one undifferentiated) using reverse transcription-polymerase chain rea ction (RT-PCR); 10 of the cases were of low malignant potential; 25 were st age I; three were stage II; 27 were stage III; and five were stage IV. The level of AM gene expression was described in terms of the relative yield of the AM gene to the beta 2-microglobulin gene. AM gene expression ranged fr om 0.04 to 1.57 (median 0.36). The association between histological grade a nd AM gene expression was significant (P = 0.027), however, the association with other clinico-pathological features, i.e. patients' age at diagnosis, stage of disease, residual tumour mass after initial surgery, and histolog ical subtype were not significant. Survival data were available for all pat ients and univariate Cox regression analysis showed that the AM gene expres sion was significantly associated with a poor prognosis (P = 0.019). Immuno histochemical studies showed that AM was localized in the outer cell membra ne or the cytoplasm of the carcinoma cells and in the endothelial cells of the tumour stroma. The AM gene expression level may play a key role in the biology of epithelial ovarian cancer and may define a more aggressive tumou r phenotype.