Histology, clinical stage and treatment response are used to define the prognosis of malignant ovarian germ cell tumors (MOGCTs). However, additional biological tools to guide treatment in MOGCTs would be desirable. We evaluated the prognostic value of several serum and tissue markers in MOGCTs. Medical charts of 30 women were reviewed as regards preoperative and treatment-related factors, with a mean follow-up time of 92 months (range 2–205). Serum levels of α-fetoprotein, human chorionic gonadotropin and CA 125 were determined, and immunohistochemistry for CA 125 as well as the pluripotent stem cell markers AP-2γ and Oct-3/4 was performed in tumor specimens and the NCC-IT human germinoma cell line. Overall survival was 73%. Elevated preoperative levels of serum CA 125 were prognostic of progressive disease (p<0.05). Immunohistochemical evaluation revealed that in most cases the elevated CA 125 levels originated from the tumor tissue. Most dysgerminomas as well as the germinoma cell line were positive for AP-2γ and Oct-3/4, whereas the majority of yolk sac tumors and immature teratomas were negative. Taken together, increased preoperative serum CA 125 levels indicate poor prognosis of MOGCTs. Tissue AP-2γ and Oct-3/4 are associated with dysgerminomas and can thus be used as additional differential diagnostic tools in MOGCTs.

Keywords:
AP-2γ, CA 125 antigen, Germ cell tumor, Oct-3/4, Prognosis
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© 2008 S. Karger AG, Basel
2008
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