Objectives Determining the roles of CD44 expression and the combination of CD133, CD44, ALDH1A1 expressions in chemotherapy response of epithelial-type ovarian cancer.

Methods Ambispective cohort (retrospective and prospective). The subject of this study was 55 patients with epithelial-type ovarian cancer at Cipto Mangunkusumo Hospital, Jakarta, from March 2017 to May 2018. Demographic and clinicopathological data were taken from medical records. CD133, CD44, and ALDH1A1 were examined using immunohistochemistry. CD133, CD44, and ALDH1A1 expressions of type I and type II ovarian cancer patients were associated with chemotherapy response. Multivariate analysis was used to model the prognosis for 10 months. Receiver Operating Characteristic (ROC) curve analysis was used as the scoring system.

Results The demographic data shows that most of the patients were older than 45 years old 72.7%, in stage I 41.8%, poorly differentiated 54.5%, and in type II 29.1%. Significant differences between histopathological types were shown in CD44 expression. The highest chemoresistance in ROC curve, based on the combination of three immunohistochemistry expressions and clinicopathology factors, namely stage III-IV, older than 45 years old, poorly differentiated, type II, negative CD133, high CD44, and high ALDH1A1 is 0.841.

Conclusions CD44 expression plays a role in the histopathological epithelial type of ovarian cancer. Negative CD133, high CD44, and high ALDH1A expressions and clinicopathology factors are highest chemoresistance group in epithelial ovarian cancer.