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Metabolic Markers and HSP60 in Chemonaive Serous Solid Ovarian Cancer Versus Ascites
  1. Elisabet Hjerpe, MD, PhD*,
  2. Suzanne Egyhazi Brage, PhD,
  3. Marianne Frostvik Stolt, BT,
  4. Hemming Johansson, BSc*,
  5. Maria Shoshan, PhD and
  6. Elisabeth Åvall-Lundqvist, MD, PhD*
  1. *Department of Oncology and Pathology, and
  2. Department of Oncologyand Pathology, Cancer Center Karolinska CCK R8:03, Karolinska Institutet, Stockholm, Sweden.
  1. Address correspondence and reprint requests to Elisabet Hjerpe, MD, PhD, Unit for Gynecologic Oncology, Department of Oncology, Karolinska University Hospital, Z500, SE-171 76 Stockholm, Sweden. E-mail: elisabet.hjerpe{at}


Objective Metabolic pathway alterations in cancer are thought to be dependent upon tumor type–specific oncogenic activation and local nutrient and oxygen supply during disease progression. In serous ovarian cancer, the typical peritoneal spread of disease is caused by shedding of tumor cells into the abdominal cavity, often along with ascites formation. Not much is known about the metabolic features of these detached serous tumor cells. In this study, we investigate the messenger RNA (mRNA) expression of GAPDH (glycolytic glyceraldehyde 3-phosphate dehydrogenase) and PKM2 (pyruvate kinase isoform M2), ATP5B (mitochondrial β-F1-ATPase), and heat shock protein 60 in matched serous solid tumor and corresponding ascites.

Materials/Methods Fresh samples from solid tumor and corresponding ascites were prospectively collected from 40 patients undergoing primary surgery for suspected advanced ovarian cancer. Of these, 25 met the study eligibility criteria, that is, stage IIC to IV disease of the serous (24) or endometrioid (1) subtype with solid and ascites specimens containing 50% or more tumor cells and with good quality and quantity mRNA yield. All but 2 patients (92%) had type II disease. GAPDH, PKM2, ATP5B, and HSP60 mRNA expressions were assessed by real-time polymerase chain reaction. For each marker, the mRNA expression in solid tumor was pairwise compared with the corresponding expression in ascites using the Wilcoxon matched pairs signed rank sum test.

Results In contrast to our hypothesis, the mRNA expression of analyzed metabolic markers and HSP60 did not significantly differ between matched solid tumor and malignant ascites.

Conclusions Our results indicate that further expression changes in genes related to glycolysis or oxidative phosphorylation are not a prerequisite for serous cancer cell survival after detachment.

  • Serous ovarian cancer
  • Ascites
  • mRNA
  • Metabolic markers

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  • This study was funded by the Swedish Cancer Society, the Cancer Research Funds of Radiumhemmet, and the Swedish State under the ALF agreement, Stockholm.

  • Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal’s Web site (

  • The authors declare no conflicts of interest.