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Claudin-1 is linked to presence of implants and micropapillary pattern in serous borderline epithelial tumours of the ovary
  1. Ahmed El-Balat1,
  2. Iryna Schmeil1,
  3. Khayal Gasimli1,
  4. Nicole Sänger1,
  5. Thomas Karn1,
  6. Andre Ahr1,
  7. Sven Becker1,
  8. Ruza Arsenic2,
  9. Uwe Holtrich1,
  10. Knut Engels3
  1. 1 Department of Obstetrics and Gynecology, University Hospital Frankfurt, Frankfurt, Germany
  2. 2 Institute of Pathology, Charite University Hospital, Berlin, Germany
  3. 3 Center for Pathology, Cytology and Molecular Pathology, Neuss, Germany
  1. Correspondence to Dr Ahmed El-Balat, Department of Obstetrics and Gynecology, Goethe University Frankfurt, Frankfurt 60590, Germany; ahmed.el-balat{at}


Aims Expression of Claudin-1 has been associated with prognosis in several cancers. Here we investigated the expression pattern of Claudin-1 in borderline tumours of the ovary (BOT).

Methods We analysed a cohort of 114 cases of borderline tumour (BOT). Claudin-1 expression was studied by immunohistochemistry using a polyclonal antibody and was compared with clinical and histopathological characteristics.

Results Strong Claudin-1 expression was found in 30 cases (26.3%) independent of histological subtype. Expression was significantly less frequent in International Federation of Gynecology and Obstetrics (FIGO) stage I (p= 0.045), while the presence of microinvasion did not correlate with Claudin-1 expression. In contrast, we detected a highly significant association of Claudin-1 expression with the presence of peritoneal implants (p=0.003) and micropapillary pattern (p=0.047), which are features exclusively seen in serous BOT. Moreover, when we restricted our analysis to the subtype of serous BOT, the association of Claudin-1 expression with peritoneal implants (p<0.001) and micropapillary pattern (p =0.003) remained highly significant.

Conclusions In conclusion, Claudin-1 expression is associated with the presence of peritoneal implants and micropapillary pattern, which have been shown to be associated with poor prognosis. We speculate that overexpression of Claudin-1 might be linked to the mitogen-activated protein kinase pathway activation in BOT and suggest further studies to define its prognostic and potential therapeutic value.

  • ovarian cancer
  • borderline tumours
  • histological subtypes
  • prognosis

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  • Handling editor Dhirendra Govender.

  • Contributors KE and RA performed histopathology, diagnosis and data assembly. UH and AE-B conceived the study. UH performed immunohistochemical analyses of the samples and coordinated the study conduct. KE evaluated and scored stained tissue slides and helped in finalising the manuscript. TK carried out the statistical analyses. AE-B, IS, NS and SB provided clinical samples and participated in study conduct. AE-B drafted the manuscript. AE-B, IS and KG finalised the manuscript. All authors approved the final manuscript.

  • Funding This work was supported by grants from the Margarete-Bonifer-Stiftung, Bad Soden, the HW&J Hector-Stiftung, Mannheim (grant number: M82), and the BANSS-Stiftung, Biedenkopf.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval The local research ethics committee (Ethik-Kommission des Fachbereichs Medizin der Goethe Universität Frankfurt am Main) approved the studies of human tissue.

  • Provenance and peer review Not commissioned; externally peer reviewed.