J Cancer 2015; 6(7):678-685. doi:10.7150/jca.11689

Research Paper

Annexin A3 Is a Potential Predictor of Platinum Resistance in Epithelial Ovarian Cancer Patients in a Prospective Cohort

Ying Jin1*, Li-ping Feng1,2*, Xiang Jiang1,3*, Yong-xue Wang1, Jie Yin1, Zi-ping Yang1, Yan Li1, Ling-ya Pan1✉

1. Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (No.1 Shuai fu yuan, Dongcheng District, Beijing 100730, China)
2. The current address for Li-ping Feng: Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong, China (No. 107 Cultural West Road, Jinan 250012, China)
3. The current address for Xiang Jiang: Department of Obstetrics and Gynecology, Shanghai First Maternity and Infant Health Hospital, Shanghai, China (No 536 Changle Road, Jingan District, Shanghai 200040,China)
*Contributed equally to this work.


Epithelial ovarian cancer (EOC) is the leading cause of death among gynecological malignancies and is rarely cured in the recurrent setting, mainly because of progressive chemoresistance, especially platinum resistance. In our previous studies, the platinum-resistance-related protein, annexin A3, was selected by comparative proteomics. In this study, we detected serum annexin A3 levels using a self-developed chemiluminescence immunoassay kit in a prospective EOC patient cohort. We also evaluated the capacity of serum annexin A3 levels to predict platinum resistance. Serum annexin A3 levels in healthy women exhibited a similar normal distribution (Z=0.723, P=0.673), allowing determination of a normal cutoff level of 0.11-1.45 ng/mL. Of the 89 EOC patients, 21 were platinum resistant and 68 were platinum sensitive. Residual disease after primary surgery (p=0.004) and serum annexin A3 levels (p=0.036) were both independent factors associated with platinum resistance. The AUC was 0.733 (95% confidence interval (CI), 0.627-0.823). The optimal cutoff value for serum annexin A3 levels was 2.05 ng/mL. Multivariate logistic analysis showed that expression of annexin A3 as assessed by immunohistochemistry (P=0.005) and residual tumor size (P=0.000) had a significant influence on platinum resistance. The AUC of ROC curve of annexin A3 expression by immunohistochemistry was 0.664 (95% CI, 0.554-0.763) and the cut off value was “>=moderate scores”. In conclusion, we demonstrate that annexin A3 is a secreted protein that may be measured in the peripheral blood using a self-developed, chemiluminescence immunoassay kit. Serum annexin A3 levels may be a potential predictor of platinum resistance in epithelial ovarian cancer patients.

Keywords: ovarian cancer, annexin A3, platinum resistance, chemiluminescence immunoassay

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How to cite this article:
Jin Y, Feng Lp, Jiang X, Wang Yx, Yin J, Yang Zp, Li Y, Pan Ly. Annexin A3 Is a Potential Predictor of Platinum Resistance in Epithelial Ovarian Cancer Patients in a Prospective Cohort. J Cancer 2015; 6(7):678-685. doi:10.7150/jca.11689. Available from http://www.jcancer.org/v06p0678.htm