Additionally, high MMP2/9 expression in primary EOC was significantly associated with aggressive features such as high stage, high grade, ascites, and positive lymph node status [13]. Importantly, preoperative serum levels of CL and MMP9 correlated with the degree of differentiation, the International Federation of Gynecology and Obstetrics (FIGO) staging, and peritoneal Dasatinib cost metastasis in patients with EOC [14]. The above work has focused on primary EOC cells. However, given the unfavorable prognostic outcome associated with omental metastatic lesions, pro-angiogenic changes in

the omentum during metastasis may also contribute to EOC patient outcome. For instance, vascular endothelial cells are critical to the angiogenic process, stimulating ECM remodeling and facilitating new vessel growth, whereas mesothelial cells Seliciclib supplier may provide metastatic cancer cells with a microenvironment conducive to survival and growth [15]. For both cell types, the presence of metastatic EOC cells in the omentum may change their

protease expression profile, shifting them toward a pro-angiogenic, cancer-inducing response. Therefore, this study aimed to 1) examine the expression of MMP2, MMP9, CD, CL, and VEGFA in EOC, endothelial, and mesothelial cells in the omentum of patients with metastatic ovarian high-grade serous carcinoma compared with control patients with benign ovarian cystadenoma and 2) investigate the relationship between their expression in each cell type and clinical outcome for patients with EOC. We show that the endothelium and mesothelium of omentum hosting EOC metastases express significantly increased levels of pro-angiogenic proteases and VEGFA and that high endothelial and mesothelial expression of MMP9 is associated with significantly reduced overall survival (OS) and disease-specific survival (DSS). Importantly, high endothelial MMP9 expression combined with the presence of ascites is predictive of poor prognosis. This PtdIns(3,4)P2 study was undertaken in the diagnostic/research laboratory of the Royal Devon and Exeter NHS Foundation Trust (RD&E

NHS Trust). Thirty-nine omental samples taken during ovarian tumor surgery and previously used for diagnostic staging were retrieved from the histopathology archives with approval from the Caldicott Guardian of the RD&E NHS Trust and the Devon and Torbay Local Research Ethics Committee. Hematoxylin and eosin stained slides were reviewed by histopathologists (N.C. and M.A.) to confirm the histopathologic diagnosis and tumor grading. Clinical information was obtained from the patients’ medical records. Two distinct groups were identified: 1) women with high-grade, serous ovarian carcinoma with omental metastases (malignant group) and 2) women with benign ovarian pathology, i.e., serous cystadenoma and normal omental biopsies (control group).