17β-hydroxysteroid dehydrogenase type 1 improves survival in serous epithelial ovarian tumors

The incidence of ovarian cancer has been epidemiologically related to female reproductive events and hormone replacement therapy after menopause. This highlights the importance of evaluating the role of sexual steroid hormones in ovarian cancer by the expression of enzymes related to steroid hormone biosynthesis in the tumor cells. This study was aimed to evaluate the presence of 17 beta-hydroxysteroid dehydrogenase type 1 (17 beta-HSD1), aromatase and estrogen receptor alpha (ER alpha) in the tumor cells and their association with the overall survival in 111 patients diagnosed with primary ovarian tumors. Positive immunoreactivity for 17 beta-HSD1 was observed in 74% of the tumors. In the same samples, aromatase and ER alpha revealed 66% and 47% positivity, respectively. No association was observed of 17 beta-HSD1 expression with the histological subtypes and clinical stages of the tumor. The overall survival of patients was improved in 17 beta-HSD1-positive group in Kaplan-Meier analysis (P = 0.028), and 17 beta-HSD1 expression had a protective effect from multivariate proportional regression evaluation (HR = 0.44; 95% CI 0.24-0.9; P = 0.040). The improved survival was observed in serous epithelial tumors but not in nonserous ovarian tumors. The expression of 17 beta-HSD1 in the cells of the serous epithelial ovarian tumors was associated with an improved overall survival, whereas aromatase and ER alpha were not related to a better survival. The evaluation of hazard risk factors demonstrated that age and clinical stage showed worse prognosis, and 17 beta-HSD1 expression displayed a protective effect with a better survival outcome in patients of epithelial ovarian tumors.