京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第21336号 / 医博第4394号 / 新制||医||1031(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 横出 正之, 教授 岩井 一宏, 教授 戸口田 淳也 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Submitted by Pós Imunologia (ppgimicsufba@gmail.com) on 2017-02-07T19:17:53Z No. of bitstreams: 1 Tese_KM_final.pdf: 2714851 bytes, checksum: ae197797f7e0966b1ad54595314ce1fa (MD5) / Approved for entry into archive by Delba Rosa (delba@ufba.br) on 2017-02-08T16:21:02Z (GMT) No. of bitstreams: 1 Tese_KM_final.pdf: 2714851 bytes, checksum: ae197797f7e0966b1ad54595314ce1fa (MD5) / Made available in DSpace on 2017-02-08T16:21:02Z (GMT). No. of bitstreams: 1 Tese_KM_final.pdf: 2714851 bytes, checksum: ae197797f7e0966b1ad54595314ce1fa (MD5) / CAPES / O tratamento das leucemias agudas continua sendo um grande desafio clínico devido, principalmente à heterogeneidade e alta toxicidade da terapia padrão utilizada. Dessa forma, novos alvos terapêuticos são urgentemente necessários e os anticorpos monoclonais tem surgido como uma das opções terapêuticas mais promissoras. A endoglina, também conhecida como CD105, é um receptor da superfamília do TGF-β, expresso nas células-tronco hematopoiéticas (HSC) de todos os sítios hematopoiéticos, incluindo a medula óssea, onde é descrita como um marcador para HSC de longo prazo. Apesar da expressão de CD105 ter sido relacionada a diversos tipos de tumores sólidos, principalmente devido ao papel desse receptor na angiogênese, relativamente pouco é conhecido em relação a expressão de CD105 e a sua função em neoplasias hematopoiéticas. Este estudo revelou alta expressão de endoglin na maioria dos blastos de pacientes com leucemia mieloide aguda (LMA) e leucemia linfoblástica aguda (LLA). Utilizando um modelo de xenotransplante, verificamos que as blastos CD105+ possuem uma actividade leucemogênica superior em comparação com a população de CD105-. Adicionalmente, investigamos se o bloqueio da endoglina, usando TRC105, poderia resultar em uma opção terapêutica para tratamento das leucemias agudas e descobrimos que na LMA, o TRC105 impediu o engraftment de blastos primários e inibiu a progressão da leucemia após o estabelecimento da doença, mas na LLA, o TRC105 sozinho foi ineficaz devido à uma maior secreção da forma soluvél da endoglina (sENG). No entanto, tanto na LLA quanto na LMA, TRC105 potencializou o efeito terapeutico da quimioterapia padrão e inibiu a progressão da doença, indicando que TRC105 pode representar uma nova opção terapêutica para LLA e LMA. / Successful treatment of acute leukemia remains a clinical challenge due to the toxicity and the relatively poor responses to the current standard therapy. Thus, treatments that address novel therapeutic targets are urgently needed and, for this purpose, monoclonal antibodies have been one of the most promising strategy once they are able to deliver their therapeutic effects with minimal toxicity. Endoglin, also known as CD105, is a receptor of the transforming growth factor-beta (TGF-β) superfamily that has been found expressed in hematopoietic stem cells (HSCs) from all hematopoietic sites, including the bone marrow, in which it is described as a marker for long-term HSC. CD105 is also found to be expressed in several cancers. However, because CD105 expression has been studied mostly in the context of solid tumors and angiogenesis, relatively little is known about CD105 expression and role in hematopoietic malignancies. We identified endoglin expression on the majority of blasts from patients with acute myeloid leukemia (AML) and acute B-lymphoblastic leukemia (B-ALL). Using a xenograft model, we find that CD105+ blasts are endowed with superior leukemogenic activity compared to the CD105- population. We test the effect of targeting this receptor using the monoclonal antibody TRC105, and find that in AML, TRC105 prevented the engraftment of primary AML blasts and inhibited leukemia progression following disease establishment, but in B-ALL, TRC105 alone was ineffective due to the shedding of soluble CD105. However, in both B-ALL and AML, TRC105 synergized with reduced intensity myeloablation to inhibit leukemogenesis, indicating that TRC105 may represent a novel therapeutic option for B-ALL and AML.

Made available in DSpace on 2014-12-17T15:32:16Z (GMT). No. of bitstreams: 1 RuthLFX.pdf: 2397744 bytes, checksum: 8d25a9f2aa705aa972d7a1d4de2b1b29 (MD5) Previous issue date: 2008-02-28 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / The purpose of this study was to assess the immunohistochemical expression of CD105 and FvW antibodies in the angiogenesis of oral epidermoid carcinoma (OEC), correlating it with the TNM clinical staging system, seeking a better understanding of its biological behavior and use as an indicator of prognosis.The sample consisted of 30 epidermoid carcinoma (EC) cases, 10 of the floor of the mouth, 10 of the retromolar region and 10 of the tongue, in addition to 10 cases of pyogenic granuloma, which made up the control group. The results showed that mean microvessel counts (MVC) were correspondingly higher in the pyogenic granuloma group (CD105 = 57.26 vessels and FvW = 39.64) than in the EC group (CD105 = 10.09 and FvW = 12.20) and that the differences were statistically significant between the groups for each of the angiogenic biomarkers (p = 0.002 for CD105 and p< 0.001 for FvW). CD105 had better positivity in the pyogenic granuloma group (mean = 57.26 vessels) and for EC, FvW had the highest expression (mean = 12.20 vessels). With respect to EC, the most affected age group was between 51 and 70 years (n = 14; 46.7%), with a representative MVC for both markers. No statistically significant difference was found between the sexes for any of the markers (p = 0.967 for CD105 and p = 0.744 for FvW). Mean CD105 levels were much higher in patients with stage T3 and T4 (17.13) and lower in those with stage N+ (6.36). Mean FvW levels were higher in the patients with stage T1 and T2 (12.23) and lower in patients with T3 and T4 (12.10), but without a statistically significant difference. In regard to anatomic location, a statistically significant difference was observed between FvW sites, with a statistically significant difference between floor of the mouth cases and those located in the retromolar region (p =0.013). Therefore, this study suggests that CD105 expression in OEC angiogenesis, in contrast to other types of malignant neoplasias, may not be correlated with prognosis and tumor aggressiveness, whereas FvW was a more effective antibody for staining this lesion / Nesta pesquisa buscou-se avaliar a express?o imunoistoqu?mica dos anticorpos CD105 e FvW na angiog?nese do Carcinoma Epiderm?ide Oral (CEO), correlacionando-o com o estadiamento cl?nico pelo sistema TNM, visando uma melhor compreens?o do seu comportamento biol?gico e utiliza??o como indicador de progn?stico. A amostra foi composta por 30 casos de CE, sendo 10 de assoalho bucal, 10 da regi?o retromolar e 10 de l?ngua, al?m de 10 casos de granuloma piog?nico, integrantes do grupo controle. Os resultados desta pesquisa mostraram que as m?dias da MVC foram correspondentemente mais elevadas no grupo do granuloma piog?nico (CD105 = 57,26 vasos e FvW = 39,64) do que no grupo do CE (CD105 = 10,09 e FvW = 12,20) e as diferen?as se revelaram estatisticamente significantes entre os grupos para cada um dos biomarcadores angiog?nicos (p=0,002 para o CD105 e p<0,001 para o FvW ). O CD105 se mostrou com melhor positividade no granuloma piog?nico (m?dia = 57,26 vasos) e, para o CE, o FvW foi o que apresentou maior marca??o (m?dia = 12,20 vasos). Com rela??o ao CE, a faixa et?ria mais acometida foi entre 51 e 70 anos (n=14; 46,7%), apresentando uma MVC representativa para ambos os marcadores. N?o se comprovou diferen?a estatisticamente significante entre os sexos para nenhum dos marcadores (p=0,967 para o CD105 e p=0,744 para o FvW). A m?dia do CD105 foi bem mais elevada entre os pacientes com estadiamento T3 e T4 (17,13) e menos elevada entre os pacientes com estadiamento N+ (6,36). Quando se avaliou o FvW, a m?dia foi mais elevada no grupo dos pacientes com T1 e T2 (12,23), sendo mais baixa nos pacientes com T3 e T4 (12,10), por?m sem diferen?a estatisticamente significante. Em rela??o ? localiza??o anat?mica, comprovou-se diferen?a estatisticamente significante entre as localiza??es assoalho bucal e retromolar (p=0,013) para o marcador FvW. Portanto, este estudo sugere que a marca??o do CD105 na angiog?nese do CEO, ao contr?rio de outros tipos de neoplasias malignas, pode n?o estar correlacionada com o progn?stico e agressividade do tumor, enquanto que o FvW se mostrou um anticorpo mais efetivo na marca??o desta les?o

Made available in DSpace on 2014-12-17T15:32:16Z (GMT). No. of bitstreams: 1 MarceloGV.pdf: 2007167 bytes, checksum: 5ee7e9c9bd56fd72fecb1874fb64a80e (MD5) Previous issue date: 2008-02-26 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Angiogenesis, a fundamental mechanism in tumor development, is used for differential diagnosis and prognosis purposes in various neoplasias of the head and neck. This study proposes to assess angiogenic activity using immunohistochemical expression by anti-CD105 and anti-CD34 antibodies in 20 cases of hemangiomas and 20 cases of oral pyogenic granulomas, in addition to determining the usefulness of these markers as one of the differential diagnosis resources for these two oral lesions. The results showed no statistically significant difference between microvascular count (MVC) means determined by anti-CD105 (p = 0.803) and anti-CD34 (p = 0.279) antibodies. The mean number of vessels obtained by MVC in the oral hemangiomas immunostained by anti-CD105 and anti-CD34 was 18.75 and 59.72, respectively, whereas in the oral pyogenic granulomas, the mean number was 20.22 and 48.09 respectively. It was also shown that CD34 was more effective than CD105 in identifying blood vessels. However, it must be pointed out that the anti-CD105 antibody seems to be more related to vascular neoformation. Overall, this assay reinforces the role of angiogenic factors in the etiopathogenesis of hemangiomas and oral pyogenic granulomas, but the results showed that angiogenesis quantification cannot be used as a differential diagnosis parameter between the two lesions analyzed / A angiog?nese ? um mecanismo fundamental para o desenvolvimento tumoral, sendo utilizada para fins de diagn?stico diferencial e determina??o de progn?stico em v?rias neoplasias de cabe?a e pesco?o. Este trabalho se prop?s avaliar a atividade angiog?nica atrav?s da express?o imuno-histoqu?mica dos anticorpos anti-CD105 e anti-CD34 em 20 casos de hemangiomas e 20 casos de granulomas piog?nicos orais, al?m de averiguar a utilidade destes marcadores como um dos recursos de diagn?stico diferencial para estas duas les?es orais. Os resultados deste experimento demonstraram que n?o houve diferen?a estatisticamente significativa entre as m?dias de contagem microvascular (MVC) determinadas pelos os anticorpos anti-CD105 (p=0,803) e anti-CD34 (p=0,279). O n?mero m?dio dos vasos obtidos pela MVC nos esp?cimes de hemangiomas orais imunomarcados pelo anti-CD105 e anti-CD34 foram respectivamente 18,75 e 59,72, enquanto nos granulomas piog?nicos orais, o n?mero m?dio dos vasos obtidos pela MVC pelo anti-CD105 e anti-CD34 foram respectivamente 20,22 e 48,09. Foi verificado, tamb?m, que o CD34 foi mais efetivo na identifica??o de vasos sang??neos quando comparado com o CD105. Entretanto, faz-se necess?rio destacar, que o anticorpo anti-CD105 parece estar mais relacionado com a neoforma??o vascular. Em linhas gerais, este ensaio refor?a a participa??o dos fatores angiog?nicos na etiopatog?nese dos hemangiomas e granulomas piog?nicos orais, por?m os resultados mostraram que a quantifica??o da angiog?nese n?o pode ser utilizada como par?metro de diagn?stico diferencial entre as duas les?es analisadas

Made available in DSpace on 2014-12-17T15:32:27Z (GMT). No. of bitstreams: 1 CristinaRFA.pdf: 1625942 bytes, checksum: 99d50db14437c5ea0e3022e4da576321 (MD5) Previous issue date: 2009-03-06 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior / Bone morphogenetic proteins (BMPs) are cytokines involved in proliferation and angiogenesis of many kind of human cancer. The present study analyzed the immunohistochemical expression of BMP-2, BMPR-II, BMPR-IA and endoglin (CD105) and their relationship with the biological behavior and local angiogenesis in tongue oral squamous cells carcinoma (SCC). The sample consisted of 25 cases of tongue SCC without metastasis, 25 tongue SCC with metastasis and 25 cases of Inflamatory Fibrous Hyperplasia (IFH).The histological grade of malignancy proposed by Bryne (1998), adapted by Miranda (2002) was used to classify all tongue SCC cases. Score 0 was attributed to absent-weak immunoexpression and score 1 for strong immunostaning and pattern of distribution was focal or diffuse. Microvessel counts (MVC) was established for CD105. Most of the patients with tongue SCC was male. The principal age in tongue SCC without metastasis was over 65 years and in tongue SCC with metastasis was between 45-65 years. There were predominance of stage II in TNM and in the specimens with high-grade, independent of studied group. For BMP-2, 56% of tongue SCC without metastasis and 72% tongue SCC with metastasis exhibited score 1 while the IFH showed secore 0 in 72% of the cases, with statistical association (p=0,007). Considering the BMPR-II, 52% of tongue SCC without metastasis exhibited score 0; 56% tongue SCC with metastasis and 60% IFH showed score 1. The majority cases of BMPR-IA demonstrated score 1 and 100% of CD105 exhibited strong immunoexpression in tongue SCC. Regarding the pattern distribution, it was noted a tendency to diffuse pattern for the proteins in all groups. The means of MVC were similar in tongue SCC without metastasis (32,91) and in tongue SCC with metastasis (32,05), however existed statistical difference with IFH (p<0,001). There was statistical association of BMP-2 expression with BMPR-II (p=0,008), BMPR-IA (p=0,006) and CD105 (p=0,046). An association between TNM and BMP-2 immunoexpression and their receptors was not detected, nevertheless this association was found with MVC (p=0,047) whose averages were higher for the stages II (35,97) e IV (35,69). No association between histological grading and these proteins was observed. This study suggests that the superexpression of BMP-2 signaling pathways acts on cell proliferation in tongue SCC and can be implicated with more invasive potential. Additionaly, the CD105 is a potent biological marker of neovascularization in this neoplasm and their association with BMP-2 and BMPR-IA receptor, showed that this type of cancer in BMP-2 is presented as pro-angiogenic in the metastatic process / As BMPs (prote?nas morfogen?ticas ?sseas) s?o citocinas relacionadas com a prolifera??o e angiog?nese em diversos tipos de c?ncer humano. Com este trabalho foi analisada a express?o imunoistoqu?mica das prote?nas BMP-2, BMPR-IA, BMPR-II e endoglina (CD105), correlacionando-a com o comportamento biol?gico e a angiog?nese local nos carcinomas epiderm?ides de l?ngua (CEL). A amostra foi composta de 25 casos de CEL sem met?stase (CELSM), 25 CEL com met?stase (CELCM) graduados segundo Bryne (1998) e adaptado por Miranda (2002), al?m de 25 casos de hiperplasia fibrosa inflamat?ria (HFI), utilizado como grupo controle. Foi utilizado escore 0 para marca??o ausente-fraca e 1 para forte; tipo de distribui??o focal ou difuso. Adicionalmente, para o CD105 foi realizada a contagem microvascular (MVC). A maior parte dos pacientes com CEL foi do sexo masculino, no grupo CELSM a faixa et?ria foi maior que 65 anos e o CELCM se encontrou entre 45-65 anos; houve predom?nio do est?gio II do TNM, assim como de esp?cimes de alto grau, independente do grupo estudado. Para BMP-2, 56% dos CELSM e 72% dos CELCM exibiram escore 1, enquanto a HFI exibiu 72% de escore 0, apresentando associa??o estat?stica (p=0,007). Para BMPR-II 52% dos CELSM exibiram escore 0; 56% CELCM e 60% da HFI escore 1 e no BMPR-IA ocorreu uma predomin?ncia de escore 1 e para o CD105 100% de marca??o forte nos CEL. Quanto ao tipo de distribui??o notou-se tend?ncia de distribui??o difusa de todas as prote?nas, em todos os grupos. Observaram-se, para MVC, m?dias muito semelhantes entre os CELSM (32,91) e os CELCM (32,05) exibindo, contudo, diferen?a estat?stica com as HFI (p<0,001).Observa-se uma associa??o estat?stica da BMP-2 com a BMPR-II (P=0,008), BMPR-IA (p=0,006) e o CD105 (0,046). N?o se observou associa??o entre o TNM e a imunoexpress?o da BMP-2 e seus receptores, por?m foi encontrada com a MVC (p=0,047), cujas maiores m?dias foram para os est?gios II (35,97) e IV (35,69), tal como n?o ocorreu associa??o entre a grada??o histol?gica e as prote?nas. Conclui-se que a superexpress?o da via de sinaliza??o da BMP-2 atua na prolifera??o celular, contribuindo para maior invasividade do CEL. O CD105 ? um potente marcador de neovasculariza??o deste neoplasma e sua associa??o com a BMP-2 e o receptor BMPR-IA, mostra que neste tipo de neoplasia a BMP-2 se apresenta como pr?-angiog?nico no processo metast?tico

Background: Angiogenesis is recognised as a critical step in tumour progression. The angiogenic switch is activated by various trigger signals, such as hypoxia, low pH, and genetic mutations. Renal cell carcinoma (RCC) is often an aggressive tumour, and advanced disease has limited treatment options and bad prognosis. This study was focused on markers of angiogenesis in RCC: endoglin (CD105) and CD31 assessing microvessel density (MVD), and carbonic anhydrase (CA) IX and hypoxia-inducible factor (HIF)-2α expressed at hypoxia. Upregulation of HIF is also associated with inactivation of the von Hippel-Lindau (VHL) tumour suppressor gene, which is common in conventional/clear cell (c)RCC. Method: A tumour bank containing 308 tumours from patients operated 1982-2003 was used. The tumours were well characterised regarding tumour type, TNM stage, nuclear grade, tumour size, and patient survival. The tumours were prepared in tissue microarrays and fresh frozen in whole sections. To analyse the expression of endoglin, CD31, CA IX, and HIF-2α mRNA, immunohistochemistry and real-time PCR were used. Results: There was a higher endoglin expression in cRCC than in papillary (p)RCC and chromophobe (ch)RCC, and a higher CD31 expression in cRCC than in pRCC. MVD correlated inversely to TNM stage and nuclear grade in cRCC. There was also an inverse correlation between tumour diameter and CD31 expression in cRCCs. Patients with cRCC with high MVD had a more favourable prognosis than patients with lower MVD. Endoglin and CD31 were not independent prognostic factors. The CA IX expression was higher in cRCC than in pRCC and chRCC. Patients with cRCC expressing low CA IX had a significantly less favourable prognosis compared with those with higher expression. CA IX is an independent prognostic factor. There was a higher HIF-2α mRNA expression in cRCC than in pRCC and chRCC. In cRCC, there was a significant inverse correlation between HIF-2α mRNA expression, and TNM stage and nuclear grade. There was also an inverse correlation between HIF-2α mRNA expression and tumour size among patients with cRCC. HIF-2α was not an independent prognostic factor. Conclusion: In these studies, the factors related to hypoxia and vascularity were all inversely correlated to tumour aggressiveness in cRCC. MVD, CA IX, and HIF-2α expression were also higher in cRCC than in pRCC and chRCC. The relationship between angiogenesis, vascularity, and hypoxia is ambiguous. A line of reasoning including mutations increasing angiogenesis in advanced disease may also be applied to RCC. Measurements of individual angiogenic factors seem to provide prognostic information, and can potentially be combined in patient monitoring and treatment.

Abstract Ovarian cancer is the leading cause of death from gynaecological cancers in the Western world. Ovarian cancer comprises of tumours with distinct behaviour and individually different responses to chemotherapy, even within the same histology. Unfortunately, there are no molecular markers in clinical use to either distinguish between patients with better and worse prognosis or to predict individual chemosensitivity. The comprehension of the molecular effects of chemotherapeutic drugs is a prerequisite for finding predictive molecular factors for chemoresponse and prognosis. Some proteins in molecular pathways contributing to DNA damage response, angiogenesis and oxidative stress have been implicated in ovarian cancer prognosis. In this study, the responses in p53 pathway and among angiogenesis-related factors to chemotherapeutic drugs were analysed in ovarian cancer cell lines. In OVCAR-3 cells with mutated p53, cisplatin but not docetaxel induced p14ARF, an important regulator of p53, at mRNA and protein level. Cisplatin also significantly increased the mRNA expression of angiogenesis-related factors TSP-1, BMP-4, ET-1 and PlGF-2 while an equivalent dose of docetaxel had only minor effects. In clinical ovarian carcinomas, the expression of BMP-4, TSP-1 and CD105 as well as the marker of oxidative stress derived DNA damage, 8-OHdG, and peroxiredoxin antioxidants were analysed by immunohistochemistry. High expression of BMP-4 and cytoplasmic peroxiredoxin IV were associated with better prognosis, while high 8-OHdG expression associated with shorter survival. Explant cultures of fresh ovarian tumour tissue were used for the evaluation of individual responses of p53 and Hdm2 after in vitro treatments of the explant cultures by carboplatin or docetaxel. Major differences between the individual tumours were found, especially in the responses of p53 to carboplatin. The results of this study suggest, that BMP-4, 8-OHdG and peroxiredoxin IV may serve as prognostic markers in ovarian cancer. The differences shown in the molecular responses to platinum and taxane drugs may have value in tailoring individual chemotherapy. Also, fresh ovarian cancer tissue explant culture is worth further studies as a predictive method for analysing individual tumour responses for chemotherapeutic agents. / Tiivistelmä Munasarjasyöpä on suurinta kuolleisuutta aiheuttava gynekologinen syöpä läntisessä maailmassa. Munasarjakasvaimet eroavat toisistaan niin käyttäytymiseltään kuin yksilölliseltä sytostaattihoitovasteeltaan, jopa sama histologisen tyypin sisällä. Kliinisessä käytössä ei valitettavasti ole sellaisia molekulaarisia merkkiaineita, jotka erottaisivat toisistaan paremman ja huonomman ennusteen kasvaimet tai ennustaisivat yksilöllistä solunsalpaajaherkkyyttä. Hoitovastetta ja potilaan prognoosia ennustavien merkkiaineiden löytämisen edellytys on kemoterapian molekyylitason vaikutusten ymmärtäminen. DNA vaurion tunnistamiseen, angiogeneesiin ja oksidatiiviseen stressiin liittyvien vaikutusreittien joillakin proteiineilla on ehdotettu olevan ennusteellista merkitystä munasarjasyövässä. Tässä väitöskirjatyössä analysoitiin munasarjasyöpäsoluja käyttäen p53 vaikutusreitin ja eräiden angiogeneesiin liittyvien tekijöiden vasteita sytostaateille. Mutatoitunutta p53 proteiinia kantavissa OVCAR-3 soluissa sisplatiini, toisin kuin dosetakseli, indusoi p53 proteiinin tärkeää säätelijää, p14ARF:a sekä mRNA- että proteiinitasolla. Sisplatiini lisäsi merkittävästi myös usean angiogeneesiin liittyvän tekijän (TSP-1, BMP-4, ET-1 ja PlGF-2) mRNA:ta. Dosetakselin vaikutukset vastaavalla annoksella olivat vähäiset. Kliinisissä munasarjasyövissä BMP-4, TSP-1 ja CD105 sekä oksidatiivisen stressin aiheuttaman DNA-vaurion merkkiaineen, 8-OHdG:n sekä peroksiredoksiiniantioksidanttien ilmeneminen analysoitiin immunohistokemiallisesti. BMP-4:n ja sytoplasmisen peroksiredoksiini IV:n vahva ilmentyminen liittyivät parempaan ennusteeseen, kun taas 8-OHdG:n vahva ilmentyminen liittyi huonompaan elinajan ennusteeseen. Tuoreen munasarjasyöpäkudoksen eksplanttiviljelyn avulla selvitettiin p53 ja Hdm2 proteiinien vasteita syöpäkudoksen karboplatiini- tai dosetakseli-käsittelyille. Selkeitä yksilökohtaisia eroja havaittiin erityisesti karboplatiinin aiheuttamissa p53 vasteissa niin eri potilaiden kuin eri histologisten kasvaintyyppien välillä. Tämän väitöskirjatutkimuksen tulokset antavat viitteitä BMP-4:n, 8-OHdG:n ja peroksiredoksiinin mahdollisesta ennusteellisesta merkityksestä munasarjasyövässä. Erot platinayhdisteiden ja taksaanien välillä saattavat osoittautua merkittäviksi yksilöllisiä syövän hoitoja räätälöitäessä. Tuoreen munasarjasyöpäkudoksen eksplanttiviljelyn mahdollisuuksia yksilöllisten kasvainten hoitovasteiden ennustamisessa kannattaa selvittää jatkotutkimuksin.