الفهرس 
INTRODUCTION
Ovarian cancerOnly 14 pages are availabe for public view
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Abstract
This study was done at Medical Biochemistry Department, Faculty of Medicine, Ain Sham University during the period from 2012 – 2014 and included 50 patients.
The aim of the current study is correlation of Foxp3 expression with Risk of Malignancy Index (RMI) to assess the diagnostic significance of this marker in ovarian malignancy
and correlation of the results with the various clinicopathological data in an attempt to find a new diagnostic and/or prognostic molecular biomarker for ovarian cancer.
The studied individuals were classified into two main groups:
· group A: Patients with malignant ovarian lesions (no.
=25).
· group B: Patients with benign ovarian lesions as a control group (no. =25).
All patients in our study were subjected to complete detailed history taking, general and local examination, routine laboratory investigations, radiodiagnostic investigations as pelvic ultrasonography (US), serum CA125 levels were measured, RMI was calculated and all patients were subjected to surgery for excision of the tumor mass. Then, tumor samples were sent for pathological staging and grading according to (TNM) classification.
RNA extraction of all samples was done for relative quantitative real time PCR of Foxp3 and -actin as a house keeping gene for both tissue samples. Then the results were calculated and statistically analyzed by the SPSS software.
The obtained results revealed the following:
· All the clinicopathological factors showed no significant differences (P>0.05) except the ultrasound score is high significantly different between the studied groups (P< 0.01).
· There is a significant difference between epithelial and stromal tumors in relation to each of grades and stages
(P < 0.05).
· There was a highly significant difference (P<0.01)
between the studied groups as regards Foxp3 gene expression by real time PCR.
· Applying (0.19), as a cut off value which was calculated by ROC curve, Foxp3 gene expression showed 84% sensitivity, 88% specificity, 87.5% PPV, 84.6% NPV and 86% accuracy.
· The positivity rate of Foxp3 in different groups of this study showed a high significant increase in malignant
group (84%) as compared with benign group (12%) (P=0.00).
· No significant difference was observed in positivity rate of Foxp3 in relation to clinicopathological factors except for breast-feeding (P < 0.05).
· No significant difference was found between Foxp3 relative quantity and any of the studied clinicopathological
factors (P>0.05).
· There was a highly significant difference (p=0.00) between the positivity rate of Foxp3 in benign Group
versus epithelial tumors, stromal tumors, early stages and low grade of the tumor.
· There was a highly significant difference of Foxp3 expression in the epithelial ovarian cancer even more
than the stromal cells ovarian cancer in comparison to the benign group (p=0.001 and 0.003, respectively).
· Foxp3 was highly expressed in early stages and low grades ovarian malignancy (P=0.00 and 0.001
respectively). This suggests the possibility of usage this gene as an early diagnostic marker in ovarian cancer that is a novel finding in this study.
· There was a highly significant correlation (p < 0.01) between Foxp3 measured by real time PCR with US score and RMI, and a significant correlation (p< 0.05) with CA125 serum levels (U/ml) in all groups of the
study.
· The concordance between results of Foxp3 by real time PCR and RMI was 87.5% that is highly significant (p <
0.01).
· Combined sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value
(NPV) of Foxp3 with RMI will result in absolute sensitivity (100%) but worsen the specificity (84%) and the PPV will decrease to 86.2% while NPV will be 100%
and accuracy will be 92%.