Soluble AXL is ubiquitously present in malignant serous effusions

Gynecol Oncol. 2019 Feb;152(2):408-415. doi: 10.1016/j.ygyno.2018.11.012. Epub 2018 Nov 15.

Abstract

Objective: The objective of this study was to analyze the expression level and clinical role of soluble AXL (sAXL) in cancers affecting the serosal surfaces, with focus on ovarian carcinoma.

Methods: sAXL protein expression by ELISA was analyzed in 572 effusion supernatants, including 424 peritoneal, 147 pleural and 1 pericardial specimens.

Results: sAXL was overexpressed in peritoneal effusions compared to pleural and pericardial specimens (p < 0.001). sAXL levels were additionally significantly higher in effusions from patients with ovarian carcinoma, malignant mesothelioma and breast carcinoma compared to specimens from patients with other cancers (predominantly carcinomas of lung, gastrointestinal or uterine corpus/cervix origin) or benign reactive effusions (p < 0.001). sAXL was further overexpressed in high-grade serous carcinoma (HGSC; n = 373) compared to low-grade serous carcinoma (LGSC; n = 32; p = 0.036). In HGSC, sAXL levels were significantly lower in post-chemotherapy effusions compared to primary diagnosis pre-chemotherapy specimens (p = 0.002). sAXL levels in HGSC were unrelated to chemoresponse at diagnosis, progression-free survival or overall survival. Levels were similarly unrelated to survival in LGSC and breast carcinoma.

Conclusions: sAXL is widely expressed in malignant effusions, particularly in ovarian and breast carcinoma and in malignant mesothelioma. sAXL is overexpressed in HGSC compared to LGSC and its levels are lower following exposure to chemotherapy. However, sAXL levels are not informative of chemoresponse or survival.

Keywords: ELISA; Effusion; Ovarian carcinoma; Soluble AXL; Survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Ascitic Fluid / drug effects
  • Ascitic Fluid / enzymology*
  • Ascitic Fluid / pathology
  • Axl Receptor Tyrosine Kinase
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / enzymology*
  • Breast Neoplasms / pathology
  • Cystadenocarcinoma, Serous / drug therapy
  • Cystadenocarcinoma, Serous / enzymology*
  • Cystadenocarcinoma, Serous / pathology
  • Female
  • Humans
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / enzymology*
  • Lung Neoplasms / pathology
  • Mesothelioma / drug therapy
  • Mesothelioma / enzymology*
  • Mesothelioma / pathology
  • Mesothelioma, Malignant
  • Middle Aged
  • Neoplasm Staging
  • Ovarian Neoplasms / drug therapy
  • Ovarian Neoplasms / enzymology*
  • Ovarian Neoplasms / pathology
  • Proto-Oncogene Proteins / biosynthesis*
  • Receptor Protein-Tyrosine Kinases / biosynthesis*
  • Young Adult

Substances

  • Proto-Oncogene Proteins
  • Receptor Protein-Tyrosine Kinases
  • Axl Receptor Tyrosine Kinase
  • AXL protein, human