Background and aims: Brain metastases from gynecological malignancies are rare. Patients with brain metastases have poor prognosis and have rapidly progressing neurologic symptoms. Therefore, early detection and optimal management of brain metastases are necessary. Recent advancement in diagnostic imaging allows the early detection of brain metastases. Several treatment methods such as radiation therapy, chemotherapy, and tumor enucleation are available. We aimed to identify a protein that is associated with brain metastases and determine if it can be used as a new diagnostic marker.
Methods: Thus far, we examined 15 cases of brain metastases from gynecological malignancies. Between 2006 and 2011, 3 of these cases underwent surgical resection (uterine cervical cancer, FIGO stage IIb; uterine corpus cancer, FIGO stage Ib; and ovarian cancer, FIGO stage IIIb). Proteomic analysis was performed on the formalin-fixed paraffin-embedded tissues of the primary tumor and brain metastases, and the samples were analyzed by liquid chromatography-mass spectrometry (LC/MS). Candidate proteins were detected by using the following analytical systems: the Scaffold system and Mascot search program. Their expression levels were analyzed by western blotting.
Results: Our analyses identified tumor metastasis related proteins(β-tubulin, triosephosphate isomerase, enolase 1)as the candidate proteins. Western blotting revealed that enolase 1 expression levels were significantly higher in the metastatic brain lesions than in the primary tumor.
Conclusion: These results suggest that enolase 1 may play a role in tumor metastasis development and brain metastasis progression. Enolase 1 might be an effective marker for the early detection of brain metastases.
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