Increased circulating hepatocyte growth factor (HGF): A marker of epithelial ovarian cancer and an indicator of poor prognosis

ObjectiveHepatocyte growth factor (HGF) has been described to be increased in different cancers. In the present study we wanted to investigate whether HGF in serum can distinguish between benign and malignant ovarian tumors, and whether serum HGF levels can predict the outcome in patients with ovarian carcinomas.MethodsWe included 123 consecutive patients appointed for laparotomy due to a pelvic mass. Preoperative levels of serum cancer antigen 125 (CA 125), HGF and HGF activator (HGFA) were quantified with immunological methods. We performed immunohistochemical analyses of HGFα, HGFβ and the receptor c-Met. Five-year survival of patients with advanced disease (stage III and stage IV) was analyzed with the Kaplan–Meier method.ResultsSixty patients had ovarian carcinomas, 23 borderline tumors, and 40 benign ovarian tumors. Patients with ovarian carcinomas had significantly higher preoperative HGF and CA 125 serum levels than patients with benign ovarian tumors, and borderline tumors. Patients with borderline tumors had significantly higher CA 125 values than benign cases. A combination of CA 125 and HGF increased the specificity in predicting carcinoma. We observed abundant HGFα, HGFβ and c-Met expressions in all ovarian tumors. Patients with advanced disease and preoperative serum HGF values ≥ 2 SD above reference value had a shorter disease-free survival than patients with advanced disease and serum HGF < 2 SD above reference value.ConclusionsHGF in serum is an indicator of ovarian carcinoma in women with a pelvic mass, and of a poor prognosis in advanced ovarian cancer.

Research Highlights
► Serum HGF is elevated in ovarian carcinoma.
► Elevated serum HGF implies a poor prognosis.
► A combination of serum HGF and CA 125 increases the specificity in predicting ovarian carcinoma in women with a pelvic mass.