Summary Ovarian adenocarcinomas develop as the result of multiple genetic and epigenetic changes in the precursor ovarian surface epithelial (OSE) cells which result in a malignant phenotype. We investigated changes in gene expression in ovarian adenocarcinoma using a cDNA array containing 588 known human genes. We found that intercellular adhesion molecule-1 (ICAM-1) was expressed at lower levels in the ovarian tumour cell lines OAW42, PEO1 and JAM than in the immortalised human ovarian surface epithelial cell line HOSE 17.1. Further investigation revealed ICAM-1 was expressed in the surface epithelium of normal ovaries and both mRNA and protein expression levels were reduced in the majority of ovarian adenocarcinoma cell lines and primary tumours. ICAM-1 expression was increased in 8/8 cell lines treated with the de novo methyltransferase inhibitor 5-aza-2′-deoxycytidine, indicating that methylation of CpG islands may play a role in the down-regulation of its expression in primary tumours. There was a significant association between patients whose tumours expressed ICAM-1 and survival (P = 0. 1351-1358© 2001 Cancer Research Campaign doi: 10.1054/ bjoc.2001.2075, available online at http://www.idealibrary.com on http://www.bjcancer.com 1987), SKOV3 (Fogh and Trempe, 1975), COLO316 (Woods et al, 1979), CAOV3 (Wong et al, 1999), OVCAR-3 (Hamilton et al, 1983) and 27/87 (derived by T Hurst) -were all maintained in RPMI 1640 with 10% FCS. Cells were harvested for RNA isolation at about 80% confluence. The cell lines OAW 42, PEO1, PEO14, JAM, SKOV3 and COLO316 were derived from serous tumours, and 27/87 was from an endometrioid tumour. The histological types of the tumours from which the cell lines HEY, CAOV3 and OVCAR3 were derived are unknown.Primary cultures of human ovarian surface epithelial (OSE) cells were prepared according to the method of Kruk et al (1990). Epithelial cells were obtained by scraping contaminating stromal cells away from proliferating epithelial sheets and were cultured in 1:1 MCDB105: Medium 199 with Earles' salts, supplemented with 20 ng ml -1 epidermal growth factor, 400 ng ml -1 hydrocortisone and 15% fetal calf serum. Their distinctive cellular morphology was used to confirm that the cultures were epithelial cells. In one case, RNA was extracted directly from the peeled epithelial cells without culturing.Ovarian adenocarcinomas were obtained from 44 patients undergoing surgery. There were 35 serous, 6 endometrioid, one mucinous and 2 clear-cell tumours. There were 43 malignant tumours and the other was of low malignant potential (LMP). All patients were staged at laparotomy, in accordance with the recommendations of the International Federation of Gynaecology and Obstetrics (FIGO). Of the malignant tumours, one was FIGO stage 1, 4 stage 2, 33 stage 3 and 5 stage 4. There were two grade 1-2, 11 grade 2, 10 grade 2/3, 17 grade 3, one grade 3-4, and 2 that were not graded. Clinicopathological data for these tumours are summarised in Table 2. Constitutional DNA was available in all ca...