ETS-1 has been identified as a transcription factor involved in tumor angiogenesis, which is essential for the growth, invasion, and metastasis of solid tumors. This result prompted us to study whether ETS-1 works as an angiogenic mediator in ovarian cancers. Immunohistochemical staining revealed that ETS-1 was expressed in vascular endothelial cells and in cancer cells of ovarian cancers. There was a significant correlation between microvessel counts and both ETS-1 histoscores and ets-1 mRNA levels in ovarian cancers. Both ETS-1 histoscores and ets-1 mRNA levels increased with the progression of ovarian cancers. Furthermore, the 24-month survival rate of 30 patients with high ets-1 (high ETS-1 histoscores and high ets-1 mRNA levels) was 30%, while that of 30 other patients with low ets-1 (low ETS-1 histoscores and ets-1 mRNA levels) was 70%. There was a significant difference between the 24-month survival rates of the 30 patients with high ets-1 and the 30 with low ets-1. This indicates that ETS-1 might act as an angiogenic mediator in, and be a prognostic factor for, ovarian cancers. ngiogenesis is essential for development, growth and progression of solid tumors.1) The angiogenic factors vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), platelet-derived endothelial cell growth factor (PD-ECGF; identical with thymidine phosphorylase (TP)), and interleukin (IL)-8 modulate angiogenesis in ovarian cancers.2-5) bFGF was found to be expressed in both cancer and interstitial cells of ovarian cancers, and its levels correlated with clinical stage, but not obviously with the patients' prognosis.2) PD-ECGF was dominantly expressed in interstitial cells of ovarian cancers, and a high level correlated with poor prognosis.3) VEGF, particularly VEGF 165 isomer, was dominantly expressed in cancer cells of primary ovarian cancers, and its level correlated with the patients' prognosis, regardless of histopathological findings.4) Furthermore, patients with higher VEGF levels in peritoneal metastatic lesions than in the primary tumors had poorer prognosis.
5)During angiogenesis, ETS-1 is strongly expressed in vascular endothelial cells and in the adjacent interstitial cells. 6) Once angiogenesis has ended, ETS-1 expression is down-regulated. 7,8) The representative angiogenic factors VEGF and bFGF immediately induce ETS-1 expression in the early stage of angiogenesis, while the inhibition of ETS-1 expression leads to suppression of angiogenesis.9, 10) The proteases urokinase typeplasminogen activator (u-PA), matrix metalloprotease (MMP)-1, MMP-3 and MMP-9 have a conserved ETS-binding motif, and transcription factor ETS-1 converts vascular endothelial cells to angiogenic phenotypes by inducing expression of u-PA, 12) Ets-1 is expressed in various gastric, pancreatic, esophageal, and hepatocellular and cholangiocellular carcinomas and in thyroid and astrocytic tumors, and acts as a proto-oncogene. [13][14][15][16][17][18][19] ETS-1 is up-regulated and involved in the overexpression of MMP-7 in hepa...