Immunoreactivities of ZCCHC3 and Efp in the High‐Grade Serous and Clear Cell Ovarian Carcinomas Are Worse Prognostic Factors

Ovarian cancer is a prevalent gynecological malignancy among women worldwide, with its high rates of recurrence, metastasis, and mortality, underscoring the need to identify reliable prognostic factors. Recent findings have indicated that zinc finger CCHC-type containing 3 (ZCCHC3) and estrogen-responsive finger protein (Efp), which function in anti-RNA virus innate immunity as protein binding partners, are potential prognostic markers in patients with triple-negative breast cancer. Furthermore, a correlation has been observed between Efp immunoreactivity (IR) and advanced disease stage in ovarian carcinomas. However, the pathophysiological role of ZCCHC3 and Efp in ovarian carcinoma remains to be elucidated. We investigated IR of ZCCHC3 and Efp in a cohort of high-grade serous ovarian carcinoma (HGSC) and clear cell ovarian carcinoma (CCC). ZCCHC3 IR was associated with pathological T factor, stage, histological type, Ki67 labeling index, and Efp IR. Positive ZCCHC3 and Efp statuses were each significantly correlated with worse disease-free survival (DFS) in Kaplan-Meier survival analysis. In addition, combined ZCCHC3 and Efp positivity was associated with poor DFS in univariate analysis and showed a trend toward worse survival in multivariate analysis. These findings suggest that ZCCHC3 and Efp play a significant role in HGSC and CCC progression, likely due to their cooperative interactions.