Using the DNA microarray technology, we have identified genes that are differentially expressed in chemosensitive and chemoresistant ovarian serous papillary carcinomas and could potentially distinguish ovarian cancer patients based on their response to chemotherapy. The present study aims to evaluate the clinical usefulness of overexpression of selected genes by immunohistochemistry. Our cohort included 158 women who were operated on and received chemotherapy for an advanced serous papillary ovarian carcinoma (FIGO stages III and IV). The end point used in this study was progression-free survival. Immunohistochemistry was performed on microarray blocks containing all 158 cases. Twelve commercially available antibodies were selected. Of them, 10 corresponded to differentially expressed genes in our micro-array study and p53 and Ki67 were included. Antibodies were obtained for the following selected genes: GSTA1, MMP1, FOSB, CTSL2, HSP10, CD36, CXCL2, RBBP7, Siva, and PTGDS. Cox proportional hazards models, adjusted for standard risk factors, were used to estimate the associations between the markers and progression-free survival. No association was found between mRNA level and protein expression by immunohistochemistry. In multivariate analyses, patients whose tumors overexpressed HSP10 had a lower risk of progression than those with low expression (HR: 0.6; CI: 0.42-0.87; P ¼ 0.007). High level of proliferation (Ki67) tended to be associated with a lower risk of progression (HR: 0.72; CI: 0.51-1.03; P ¼ 0.07) whereas MMP1 overexpression tended to be associated with a higher risk of progression (HR: 1.61; CI: 0.94-2.79; P ¼ 0.08). Our study shows that gene expression analysis coupled with immunohistochemistry allowed the identification of HSP10 as an independent factor of progression-free survival. Modern Pathology (2008Pathology ( ) 21, 1002Pathology ( -1010 doi:10.1038/modpathol.2008 published online 23 May 2008 Keywords: serous ovarian carcinoma; chemoresistance; HSP10; DNA microarray; immunohistochemistry Ovarian cancer is responsible for more cancer deaths among women in the Western world than any other gynecologic malignancy. 1 An initial surgical approach is essential for aggressive cytoreduction and proper staging of the disease, since minimal residual tumor after surgery is a major factor of better response to chemotherapy and survival. 2 Intravenous combinated chemotherapy with taxol plus carboplatin is the current regimen of choice for the treatment of advanced ovarian cancer and is followed by a 50% complete pathologic remission rate. 3 Resistance to chemotherapy is, however, a major concern. Indeed, although significant proportions of women respond to chemotherapy, the majority of responders (approximately 60-75%) eventually relapses and dies from recurrent disease while 20-30% of patients never experience a clinical remission. 4 Chemotherapy resistance in ovarian