Abstract Background: Acid ceramidase (AC), a key enzyme of sphingolipid metabolism, seems to play an important role in cancer progression. Aim: The objective of this study was to explore the expression of AC in epithelial ovarian cancer relapse patients and its impact on prognosis. Materials And Methods: Expression analysis of AC in n= 90 epithelial ovarian cancer patients were of (11stageI, 24 stage II, 27 stage III, and 28 stage IV) were analyzed by ELISA sandwich these include relapse patients from (15 stage III and 18 Stage IV) through 6 months after chemotherapy. AC expression ranged from (7.0_52.91) (median 10. 05) A follow-up study of 90 cases through 6 months after complete resection of the primary tumors by surgical operation was performed and chemotherapy finished. Results: AC expression of the cases with recurrence tumor showed significantly higher levels compared to cases without recurrence (P = 0.001 As 33 patients relapsed after treatment out of 90 patients These results were correlated to clinical and pathologic characteristics and survival. AC expression correlated significantly with FIGO stage (0.001) In serous carcinoma, high level of AC was independently associated with reduced progression-free survival and overall survival of 6.0 months acid ceramidase > 21.22 ng/ml (HR= 11.98, 95%CI= 2.21-65.1, p= (0.004) high AC expression can be associated with tumor progression in carcinoma of the ovaries. acid ceramidase (AC) is upregulated in tumor tissues. Conclusion: This study has now concluded that this creates a dysfunctional ceramide pathway, which is responsible for tumor progression and resistance to chemotherapy and radiation.

Keywords: Acid Ceramidase—Ovarian Cancer—Sphingolipid Metabolism