Gamma-glutamyl transpeptidase (GGT) is a cell surface enzyme that initiates the cleavage of extracellular glutathione, thereby providing the cell with the amino acids necessary for increased synthesis of glutathione. GGT is induced in ovarian tumor cell lines selected in vitro for resistance to cisplatin. No study has examined GGT expression in primary human ovarian tumors. We analyzed frozen sections of 80 normal human ovaries and 56 ovarian tumors for expression of GGT. Histochemical staining showed that GGT was not expressed in the cells of the follicle or surface germinal epithelium of the normal ovary. GGT was expressed in some epithelial inclusion glands and occasionally in a small subset of stromal cells. Granulosa-stromal cell tumors were largely GGT-negative. In contrast, GGT-positive neoplastic cells were observed in 33 of 45 common epithelial ovarian tumors. None of the patients had been treated with chemotherapy. Some of the tumors had only rare GGT-positive cells, while others consisted almost entirely of GGT-positive cells. Among the low malignant potential and invasive tumors, at least one-half of the cells were GGT-positive in 6 of 9 serous borderline tumors (2 with mucinous foci), 0 of 1 borderline mucinous tumor, 3 of 12 serous papillary carcinomas, 2 of 3 mucinous carcinomas, 1 of 2 endometrioid carcinomas, 2 of 2 clear cell carcinomas, 0 of 2 transitional cell carcinomas, and 4 of 5 undifferentiated carcinomas. There was no correlation between the stage of the tumor and GGT expression, indicating that a GGT-negative tumor does not become GGT-positive as it progresses to a more widely disseminated lesion. In addition, there was no correlation between serum levels of CA 125 and GGT expression. These data show that GGT is expressed in many common ovarian epithelial neoplasms. We are currently following the response of these patients to chemotherapy to determine if expression of GGT serves as a marker for identifying neoplasms with enhanced resistance to platinum-based therapy.