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Differential cyclooxygenase-2 expression in squamous cell carcinoma and adenocarcinoma of the uterine cervix

Authors
 Yong Bae Kim  ;  Gwi Eon Kim  ;  Tchan Kyu Park  ;  Chang Ok Suh  ;  Jinsil Seong  ;  Chang Geol Lee  ;  Ki Chang Keum  ;  Nam Hoon Cho  ;  Hong Ryull Pyo 
Citation
 INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, Vol.60(3) : 822-829, 2004 
Journal Title
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
ISSN
 0360-3016 
Issue Date
2004
MeSH
Adenocarcinoma/enzymology* ; Adenocarcinoma/mortality ; Adenocarcinoma/radiotherapy ; Adult ; Aged ; Carcinoma, Squamous Cell/enzymology* ; Carcinoma, Squamous Cell/mortality ; Carcinoma, Squamous Cell/radiotherapy ; Cyclooxygenase 2 ; Female ; Humans ; Immunohistochemistry ; Isoenzymes/analysis* ; Membrane Proteins ; Middle Aged ; Neoplasm Proteins/analysis* ; Prostaglandin-Endoperoxide Synthases/analysis* ; Statistics as Topic ; Uterine Cervical Neoplasms/enzymology* ; Uterine Cervical Neoplasms/mortality ; Uterine Cervical Neoplasms/radiotherapy
Keywords
COX-2 ; Squamous cell carcinoma ; Adenocarcinoma ; Uterine cervical cancer
Abstract
PURPOSE: To determine the differential expression of cyclooxygenase-2 (COX-2) in patients with squamous cell carcinoma (SCC) and adenocarcinoma (ADC) of the uterine cervix and the prognostic significance of COX-2 expression in these histologic types. METHODS AND MATERIALS: A total of 105 International Federation of Gynecology and Obstetrics Stage IIB uterine cervical cancer patients were screened for COX-2 expression immunohistochemically. COX-2 expression was determined in invasive cervical SCC (n = 84) and invasive cervical ADC (n = 21). To determine the clinical significance of COX-2 expression by histologic type, the patients were arbitrarily divided into four groups: SCC/COX-2 negative (n = 64); SCC/COX-2 positive (n = 20); ADC/COX-2 negative (n = 9); and ADC/COX-2 positive (n = 12). The clinical response to treatment, patterns of treatment failure, and survival data by COX-2 expression were compared for these two major histologic types. Univariate and multivariate analyses were performed to identify the prognostic factors influencing survival. RESULTS: Immunohistochemical examination showed that COX-2 expression was more frequently observed in ADC than in SCC (57% vs. 24%, p = 0.007). Moreover, COX-2 expression was an important predictor of treatment response, irrespective of the histologic type. All COX-2-negative patients achieved complete remission after initial treatment; 17% of SCC patients and 33% of ADC patients with COX-2 expression did not have complete remission after the initial treatment. The incidence of local failure for those with COX-2 expression was significantly greater than for COX-2-negative patients, regardless of histologic type. With a minimal follow-up of 60 months, the overall 5-year actuarial survival rate for SCC and ADC patients was 79% and 62%, respectively (p = 0.05). The 5-year disease-free survival rate for SCC and ADC patients was 73% and 56%, respectively (p = 0.13). Irrespective of the pathologic type, COX-2-positive patients had an unfavorable prognosis. The overall 5-year actuarial survival rate was 57% for COX-2-positive patients and 83% for COX-2-negative patients (p = 0.001). When patients were stratified into the four groups according to histologic type and COX-2 expression status, ADC/COX-2-positive patients had the worst prognosis, with an overall 5-year actuarial survival rate of 49% compared with 78% for ADC/COX-2-negative patients, 62% for SCC/COX-2-positive, and 84% for SCC/COX-2-negative patients (p = 0.007, log-rank test). Irrespective of histologic type, COX-2 expression was an independent prognostic factor by univariate and multivariate analyses. CONCLUSION: In uterine cervical cancer, COX-2 was expressed in a greater proportion of ADC patients than SCC patients. COX-2 expression was also identified as a major determiner of a poor response to treatment and of an unfavorable prognosis, irrespective of the histologic type, reflecting the importance of the COX-2 protein in the acquisition of biologic aggressiveness and more malignant phenotype or increased resistance to the standard chemotherapy and radiotherapy in both histologic types. Given these observations, we believe that that ADC/COX-2-positive patients might be appropriate candidates for future trials of selective COX-2 inhibitor adjunctive therapy.
Full Text
http://www.sciencedirect.com/science/article/pii/S0360301604006686
DOI
10.1016/j.ijrobp.2004.04.030
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Gwi Eon(김귀언)
Suh, Chang Ok(서창옥)
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Lee, Chang Geol(이창걸) ORCID logo https://orcid.org/0000-0002-8702-881X
Cho, Nam Hoon(조남훈) ORCID logo https://orcid.org/0000-0002-0045-6441
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/111655
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