COX-1 and COX-2 expression in stage I and II invasive cervical carcinoma: relationship to disease relapse and long-term survival

Abstract

COX-1 and COX-2 are members of the cyclooxygenase (COX) family, which influence tumor invasion and apoptosis. The objective of the study was to assess the relationship between COX-1 and COX-2 expression in early-stage disease and subsequent disease relapse and long-term survival. Women with FIGO stage I and II cervical carcinoma, younger than 50 years, treated between 1981 and 1990 were included. COX-1 and COX-2 expressions in the tumors were assessed by immunohistochemistry. COX-1 and COX-2 were expressed in 61% (17/28) and 57% (16/28) of tumors, respectively. COX-1 nonexpressers showed an improved overall survival compared to expressers (log-rank test, P= 0.09). There was no significant difference in the overall survival in COX-2 nonexpressers compared to expressers (P= 0.6). Out of eight women with disease relapse, COX-1 or COX-2 expression was noted in six of eight tumors, and both were expressed in five of eight tumors. Our preliminary data suggest an adverse prognosis with COX-1 expression in early-stage cervical carcinoma and a trend toward COX-1 expression in disease relapse. The association between COX-2 expression and a worse prognosis was not proven in this study.

Cyclooxygenase Isozymes in Oral Squamous Cell Carcinoma: A Real-Time RT-PCR Study with Clinic Pathological Correlations

“…Such findings are in keeping with recent studies by immunohistochemistry, which demonstrate staining of COX-l in thyroid tumors but not in normal thyroid tissue (7); over expression of COX-l was also found in ovarian (8) and cervical cancer (9)(10). Also, experiments on murine models of cancer underline that both isoforms are involved in the development of skin cancer (11).…”

Prognostic significance of cyclooxygenase‐2 in cervical cancer: A meta‐analysis

“…By the literature search and careful evaluation, a total of 28 eligible studies5–11, 16–31, 38–42 were identified. Of the 28 studies,5–11, 16–31, 38–42 three articles6, 38, 41 were eliminated due to inadequate data for meta‐analysis. In four studies,10, 24, 25, 40 patients involved were overlapping, therefore only the study24 with more complete data was selected in the overall analysis; one study25 involving only SCC patients was used in the subgroup analysis.…”

“…Beside, five studies,8, 16–19 which all came from another research group, were different in treatment, assay method (antibody), and scoring protocol employed, so all of them were included. Thus, 23 studies5, 7–9, 11, 16–31, 39, 42 with 1,477 patients which met our inclusion criteria were selected for our meta‐analysis finally (For an overview of the studies identified, and their main characteristics, see Table 1). Regarding treatment, generally, cervical cancer can be treated with either surgery, radiotherapy, chemotherapy or a combination of these treatments.…”

“…As one of the two isoforms of the key enzyme in the biosynthesis of prostaglandins,12 COX‐2 plays an important role in tumor progression, such as cell proliferation, apoptosis inhibition, angiogenesis, invasiveness and immunosuppression 13–15. Multiple studies5, 8, 16–25 showed that patients with strong COX‐2 expression had a significantly poor overall survival (OS) and disease‐free survival (DFS) in cervical cancer, however, other studies7, 11, 26–29 could not confirm this. Many studies8, 16, 24 found COX‐2 overexpression associated with poor response to chemoradiation (RC); others30, 31 could not confirm this .…”

“…Many studies8, 16, 24 found COX‐2 overexpression associated with poor response to chemoradiation (RC); others30, 31 could not confirm this . When it comes to the associations between COX‐2 expression and clinicopathological parameters [such as lymph node metastasis (LNM), tumor grade and international federation of gynecology and obstetrics (FIGO) stage], the studies7, 8, 11, 16–19, 22, 23, 25–27, 29 were heterogeneous. As mentioned above, there is a need for a systematic and comprehensive meta‐analysis.…”