Elevated expression of cyclooxygenase-2 is a negative prognostic factor for disease free survival and overall survival in patients with breast carcinoma
Elevated expression of cyclooxygenase-2 is a negative prognostic factor for disease free survival and overall survival in patients with breast carcinoma
复制标题
DOI：
10.1002/cncr.11437
复制
发表时间：
2003-06-15
期刊：
影响因子：
6.2
通讯作者：
Hauptmann, S
中科院分区：
文献类型：
--
作者：
Denkert, C;Winzer, KJ;Hauptmann, S
背景资料。环氧合酶调节前列腺素的产生，并在肿瘤的发生和发展中发挥作用。结果：COX-2在36%的乳腺癌标本中表达，并与淋巴结阳性(P<；0.0005)、肿瘤体积(P<；)等临床病理参数显著相关。0.0005)、低分化(P<；0.0005)、血管侵犯(P=0.03)、雌激素受体阴性(P=0.04)。而COX-I在45%的肿瘤中表达，与肿瘤较小(P=0.02)和无淋巴结转移(P=0.01)有关。在单因素生存分析中，COX-2表达升高与无病生存期(P=0.0007)和总生存期(P=0.02)的降低显著相关。在多变量分析中，COX-2的表达对无病生存期具有边缘意义(相对危险度为1.90；95%可信区间为1.00-3.59)，调整了肿瘤大小、组织学分级、阳性淋巴结数和患者年龄。COX-1在肿瘤组织中的高表达对患者的预后无统计学意义。结论目前的数据提示COX-2的高表达可能在乳腺癌的发生发展中起一定作用。使用选择性COX-2抑制剂治疗是否可能是乳腺癌患者的另一种治疗选择仍有待调查。(C)2003年美国癌症协会。
BACKGROUND. Cyclooxygenases regulate the production of prostaglandins and play a role in tumor development and progression. The authors investigated the prognostic impact of expression of the cyclooxygenase (COX) isoforms, COX-1 and COX-2, on disease-free survival and progression-free survival in patients with primary breast carcinoma as well as the association between COX expression and other clinicopathologic parameters.METHODS. in this study COX isoform expression was determined by immunohistochemistry in a cohort of 221 patients with primary breast carcinoma.RESULTS. Expression of COX-2 was detected in 36% of breast carcinoma samples and was associated significantly with several clinicopathologic parameters, including positive lymph node status (P < 0.0005), larger tumor size (P < 0.0005), poor differentiation (P < 0.0005), vascular invasion (P = 0.03), and negative estrogen receptor status (P = 0.04). In contrast, COX-I was expressed in 45% of tumors and was associated with smaller tumor size (P = 0.02) and with negative lymph node status (P = 0.01). In a univariate survival analysis, a significant association was observed between elevated COX-2 expression and decreases in disease-free survival (P = 0.0007) and overall survival (P = 0.02). In a multivariate analysis, expression of COX-2 was of borderline significance for disease-free survival (relative risk, 1.90; 95% confidence interval, 1.00-3.59), adjusting for tumor size, histologic grade, number of positive lymph nodes, and patient age. Elevated expression of COX-1 in tumor tissue had no statistically significant influence on patient prognosis.CONCLUSIONS. The current data suggest that increased expression of COX-2 may play a role in the progression of primary breast carcinoma. It remains to be investigated whether treatment with selective inhibitors of COX-2 may be an additional therapeutic option for patients with breast carcinoma. (C) 2003 American Cancer Society.