Cyclooxygenase-2 Expression and it's Usefulness as a Prognostic Factor in Cervical Carcinoma / 대한산부인과학회잡지

ABSTRACT

OBJECTIVE: Recent epidemiologic studies indicate that use of nonsteroidal anti-inflammatory drugs that inhibit cyclooxygenase (COX) activity reduce the risk of colorectal cancer. COX-2 expression has been identified in cancers of many organs. There are also many reports that identify COX-2 expression and its possible role in tumorigenesis in cervical cancers. This study was performed to determine wether COX-2 is expressed in cervical cancer and to evaluate the value of COX-2 as a predictor of treatment results. PATIENTS AND METHODS: The study included 34 cases of stage IB to IVA cervical cancer and 22 cases of normal cervical specimens obtained through biopsy or surgery at the Chungnam National University Hospital. A COX-2 immunohistochemical stain was performed on these specimens. RESULTS: There was a statistically significant difference of COX-2 positivity between the cervical cancer group and a control group (p=0.01, Fisher's exact test), between the well controlled group and the treatment failure group (p=0.00, Fisher's exact test) and among stages (p=0.01, linear-by-linear association). The COX-2 positive group had a mean overall survival time of 55 months compared with 80 months for COX-2 negative group (p=0.00, log-rank test). The Locally advanced cervical cancer group (stage IIB-IV A) had a mean overall survival time of 46 months compared with 84 months for early stage disease group (stage IB, II A) (p=0.00, log-rank test). A Cox regression model showed that COX-2 positivity and clinical stages retained independent roles in predicting treatment results and prognosis. CONCLUSION: Evaluation of COX-2 expression in cervical cancer patients is valuable for predicting the treatment results and prognosis.