DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20182451

Cyclooxygenase-2 expression in squamous cell carcinoma of larynx: association with clinico-pathological factors and treatment outcomes

Elizabeth Mathew Iype, Rajan Balakrishna, Lakshmi Subhadradevi, Jissa Vinoda Thulaseedharan, Rajesh Singh, Jayasree K.

Abstract


Background: Squamous cell carcinoma (SCC) of larynx is widely prevalent in India and is one of the leading cancers in males. Tumor Cyclooxygenase-2 (Cox-2) expression can be used as a prognostic and predictive marker in laryngeal SCC. The primary objective of the present study was to determine the association between tumor Cox-2 expression and clinico-pathological characteristics and treatment outcome in patients with LSCC. Secondly, to evaluate the clinical utility of Cox-2 expression as a tool, to decide treatment strategy for LSCC.

Methods: Seventy two patients with stage III and IV LSCC who underwent upfront surgery were included in this study. Tumor Cox-2 expression was analysed by immunohistochemistry using standard Streptavidin biotin method.  

Results: Thirty seven patients had pathological node involvement, ipsilateral in 35 and bilateral in two. Cox-2 was intensely expressed in patients with advanced (N2/N3) nodal disease and perineural invasion. There was no significant difference in 5 year disease free survival and overall survival when Cox-2 was correlated with perineural invasion, extra capsular spread and the T and N stage of the disease.

Conclusions: Preoperative Cox-2 analysis can be used to individualize need for routine neck dissection in cases of locally advanced laryngeal carcinoma.


Keywords


Cyclooxygenase 2, Larynx, Predictive marker, Reverse transcriptase polymerase chain reaction, Squamous cell carcinoma

Full Text:

PDF

References


Annual Report. Regional Cancer Center T, India; 2010-2011.

Jemal A, Murray T, Ward E, Samuels A, Tiwari RC, Ghafoor A, et al. Cancer statistics, 2005. CA: a Cancer J Clin. 2005;55(1):10-30.

Shah JP, Karnell LH, Hoffman HT, Ariyan S, Brown GS, Fee WE, et al. Patterns of care for cancer of the larynx in the United States. Archives Otolaryngol Head Neck Surg. 1997;123(5):475-83.

Franchin G, Minatel E, Gobitti C, Talamini R, Vaccher E, Sartor G, et al. Radiotherapy for patients with early‐stage glottic carcinoma. Cancer. 2003;98(4):765-72.

Reddy SP, Mohideen N, Marra S, Marks JE. Effect of tumor bulk on local control and survival of patients with T1 glottic cancer. Radiotherap Oncol. 1998;47(2):161-6.

Rudoltz MS, Benammar A, Mohiuddin M. Prognostic factors for local control and survival in T1 squamous cell carcinoma of the glottis. Int J Radiation Oncol Biol Physics. 1993;26(5):767-72.

Soslow RA, Dannenberg AJ, Rush D, Woerner B, Khan KN, Masferrer J, et al. COX‐2 is expressed in human pulmonary, colonic, and mammary tumors. Cancer. 2000;89(12):2637-45.

Liu B, Qu L, Yan S. Cyclooxygenase-2 promotes tumor growth and suppresses tumor immunity. Cancer Cell Int. 2015;15(1):106.

Sobin LH, Gospodarowicz MK, Wittekind C. TNM classification of malignant tumours: John Wiley & Sons; 2011.

Chen YF, Luo RZ, Li Y, Cui BK, Song M, Yang AK, et al. High expression levels of COX-2 and P300 are associated with unfavorable survival in laryngeal squamous cell carcinoma. European Arch Otorhinolaryngol. 2013;270(3):1009-17.

Cho NP, Han HS, Soh Y, Lee KY, Son HJ. Cytoplasmic HuR over‐expression is associated with increased cyclooxygenase‐2 expression in laryngeal squamous cell carcinomas. Pathology. 2007;39(6):545-50.

Ranelletti FO, Almadori G, Rocca B, Ferrandina G, Ciabattoni G, Habib A, et al. Prognostic significance of cyclooxygenase‐2 in laryngeal squamous cell carcinoma. Int J Cancer. 2001;95(6):343-49.

Nix P, Cawkwell L, Patmore H, Greenman J, Stafford N. Bcl-2 expression predicts radiotherapy failure in laryngeal cancer. Br J Cancer. 2005;92(12):2185-9.

Chang BW, Kim DH, Kowalski DP, Burleson JA, Son YH, Wilson LD, et al. Prognostic significance of cyclooxygenase-2 in oropharyngeal squamous cell carcinoma. Clin Cancer Res. 2004;10(5):1678-84.

Takatori H, Natsugoe S, Okumura H, Matsumoto M, Ishigami S, Owaki T, et al. Predictive value of COX-2 for the effect of chemoradiotherapy on esophageal squamous cell carcinoma. Oncology Reports. 2005;13(4):697-701.

Kyzas PA, Stefanou D, Agnantis NJ. COX-2 expression correlates with VEGF-C and lymph node metastases in patients with head and neck squamous cell carcinoma. Modern Pathol. 2005;18(1):153-60.

Sun X, Ge R, Dong Q, Zheng C. The expression of cyclooxygenase-2 in laryngeal squamous cell carcinoma and its relationship with MVD. J Clin Otorhinolaryngol. 2005;19(21):967-70.

Atula T, Hedström J, Ristimäki A, Finne P, Leivo I, Markkanen-Leppänen M, et al. Cyclooxygenase-2 expression in squamous cell carcinoma of the oral cavity and pharynx: association to p53 and clinical outcome. Oncol Reports. 2006;16(3):485-90.

Kourelis K, Vandoros G, Kourelis T, Papadas T, Goumas P, Sotiropoulou‐Bonikou G. Low COX2 in tumor and upregulation in stroma mark laryngeal squamous cell carcinoma progression. Laryngoscope. 2009;119(9):1723-9.

Cho EI, Kowalski DP, Sasaki CT, Haffty BG. Tissue Microarray Analysis Reveals Prognostic Significance of COX‐2 Expression for Local Relapse in T1–2N0 Larynx Cancer Treated with Primary Radiation Therapy. Laryngoscope. 2004;114(11):2001-8.