Kim Yong Bae, Kim Gwi Eon, Cho Nam Hoon, Pyo Hong Ryull, Shim Su Jung, Chang Sei Kyung, Park Hee Chul, Suh Chang Ok, Park Tchan Kyu, Kim Byung Soo
Department of Radiation Oncology, Yonsei Cancer Center, Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Seodaemoon-Gu, Shinchon-Dong, 134 Seoul 120-752, Korea.
Cancer. 2002 Aug 1;95(3):531-9. doi: 10.1002/cncr.10684.
The objective of this study was to determine whether cyclooxygenase-2 (COX-2) overexpression was an indicator of prognosis in patients with International Federation of Gynecology and Obstetrics (FIGO) Stage IIB uterine cervical carcinoma who underwent radiation and concurrent chemotherapy.
Seventy-five patients with FIGO Stage IIB squamous cell carcinoma (SCC) of the uterine cervix who were treated with radiotherapy and concurrent chemotherapy between 1991 and 1996 were divided into two groups according to their COX-2 level in an immunohistochemical study: the COX-2 negative group (n = 54 patients) and the COX-2 positive group (n = 21 patients). The clinicopathologic features, patterns of treatment failure, and survival data for patients in the COX-2 positive group were compared with data from the patients in the COX-2 negative group. Univariate and multivariate analyses were performed to determine the prognostic factors that influenced patient survival.
In the immunohistochemical study, COX-2 overexpression was observed in approximately 30% of patients with FIGO Stage IIB SCC of the uterine cervix. With delayed regression to the initial treatment, the treatment failure rate of patients in the COX-2 positive group was much higher compared with the treatment failure rate of patients in the COX-2 negative group. The higher incidence of central failure and lymph node failure for patients in the COX-2 positive group was statistically significant (48% for the COX-2 positive group vs. 13% for the COX-2 negative group). However, there was no difference in the incidence of hematogenous metastases between the two groups (5% for the COX-2 positive group vs. 7% for the COX-2 negative group). In addition, increased COX-2 expression in tumor cells also was correlated with a shorter interval to tumor recurrence (median interval to recurrence, 9 months in the COX-2 positive group vs. 26 months in the COX-2 negative group). Compared with patients in the COX-2 negative group, patients in the COX-2 positive group had lower overall actuarial and disease free survival rates (overall 5-year actuarial survival rates: 56% for the COX-2 positive group vs. 94% for the COX-2 negative group; P = 0.003). Univariate and multivariate analyses showed that COX-2 overexpression was an independent prognostic factor that surpassed other well-known clinicopathologic parameters.
COX-2 overexpression can be used as a potent molecular risk factor in patients with FIGO Stage IIB SCC of the uterine cervix who are treated with radiotherapy and concurrent chemotherapy.
本研究的目的是确定环氧合酶 -2（COX-2）过表达是否是接受放疗和同步化疗的国际妇产科联盟（FIGO）IIB期子宫颈癌患者预后的一个指标。
1991年至1996年间接受放疗和同步化疗的75例FIGO IIB期子宫颈鳞状细胞癌（SCC）患者，在一项免疫组织化学研究中根据其COX-2水平分为两组：COX-2阴性组（n = 54例患者）和COX-2阳性组（n = 21例患者）。将COX-2阳性组患者的临床病理特征、治疗失败模式和生存数据与COX-2阴性组患者的数据进行比较。进行单因素和多因素分析以确定影响患者生存的预后因素。
在免疫组织化学研究中，约30%的FIGO IIB期子宫颈SCC患者观察到COX-2过表达。随着对初始治疗的延迟消退，COX-2阳性组患者的治疗失败率远高于COX-2阴性组患者的治疗失败率。COX-2阳性组患者中心性失败和淋巴结失败的发生率较高，具有统计学意义（COX-2阳性组为48%，COX-2阴性组为13%）。然而，两组之间血行转移的发生率没有差异（COX-2阳性组为5%，COX-2阴性组为7%）。此外，肿瘤细胞中COX-2表达增加也与肿瘤复发间隔时间缩短相关（复发的中位间隔时间，COX-2阳性组为9个月，COX-2阴性组为26个月）。与COX-2阴性组患者相比，COX-2阳性组患者的总体精算生存率和无病生存率较低（总体5年精算生存率：COX-2阳性组为56%，COX-2阴性组为94%；P = 0.003）。单因素和多因素分析表明，COX-2过表达是一个独立的预后因素，超过了其他知名的临床病理参数。
COX-2过表达可作为接受放疗和同步化疗的FIGO IIB期子宫颈SCC患者的一个有力分子危险因素。
