Tan K-B, Yong W-P, Putti T C
Department of Pathology, National University of Singapore, National University Hospital, Singapore.
Histopathology. 2004 Jan;44(1):24-8. doi: 10.1111/j.1365-2559.2004.01774.x.
To study cyclooxygenase-2 (COX-2) expression in ductal carcinoma in situ (DCIS) of the breast and its association with histological features. COX-2, an inducible prostaglandin synthase, has been shown to be important in mammary carcinogenesis, being associated with increased tumour size and unfavourable outcome in breast cancer. Animal studies indicate that COX-2 inhibition is effective in the prevention and treatment of mammary cancers.
Fifty-one cases of DCIS diagnosed during 1990-2000 were reviewed. Immunohistochemistry for COX-2 was performed and the COX-2 staining scores were correlated with histological features. The majority of cases [41 of 51 (80%)] had positive COX-2 staining, of which 13 cases (25%) had strong staining. High nuclear grade DCIS was significantly associated with increased COX-2 staining (P = 0.04).
High-grade lesions are known to be associated with a higher recurrence rate following excision and are often oestrogen receptor negative, and as such, may be less responsive to adjuvant tamoxifen therapy. There is a need to examine further the role of COX-2 expression in DCIS, as both a prognostic and predictive factor.
研究环氧化酶-2（COX-2）在乳腺导管原位癌（DCIS）中的表达及其与组织学特征的关系。COX-2是一种诱导型前列腺素合酶，已被证明在乳腺癌发生过程中起重要作用，与肿瘤大小增加和乳腺癌不良预后相关。动物研究表明，COX-2抑制在乳腺癌的预防和治疗中有效。
回顾了1990年至2000年间诊断的51例DCIS病例。进行了COX-2免疫组织化学检测，并将COX-2染色评分与组织学特征相关联。大多数病例[51例中的41例（80%）]COX-2染色呈阳性，其中13例（25%）染色强。高核级DCIS与COX-2染色增加显著相关（P = 0.04）。
已知高级别病变在切除后复发率较高，且常为雌激素受体阴性，因此可能对辅助他莫昔芬治疗反应较差。有必要进一步研究COX-2表达在DCIS中作为预后和预测因素的作用。
