Sackett Melanie K, Bairati Isabelle, Meyer François, Jobin Edith, Lussier Sébastien, Fortin André, Gélinas Michel, Nabid Abdenour, Brochet François, Têtu Bernard
Pathology Department, Centre Hospitalier Universitaire de Québec and Université Laval, Quebec, Canada.
Clin Cancer Res. 2008 Jan 1;14(1):67-73. doi: 10.1158/1078-0432.CCR-07-2028.
Cyclooxygenase-2 (COX-2) overexpression has been associated with a poor prognosis in many cancers. However, the role of COX-2 overexpression in head and neck cancers remains undetermined. The objective of this study was to evaluate whether COX-2 is a prognostic factor in glottic cancer.
This study was part of a phase III placebo-controlled randomized trial evaluating the efficacy of alpha-tocopherol in reducing second primary cancers (SPC) in head and neck cancer patients. Immunohistochemical analyses were conducted on pretreatment biopsies of 301 patients with early-stage glottic cancer treated by radiotherapy. The median value of 50% of positive tumor cells was the cutoff point used to define COX-2 overexpression. Outcomes considered in the statistical analysis were recurrence, SPC, and death. The Cox proportional hazards model was used to estimate the hazard ratios (HR) and their 95% confidence intervals (95% CI).
The HR associated with COX-2 overexpression was 0.94 (95% CI, 0.55-1.62) for recurrence. The HR associated with SPC was 2.63 (95% CI, 1.32-5.23) for the first 3.5 years of follow-up and 0.55 (95% CI, 0.22-1.32) for the following 3.5 years. The HR associated with COX-2 overexpression was 1.57 (95% CI, 1.01-2.45) for overall mortality.
COX-2 overexpression in glottic cancer was associated with increased overall mortality and an increased risk of SPC during the early follow-up period. Future studies are needed to explain observed effects on SPC. COX-2 expression may prove helpful in defining an individual patient's prognosis.
环氧合酶 -2（COX -2）的过表达与多种癌症的不良预后相关。然而，COX -2过表达在头颈癌中的作用仍未确定。本研究的目的是评估COX -2是否为声门癌的预后因素。
本研究是一项III期安慰剂对照随机试验的一部分，该试验评估α -生育酚在降低头颈癌患者第二原发性癌症（SPC）方面的疗效。对301例接受放射治疗的早期声门癌患者的治疗前活检组织进行了免疫组织化学分析。以50%阳性肿瘤细胞的中位数作为定义COX -2过表达的临界值。统计分析中考虑的结果为复发、SPC和死亡。采用Cox比例风险模型估计风险比（HR）及其95%置信区间（95%CI）。
COX -2过表达与复发相关的HR为0.94（95%CI，0.55 - 1.62）。在随访的前3.5年，COX -2过表达与SPC相关的HR为2.63（95%CI，1.32 - 5.23），在随后的3.5年为0.55（95%CI，0.22 - 1.32）。COX -2过表达与总死亡率相关的HR为1.57（95%CI，1.01 - 2.45）。
声门癌中COX -2过表达与总死亡率增加以及随访早期SPC风险增加相关。需要进一步研究来解释观察到的对SPC的影响。COX -2表达可能有助于确定个体患者的预后。
