Kargi A, Uysal M, Bozcuk H, Coskun H S, Savas B, Ozdogan M
Akdeniz University Faculty of Medicine, Department of Medical Oncology, Antalya, Turkey.
J BUON. 2013 Jul-Sep;18(3):579-84.
A number of studies have been carried out, showing that the risk for breast carcinoma is decreased in those using non-steroidal anti-inflammatory drugs (NSAIDs). Increased cyclooxygenase-2 (COX-2) level is considered as a factor indicating poor prognosis and responsible for angiogenesis, increased cellular proliferation, apoptotic defect and aromatase enzyme induction. For this reason the level of COX-2 might have a prognostic and predictive value in breast cancer as well. This question has become the basis of the present study.
Eighty-eight female patients with early stage breast cancer being under adjuvant anthracycline based chemotherapy were prospectively recruited. The patient age, body weight, menopausal status, tumor size and grade as well as axillary lymph node involvement were recorded. Routine pathological examination was performed, and COX-2, CerbB2 (HER2), estrogen (ER) and progesterone receptors (PR) levels in breast cancer tissue were determined immunohistochemically.
Multivariate analysis confirmed the independent predictive value of both menopausal status and ER expression for overall survival (OS) (p=0.009, HR=1.92, and p=0.014, HR=0.20, respectively). A negative correlation was observed between COX-2 levels and the levels of ER and PR (p=0.006, R= -0.303, and p=0.004, R=-0.312, respectively) whereas no significant correlation was observed concerning CerbB2. No statistically significant correlation was determined between COX-2 levels and the disease-free (DFS) and OS rates.
Further studies investigating the role of COX- 2 levels in breast cancer progression are needed.
已开展多项研究，结果表明使用非甾体抗炎药（NSAIDs）的人群患乳腺癌的风险降低。环氧合酶-2（COX-2）水平升高被认为是预后不良的一个因素，且与血管生成、细胞增殖增加、凋亡缺陷及芳香化酶诱导有关。因此，COX-2水平在乳腺癌中可能也具有预后和预测价值。这一问题已成为本研究的基础。
前瞻性招募了88例接受基于蒽环类药物的辅助化疗的早期乳腺癌女性患者。记录患者的年龄、体重、绝经状态、肿瘤大小和分级以及腋窝淋巴结受累情况。进行常规病理检查，并通过免疫组织化学方法测定乳腺癌组织中COX-2、CerbB2（HER2）、雌激素（ER）和孕激素受体（PR）的水平。
多因素分析证实绝经状态和ER表达对总生存期（OS）均具有独立的预测价值（p = 0.009，HR = 1.92；以及p = 0.014，HR = 0.20）。观察到COX-2水平与ER和PR水平呈负相关（分别为p = 0.006，R = -0.303；以及p = 0.004，R = -0.312），而与CerbB2无显著相关性。未确定COX-2水平与无病生存期（DFS）和OS率之间存在统计学显著相关性。
需要进一步研究以探讨COX-2水平在乳腺癌进展中的作用。
