Pediatric Oncology Department, National Cancer Institute (NCI), Cairo University, Fom El-khalig Square Kasr El-Aini St., Cairo, 11796, Egypt.
Pathology Department, National Cancer Institute (NCI), Cairo University, Cairo, Egypt.
Clin Transl Oncol. 2020 Sep;22(9):1539-1547. doi: 10.1007/s12094-020-02297-8. Epub 2020 Jan 22.
Cyclooxygenase-2 (COX-2) is an inflammation-related enzyme that has been shown to have a role in tumor initiation, angiogenesis, and proliferation. It has been demonstrated that COX-2 expression is increased in many tumors and is a negative prognostic parameter. Our objective is to investigate the prognostic value of COX-2 expression in pediatric patients with classical Hodgkin lymphoma (CHL).
This was a retrospective analysis in pediatric patients (n = 127) diagnosed with CHL and treated at the pediatric oncology department, National Cancer Institute, Cairo University, January 2005-June 2013. We correlated COX-2 immunostaining in Reed-Sternberg (RS) cells with clinical variables and outcome.
COX-2 was expressed on 38.6% of RS cells. The median follow-up time was 48.4 months (range 4-114 months). The 5-year OS and PFS, in COX-2(+ve) versus COX-2(-ve) was 85.3% versus 96.0% (p = 0.248) and 78.6% versus 84.3% (p = 0.354), respectively. A multivariate analysis showed that COX-2(+ve) was not significantly associated with the 5-year OS (HR = 2.9; 95% CI 0.7-12.4, p = 0.149) or with the 5-year PFS (HR = 1.4; 95% CI 0.6-3.2, p = 0.490). High-risk patients in the COX-2(+ve) group had a significantly lower 5-year OS (p = 0.021). The 5-year PFS was significantly lower in the COX-2(+ve) group with B symptoms (p = 0.023) and bulky disease (p = 0.028). Radiotherapy was given only to high-risk patients; survival was much better in radiation-treated children in both the Cox-2(+ve) and Cox-2(-ve) groups. The magnitude of the radiotherapy effect was also greater in the Cox-2(+ve) group, but this difference was not statistically significant.
COX-2 expression showed a tendency to be a poor prognostic factor, but it failed to provide meaningful independent information. Further larger studies are needed to investigate COX-2 as a prognostic factor and potential therapeutic target.
环氧化酶-2（COX-2）是一种与炎症相关的酶，它在肿瘤的发生、血管生成和增殖中起作用。已经证明，COX-2 的表达在许多肿瘤中增加，并且是一个负预后参数。我们的目的是研究 COX-2 表达在儿科经典霍奇金淋巴瘤（CHL）患者中的预后价值。
这是对 2005 年 1 月至 2013 年 6 月在埃及开罗大学国家癌症研究所儿科肿瘤科诊断为 CHL 并接受治疗的 127 例儿科患者进行的回顾性分析。我们将 COX-2 免疫染色在 Reed-Sternberg（RS）细胞中的表达与临床变量和结局相关联。
RS 细胞中有 38.6%表达 COX-2。中位随访时间为 48.4 个月（范围 4-114 个月）。COX-2（+ve）与 COX-2（-ve）的 5 年 OS 和 PFS 分别为 85.3%与 96.0%（p=0.248）和 78.6%与 84.3%（p=0.354）。多变量分析显示，COX-2（+ve）与 5 年 OS（HR=2.9；95%CI 0.7-12.4，p=0.149）或 5 年 PFS（HR=1.4；95%CI 0.6-3.2，p=0.490）均无显著相关性。COX-2（+ve）组高危患者的 5 年 OS 显著降低（p=0.021）。COX-2（+ve）组伴有 B 症状（p=0.023）和肿块性疾病（p=0.028）的患者 5 年 PFS 显著降低。仅对高危患者进行放疗；在 Cox-2（+ve）和 Cox-2（-ve）组中，接受放疗的儿童的生存率都要好得多。Cox-2（+ve）组的放疗效果也更大，但差异无统计学意义。
COX-2 表达有成为预后不良因素的趋势，但未能提供有意义的独立信息。需要进一步开展更大规模的研究，以探讨 COX-2 作为预后因素和潜在治疗靶点的作用。
