Abdulrazaq Jimoh Ajanaku, Abdullahi Mohammed, Chim Nzekwe Patric, Samuel Richard Kelechi
Department of Pathology, Federal University of Health Sciences Azare, Azare 751101, Bauchi State, Nigeria.
https://orcid.org/0000-0003-4052-3300.
Ecancermedicalscience. 2025 Feb 5;19:1838. doi: 10.3332/ecancer.2025.1838. eCollection 2025.
The high case-fatality of epithelial ovarian cancer (EOC) stems from the absence of recognisable premalignant lesion, lack of effective screening, advanced stage at presentation, high recurrence and COX-2 over-expression. Expression of COX-2 in EOCs is associated with unfavorable survival outcomes. In Nigeria, younger age affectation, rising incidence and poor survival outcomes of EOC provide the driving forces for researchers in terms of screening, prevention and targeted therapy.
All the 52 EOC cases over a 5-year period were included, but only 48 formalin-fixed paraffin-embedded tissue blocks were sectioned and stained with COX-2 antibody. COX-2 expression was scored for distribution (no cells = 0, 1%-10% = 1, 11%-50% = 2, 51%-80% = 3, 81%-100% = 4) and intensity (no stain = 0; weak = 1; moderate = 2, strong = 3). The immunoreactive score (IRS) is a product of intensity (I) and distribution (D) as: 9-12 strongly +, 5-8 moderately +, 1-4 weakly + and 0 negative. Over-expression of COX-2 is an IRS of 5-12. Outcomes were statistically evaluated with clinicopathological data.
EOC cases have a mean age of 50.0 years, and peaked in the 6th decade. High-grade serous carcinoma (HGSC) accounted for the majority (50%), followed by low-grade serous carcinoma and mucinous carcinomas each at 17.3%. High-grade carcinomas accounted for 61.5% of cases. Over-expression of COX-2 was observed in 52.1% of the cases with significant associations between COX-2 expression and high-grade EOC, type II EOC or HGSC but not with the other histological sub-type or age.
More than one-third of EOCs occurred ≤50 years and more than half of EOCs over-expressed COX-2. There were significant statistical associations between COX-2 over-expression and grade, type II tumours or HGSC indicating that it may influence the outcomes of EOC with possible variation in tumour type and grade.
上皮性卵巢癌（EOC）的高病死率源于缺乏可识别的癌前病变、缺乏有效的筛查手段、就诊时处于晚期、高复发率以及COX-2的过度表达。EOC中COX-2的表达与不良生存结局相关。在尼日利亚，EOC患者的年轻化、发病率上升以及生存结局较差为研究人员在筛查、预防和靶向治疗方面提供了动力。
纳入了5年期间的所有52例EOC病例，但仅对48个福尔马林固定石蜡包埋组织块进行切片并用COX-2抗体染色。对COX-2表达进行分布评分（无细胞 = 0，1%-10% = 1，11%-50% = 2，51%-80% = 3，81%-100% = 4）和强度评分（无染色 = 0；弱 = 1；中度 = 2，强 = 3）。免疫反应评分（IRS）是强度（I）和分布（D）的乘积，即：9-12为强阳性，5-8为中度阳性，1-4为弱阳性，0为阴性。COX-2的过度表达是指IRS为5-12。将结果与临床病理数据进行统计学评估。
EOC病例的平均年龄为50.0岁，在第6个十年达到峰值。高级别浆液性癌（HGSC）占大多数（50%），其次是低级别浆液性癌和黏液性癌，各占17.3%。高级别癌占病例的61.5%。在52.1%的病例中观察到COX-2的过度表达，COX-2表达与高级别EOC、II型EOC或HGSC之间存在显著关联，但与其他组织学亚型或年龄无关。
超过三分之一的EOC发生在≤50岁，超过一半的EOC过度表达COX-2。COX-2的过度表达与肿瘤分级、II型肿瘤或HGSC之间存在显著的统计学关联，表明它可能影响EOC的结局，且在肿瘤类型和分级上可能存在差异。
