Correlation of cyclooxygenase-2 (COX-2) and aromatase expression in human endometrial cancer: Tissue microarray analysis
Received 31 December 2004; received in revised form 6 January 2005; accepted 6 January 2005.
Objective
The objective of this study was to compare the prevalence of cyclooxygenase-2 (COX-2), aromatase, and hormone receptor immunohistochemical (IHC) expression to well defined clinical-pathologic prognostic factors in a large group of surgically staged endometrial cancer patients.
Study design
A tissue microarray (TMA) was constructed from 336 separate specimens of endometrial cancer. IHC was perfomed for estrogen (ER) and progesterone (PR) receptor, COX-2, COX-1, and aromatase.
Results
The majority of tumors expressed COX-2 (59%) and aromatase (65%). COX-2 staining significantly correlated with aromatase expression (P < .014) but did not correlate with ER and PR. COX-2 expression was correlated with worsening histologic grade (P < .026) and approached statistical significance for deep myometrial invasion (P < .055). After applying multivariate analysis, no single IHC or combination of IHCs correlated with intrauterine poor prognostic factors or advanced stage. Only myometrial invasion >50% (OR 6.98, P < .001) and nonendometrioid histology (OR 4.933, P < .001) were predictive of advanced stage after multivariate analysis.
Conclusion
COX-2 and aromatase are expressed in the majority of endometrial cancer patients. COX-2 expression was not associated with the great majority of surgical-pathologic prognostic factors. COX-2 expression did significantly correlate with aromatase expression, suggesting that intratumoral production of estrogen in endometrial cancer may be an important mechanism in tumorigenesis.
cCenter for Biostatistics, and The Arthur James Cancer Hospital and Richard Solove Research Institute, The Ohio State University Medical School, Columbus, Ohio
Reprint requests: Jeffrey M. Fowler, MD, Director, Division of Gynecologic Oncology, JG Boutselis Professor in Gynecologic Oncology, 210-M SL, 320 W 10th Ave, Columbus, OH 43210.
Presented at the 23rd Annual Meeting of the American Gynecological and Obstetrical Society, September 9-11, 2004, Bolton Landing, NY.
ABSTRACT