Prognostic influence of cyclooxygenase-2 protein and mRNA expression in node-negative breast cancer patients

BMC Cancer

Isabel Sicking³  Karlien Rommens³  Marco J Battista³  Daniel Böhm³  Susanne Gebhard³  Antje Lebrecht³  Cristina Cotarelo¹  Gerald Hoffmann³  Jan G Hengstler²  Marcus Schmidt³ 

[1] Institute of Pathology, Johannes Gutenberg University, Mainz, Germany

[2] Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund University of Technology, Dortmund, Germany

[3] Department of Obstetrics and Gynecology, Johannes Gutenberg University, Mainz, Germany

关键词: Prognosis;    Node-negative;    Breast cancer;    COX-2;   

Others  :  1117886
DOI  :  10.1186/1471-2407-14-952

 received in 2014-01-03, accepted in 2014-12-11,  发布年份 2014

【 摘 要 】

Background

Cyclooxygenases (COX) play a key role in prostaglandin metabolism and are important for tumor development and progression. The aim of this study was to analyze the prognostic impact of COX-2 expression in a cohort of lymph node-negative breast cancer patients not treated in the adjuvant setting.

Methods

COX-2 expression was determined by immunohistochemistry (IHC) in tumor tissue of 193 node-negative breast cancer patients. Additionally, mRNA expression was determined in corresponding tumor samples using microarray based gene-expression data. Univariate and multivariate Cox regression analyses adjusted for age at diagnosis, tumor size, histological grade, human epithelial growth factor receptor 2 (HER2), estrogen receptor (ER) and progesterone receptor (PR) were performed to evaluate the association of both COX-2 protein and mRNA expression with survival. Survival rates were determined by the Kaplan-Meier method. Correlations between COX-2 expression and established prognostic factors were analyzed using the Chi-square test. A potential correlation between COX-2 protein expression and COX-2 mRNA expression was assessed utilizing the Kruscal-Wallis-H-test.

Results

COX-2 protein expression was positive in 24.9% of the breast cancer samples. Univariate analysis showed that COX-2 protein expression was associated with shorter disease-free survival (DFS) (P = 0.0001), metastasis-free survival (MFS) (P = 0.002) as well as breast cancer specific overall survival (OS) (P = 0.043). In multivariate analysis COX-2 expression retained its significance independent of established prognostic factors for shorter DFS (P < 0.001, HR = 2.767, 95% CI = 1.563-4.901) and for inferior MFS (P = 0.002, HR = 2.7, 95% CI = 1.469-5.263) but not for OS (P = 0.096, HR = 1.929, 95% CI = 0.889-4.187). In contrast, COX-2 mRNA expression was not related to survival and failed to show a correlation with protein expression (P = 0.410).

Conclusions

The present findings support the hypothesis that COX-2 protein but not mRNA expression is associated with an unfavorable outcome in node-negative breast cancer.

【 授权许可】

   
2014 Sicking et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

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