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Journal of Korean Neurosurgical Society 2004;36(6): 437-442.
Cyclooxygenase-2 Expression Predicts Prognosis in Astrocytic Tumors.
Jong Myong Lee, Shin Jung, Hyang Hwa Rhu, In Young Kim, Min Cheol Lee
1Department of Neurosurgery, Chonnam National University Medical School, Gwangju, Korea. sjung@chonnam.ac.kr
2Brain Tumor Research Laboratory, Chonnam National University Medical School, Gwangju, Korea.
3Research Institute of Medical Science, Chonnam National University Medical School, Gwangju, Korea.
ABSTRACT
OBJECTIVE
Cyclooxygenase-2, the inducible isoform of prostaglandin H synthesis, has been implicated in the growth and progression of a various human cancer. Although COX-2 overexpression has been observed in humangliomas, the prognostic or clinical relevance of this overexpression has rarely been investigated to date. METHODS: We examined COX-2 expression by immunohistochemistry in tumor specimens from 25 patients with low- and high grade astrocytomas and correlated the grade of COX-2 expression with patients survival. RESULTS: Immunohistochemical staining results were as follows: negative staining, N=4(16%), positive staining, N=21(84%). Results of low grade astrocytoma(N=10) were as follows: negative staining, N=3(30%), weak positivestaining, N=7(70%). Anaplastic astrocytomas(N=4) as follows: negative staining, N=1(25%), weak positivestaining, N=3(75%). Glioblastomas(N=11) as follows: negative staining, N=0(0%), weak positive staining, N=5(45%), strong positive staining, N=6(55%). As a group, tumors with higher rate of cell proliferation tended to have increased expression of COX-2. The percentage of COX-2 expression were associated with a worse survival rate(p=0.0028), and the grade of astrocytic tumors(p=0.001). These findings indicate that high COX-2 expression in tumor cell is associated with clinically more aggressive gliomas, and is a strong predictor of poor survival. CONCLUSION: Our study provides evidence that COX-2 is up-regulated in the majority of high-grade gliomas and that increased COX-2 expression is a significant negative predictor of survival and selective COX-2 inhibitors may have a potential role as an adjuvant therapy of astrocytic tumors.
Key Words: Cyclooxygenase-2; Immunohistochemistry; Astrocytic neoplasm; Prognosis
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