A systematic review to establish the frequency of cyclooxygenase-2 expression in normal breast epithelium, ductal carcinoma in situ, microinvasive carcinoma of the breast and invasive breast cancer

Abstract

Background:Epidemiological studies have suggested a protective effect of cyclooxygenase (COX)-inhibiting non-steroidal anti-inflammatory drugs in breast cancer risk and disease progression. We performed a systematic review to evaluate the frequency of COX-2 expression in normal breast epithelium, ductal carcinoma in situ of breast (DCIS), DCIS-adjoining invasive breast cancer, microinvasive carcinoma of the breast (MICB) and invasive breast cancer.Methods:Literature searches were carried out on MEDLINE, EMBASE and Web of Science from their commencement until September 2010. Primary studies examining COX-2 expression by immunohistochemistry methodology were included. Meta-analyses were carried out using random effects models for individual study estimates of COX-2 expression and pooled to give an overall estimate.Results:The pooled prevalences (95% confidence intervals) of COX-2 expressions were 53% (44–61) in DCIS studies and 42% (36–49) in the invasive breast cancer studies. There were too few studies involving normal breast epithelium, DCIS-adjoining invasive breast cancer and MICB to conduct meta-analyses.Conclusion:The findings from our meta-analyses have shown similar COX-2 expression in DCIS and invasive breast cancer. This may suggest the involvement of COX-2 in early carcinogenesis. Further studies of COX-2 expression in DCIS are required to investigate the use of COX-2 as a potential drug target for prevention of disease progression in DCIS.

Identification of Biomarkers for Breast Cancer Using Databases

“…COX-2 is expressed in normal breast epithelium, ductal carcinoma in situ of breast (DCIS), and in invasive breast cancer. COX-2 expressions are comparable to DCIS and invasive breast cancer 54. Analysis of Embase data showed that mixed chemotherapy can give a better prognosis than mono-therapy 55–58.…”

Perioperative Interventions During Cancer Surgery: Can Anesthetic and Analgesic Techniques Influence Outcome?

“…COX-2 expression is highest in ductal carcinomas in situ [62]. A study examining 248 cases of breast cancer demonstrated a more dramatic increase in COX-2 expression in those cells that were hormone receptor negative and human epidermal growth factor positive and also correlated well with activation of the oncogene Atk and with a decreased survival [63]. It would also appear that silencing the COX-2 in breast cancer cells resulted in a profound decrease in metastasis and tumor onset in vitro [64].…”

Biology of DCIS and Progression to Invasive Disease

“…Increased Ki-67 expression is associated with high grade and comedo necrosis (Lari and Kuerer 2011). Alterations to COX-2 expression and the accumulation of its enzymatic product prostaglandins have been implicated in a variety of human cancers, including approximately 45-65 % of DCIS (Boland et al 2004;Kerlikowske et al 2010;Glover et al 2011). COX-2 expression has been associated with high nuclear grade and the Ki-67+/ER-molecular signatures (Lari and Kuerer 2011).…”