Cyclo-Oxygenase 2 Expression in Laryngeal Squamous Cell Carcinoma and Its Clinical Correlates

Bayazıt, Yıldırım A.; Büyükberber, Süleyman; Sarı, İbrahim; Camcı, Celalettin; Özer, Enver; Sevinç, Alper; Karakök, Metin; Kanlı́kama, Muzaffer; Mumbuç, Semih

doi:10.1159/000077797

Cited by 16 publications

(12 citation statements)

References 23 publications

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“…This study was conducted among 61 patients with stage I to IV larynx cancer having received different treatment modalities. Bayazit et al (31) found no correlation between COX-2 expression and survival, but this study was restricted to a small group of 39 patients with stage I to IV larynx cancer treated by surgery. All these studies were carried out on patients with different tumornode-metastasis stages and/or exposed to a variety of therapies.…”

Section: Discussionmentioning

confidence: 84%

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Prognostic Significance of Cyclooxygenase-2 Overexpression in Glottic Cancer

Sackett¹,

Bairati

Meyer

et al. 2008

Clinical Cancer Research

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Purpose: Cyclooxygenase-2 (COX-2) overexpression has been associated with a poor prognosis in many cancers. However, the role of COX-2 overexpression in head and neck cancers remains undetermined.The objective of this study was to evaluate whether COX-2 is a prognostic factor in glottic cancer. Experimental Design: This study was part of a phase III placebo-controlled randomized trial evaluating the efficacy of a-tocopherol in reducing second primary cancers (SPC) in head and neck cancer patients. Immunohistochemical analyses were conducted on pretreatment biopsies of 301patients with early-stage glottic cancer treated by radiotherapy. The median value of 50% of positive tumor cells was the cutoff point used to define COX-2 overexpression. Outcomes considered in the statistical analysis were recurrence, SPC, and death. The Cox proportional hazards model was used to estimate the hazard ratios (HR) and their 95% confidence intervals (95% CI). Results: The HR associated with COX-2 overexpression was 0.94 (95% CI, 0.55-1.62) for recurrence. The HR associated with SPC was 2.63 (95% CI, 1.32-5.23) for the first 3.5 years of follow-up and 0.55 (95% CI, 0.22-1.32) for the following 3.5 years. The HR associated with COX-2 overexpression was 1.57 (95% CI, 1.01-2.45) for overall mortality. Conclusions: COX-2 overexpression in glottic cancer was associated with increased overall mortality and an increased risk of SPC during the early follow-up period. Future studies are needed to explain observed effects on SPC. COX-2 expression may prove helpful in defining an individual patient's prognosis.Glottic cancer is the most common early-stage head and neck cancer. The 5-year overall survival rate is between 72% and 85% for stage I cancer and from 59% to 77% for stage II cancer (1 -3). Local recurrence occurs in about 6% to 28% of patients within 5 years (1). Another important outcome for patients with early-stage glottic cancer is the occurrence of a second primary cancer (SPC), which is discovered in 15% to 18% of the patients within 5 years and is associated with poor survival (2, 4, 5). The most common site of SPC is the upper aerodigestive tract (2, 5). SPCs are attributed to a ''field cancerization'' effect induced by carcinogens such as tobacco, which can alter the respiratory, oral, and esophageal mucosa (6, 7). Although the early stage of glottic cancer is relatively well controlled by therapy, prognosis of these patients is often compromised by the occurrence of SPC.Cyclooxygenase (COX) is the rate-limiting enzyme in the conversion of arachidonic acid into prostaglandins. It exists in two isoforms, COX-1, which is constitutional, and COX-2, which can be induced by stimuli such as smoking and radiotherapy (8-10). COX-2 overexpression increases prostaglandins, which are known to promote tumor development, invasion, and metastasis by many mechanisms, most importantly by stimulating angiogenesis through the action of vascular endothelial growth (11)(12)(13). Prostaglandins also induce cell proliferation, reduce apop...

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Section: Discussionmentioning

confidence: 84%

“…High levels of COX-2 expression have been found in many cancers (15 -21) and have been associated with poor survival and increased risk of recurrence (22)(23)(24)(25)(26)(27)(28). In head and neck cancers, COX-2 overexpression has been clearly shown (29,30) but its effect on prognosis is still uncertain (12,(31)(32)(33)(34).…”

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confidence: 99%

Prognostic Significance of Cyclooxygenase-2 Overexpression in Glottic Cancer

Sackett¹,

Bairati

Meyer

et al. 2008

Clinical Cancer Research

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“…After the article titles and abstracts were checked, 38 articles were reviewed in detail [22–59]. 9 studies were excluded as they did not provide sufficient data for extracting odds ratio (OR) or hazard ratio (HR) or 95% confidence intervals (CI) [28–36], leaving 29 studies that fulfilled the eligibility criteria [22–27, 37–59] (Table 1). Four studies reported no site-specific HNC [24, 54–57] and others recorded site-specific HNC.…”

Section: Resultsmentioning

confidence: 99%

Clinicopathological and prognostic significance of cyclooxygenase-2 expression in head and neck cancer: A meta-analysis

et al. 2016

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Several studies have assessed the clinicopathological and prognostic value of cyclooxygenase-2 (COX-2) expression in patients with head and neck cancer (HNC), but their results remain controversial. To address this issue, a meta-analysis was carried out. A total of 29 studies involving 2430 patients were subjected to final analysis. Our results indicated that COX-2 expression was not statistically associated with advanced tumor stage (OR, 1.23; 95% CI, 0.98–1.55) but correlated with high risk of lymph node metastasis (OR, 1.28; 95% CI, 1.03–1.60) and advanced TNM stage (OR, 1.33; 95% CI, 1.06–1.66). Moreover, COX-2 expression had significant effect on poor OS (HR, 1.93; 95% CI, 1.29–2.90), RFS (HR, 2.02; 95% CI, 1.00–4.08) and DFS (HR, 5.14; 95% CI, 2.84–9.31). The results of subgroup analyses revealed that COX-2 expression was related with high possibility of lymph node metastasis in oral cancer (OR, 1.49; 95% CI, 1.01–2.20) and advanced TNM stage in oral cancer (OR, 1.58; 95% CI, 1.05–2.37) and no site-specific HNC (OR, 1.64; 95% CI, 1.02–2.62). However, subgroup analyses only showed a tendency without statistically significant association between COX-2 expression and survival. Significant heterogeneity was not found when analyzing clinicopathological data, but it appeared when considering survival data. No publication bias was detected in this study. This meta-analysis suggested that COX-2 expression could act as a prognostic factor for patients with HNC.

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“…COX-2 and its metabolites affect cell growth, and COX-2 can suppress the immune system and inhibit apoptosis, and is associated with the invasiveness of cancer. Overexpression of the COX-2 enzyme was reported in laryngeal carcinoma, and other head and neck tumors [28,29] . Overexpression of COX-2 should be more related to tumorigenesis and prognosis.…”

Section: Discussionmentioning

confidence: 99%

Can Bile Acids Be an Etiological Factor for Laryngeal Carcinoma?

Tutar¹,

Erdamar

Köybaşıoğlu³

et al. 2011

ORL

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Purpose: The objective of this study is to show the accumulation of bile acids in laryngeal tissues of laryngeal carcinoma patients. Materials and Methods: The present study compared the total bile acid level in the hypopharyngeal tissue, tumor tissue, and blood of 21 primary laryngeal carcinoma patients (study group) to that in the hypopharyngeal tissue and blood of 15 patients with benign laryngeal lesions (control group). Results: The total bile acid level was significantly higher in the tumor and hypopharyngeal tissues of the study group than in the hypopharyngeal tissues of the control group; however, the difference in the blood total bile acid level between the 2 groups was not significant. Conclusion: Bile acids in reflux material accumulate in the laryngeal tissue in laryngeal carcinoma patients; therefore, bile acids should be considered a carcinogenic factor in the etiology of laryngeal carcinoma because of their mutagenicity due to DNA breaking, as they cause chronic inflammation due to intracellular accumulation.

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Cyclo-Oxygenase 2 Expression in Laryngeal Squamous Cell Carcinoma and Its Clinical Correlates

Cited by 16 publications

References 23 publications

Prognostic Significance of Cyclooxygenase-2 Overexpression in Glottic Cancer

Prognostic Significance of Cyclooxygenase-2 Overexpression in Glottic Cancer

Clinicopathological and prognostic significance of cyclooxygenase-2 expression in head and neck cancer: A meta-analysis

Can Bile Acids Be an Etiological Factor for Laryngeal Carcinoma?

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