Background: Recent experimental studies have indicated that cyclooxygenase-2 (COX-2) suppresses tumor-cell apoptosis and induces intratumoral angiogenesis.
Patients and methods: A series of 70 endometrial cancer cases that had undergone a curative resection was studied to determine the correlation between COX-2 expression, apoptosis and angiogenesis in human endometrial cancer tissue. Tissue specimens were evaluated for COX-2, single-strand DNA (ssDNA, apoptosis) and CD31 (angiogenesis) by immunohistochemistry.
Results: COX-2 expression was positive exclusively in cancer cells in 37 cases (53%). The apoptotic index was lower in COX-2-positive cancer cells than COX-2-negative cases. Microvessel density was higher in COX-2-positive cancer cases than COX-2-negative cases. COX-2 overexpression was significantly associated with poor prognosis.
Conclusion: These results suggested that tumor-produced COX-2, which was associated with inhibiting apoptosis and promoting angiogenesis, provided additional prognostic information in endometrial cancer patients.