The prognostic significance of COX-2 and survivin expression in ovarian cancer

Pathol Res Pract. 2008;204(4):241-9. doi: 10.1016/j.prp.2007.11.004. Epub 2008 Jan 2.

Abstract

We investigated the prognostic significance of cyclooxygenase-2 (COX-2) and survivin in ovarian carcinoma. Imprint smears were obtained from 100 ovarian carcinoma specimens and were studied immunocytochemically for the expression of COX-2 and survivin. The results were correlated with several clinicopathological parameters, including 5-year survival. Increased COX-2 staining pattern correlated with a non-mucinous histological type (p=0.008), increased stage (p<0.0001), high histological grade (p<0.0001), and reduced survival rates (p<0.00001). Survivin expression was strongly associated with increased stage (p<0.0001), increased histological grade (p<0.0001), and reduced survival (p<0.00001). Elevated survivin expression also correlated significantly with pre-menopausal status (p=0.033). In addition, COX-2 and survivin staining patterns correlated strongly with one another (p<0.0001). However, on multivariate analysis, an independent prognostic value was found only for tumor stage and grade. The findings of our study indicate that the increased expression of COX-2 and survivin in ovarian cancer is associated with one another and with several adverse clinicopathologic parameters, including reduced survival, thus suggesting a role of these molecules in disease progression. Further investigations of the exact prognostic and therapeutic implications of COX-2 and survivin expression are strongly warranted.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / analysis*
  • Cyclooxygenase 2 / analysis*
  • Disease Progression
  • Female
  • Humans
  • Immunohistochemistry
  • Inhibitor of Apoptosis Proteins
  • Kaplan-Meier Estimate
  • Microtubule-Associated Proteins / analysis*
  • Middle Aged
  • Neoplasm Proteins / analysis*
  • Neoplasm Staging
  • Ovarian Neoplasms / chemistry*
  • Ovarian Neoplasms / enzymology
  • Ovarian Neoplasms / mortality
  • Ovarian Neoplasms / pathology
  • Ovarian Neoplasms / therapy
  • Proportional Hazards Models
  • Prospective Studies
  • Risk Assessment
  • Survivin
  • Time Factors
  • Treatment Outcome
  • Up-Regulation

Substances

  • BIRC5 protein, human
  • Biomarkers, Tumor
  • Inhibitor of Apoptosis Proteins
  • Microtubule-Associated Proteins
  • Neoplasm Proteins
  • Survivin
  • Cyclooxygenase 2
  • PTGS2 protein, human