title: Cyclo-oxygenase 2 expression is associated with angiogenesis and lymph node metastasis in human breast cancer.
abstract: OBJECTIVE
  Cyclo-oxygenases 1 and 2 (COX-1 and COX-2) are key enzymes in prostaglandin biosynthesis. COX-2 is induced by a wide variety of stimuli, and present during inflammation. COX-2 overexpression has been observed in colon, head and neck, lung, prostate, stomach, and breast cancer. In colon and gastric cancer, COX-2 expression was associated with angiogenesis. The aim of this study was to determine the relation between COX-2 expression and angiogenesis in breast cancer, and to correlate the expression of this enzyme with classic clinicopathological parameters.
  
  
  METHODS
  COX-2 expression was investigated by immunohistochemistry and western blotting analysis. The expression of COX-2 was then related to age, histological grade, nodal status, oestrogen receptor status, p53 expression,c-erb-B2 overexpression, mitotic counts, MIB-1 labelling index, apoptotic index, sialyl-Tn expression, transforming growth factor alpha expression, microvessel density, and disease free survival in 46 patients with invasive ductal breast carcinoma.
  
  
  RESULTS
  By means of immunohistochemistry, COX-2 expression was detected in eight of the 46 carcinomas studied. Western blotting showed COX-2 protein expression in the same breast tumours, but not in normal adjacent tissues. The density of microvessels immunostained with anti-F-VIII related antigen was significantly higher in patients with COX-2 expression than in those without expression (p = 0.03). In addition, COX-2 was significantly associated with the presence of sialyl-Tn expression (p = 0.02), lymph node metastasis (p = 0.03), a high apoptotic index (p = 0.03), and a short disease free survival (p = 0.03) in univariate analyses.
  
  
  CONCLUSIONS
  These data suggest that COX-2 expression is associated with angiogenesis, lymph node metastasis, and apoptosis in human breast cancer. Moreover, these results warrant further studies with larger series of patients to confirm the association with short disease free survival in patients with breast cancer.
authors.affiliation: Institute of Molecular Pathology and Immunology of the University of Porto, Rua Dr. Roberto Frias S/N, 4200-Porto, Portugal.
authors.forename: C
authors.initials: C
authors.lastname: Costa
authors.forename: R
authors.initials: R
authors.lastname: Soares
authors.forename: J S
authors.initials: JS
authors.lastname: Reis-Filho
authors.forename: D
authors.initials: D
authors.lastname: Leitão
authors.forename: I
authors.initials: I
authors.lastname: Amendoeira
authors.forename: F C
authors.initials: FC
authors.lastname: Schmitt
mesh_terms: D000328:Adult; D000368:Aged; D017209:Apoptosis; D015153:Blotting, Western; D001943:Breast Neoplasms / Q000098:blood supply* / Q000201:enzymology / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000098:blood supply* / Q000201:enzymology / Q000556:secondary; D051546:Cyclooxygenase 2; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007527:Isoenzymes / Q000378:metabolism*; D008207:Lymphatic Metastasis; D008565:Membrane Proteins; D008875:Middle Aged; D008940:Mitotic Index; D009363:Neoplasm Proteins / Q000378:metabolism*; D009389:Neovascularization, Pathologic / Q000201:enzymology*; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism*
chemical_list: D007527:Isoenzymes; D008565:Membrane Proteins; D009363:Neoplasm Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases