title: Expression of cyclooxygenase-2 (COX-2) in tumour and stroma compartments in cervical cancer: clinical implications.
abstract: This study aims at investigating the relationship between cyclooxygenase-2 expression in tumour vs stroma inflammatory compartment and its possible clinical role. The study included 99 stage IB-IV cervical cancer patients: immunostaining of tumour tissue sections was performed with rabbit antiserum against cyclooxygenase-2. CD3, CD4, CD8, CD25, Mast Cell Tryptase monoclonal antibodies were used to characterise stroma inflammatory cells in nine cervical tumours. An inverse relation was found between cyclooxygenase-2 levels (cyclooxygenase-2 IDV) of tumour vs stroma compartment (r=-0.44, P<0.0001). The percentage of cases showing high tumour/stromal cyclooxygenase-2 IDV ratio was significantly higher in patients who did not respond to treatment (93.3%) with respect to patients with partial (60.5%), and complete (43.7%) response (P= 0.009). Cases with a high tumour/stroma cyclooxygenase-2 IDV ratio had a shorter overall survival rate than cases with a low tumour/stroma cyclooxygenase-2 IDV (P<0.0001). In the multivariate analysis advanced stage and the status of tumour/stroma cyclooxygenase-2 IDV ratio retained an independent negative prognostic role. The proportion of CD3(+), CD4(+), and CD25(+) cells was significantly lower in tumours with high tumour/stroma cyclooxygenase-2 IDV ratio, while a higher percentage of mast cells was detected in tumours showing high tumour/stroma cyclooxygenase-2 IDV ratio. Our study showed the usefulness of assessing cyclooxygenase-2 status both in tumour and stroma compartment in order to identify cervical cancer patients endowed with a very poor chance of response to neoadjuvant therapy and unfavourable prognosis.
authors.affiliation: Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, Largo F. Vito, I-00168 Rome, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Ferrandina
authors.forename: L
authors.initials: L
authors.lastname: Lauriola
authors.forename: G F
authors.initials: GF
authors.lastname: Zannoni
authors.forename: M G
authors.initials: MG
authors.lastname: Distefano
authors.forename: F
authors.initials: F
authors.lastname: Legge
authors.forename: V
authors.initials: V
authors.lastname: Salutari
authors.forename: M
authors.initials: M
authors.lastname: Gessi
authors.forename: N
authors.initials: N
authors.lastname: Maggiano
authors.forename: G
authors.initials: G
authors.lastname: Scambia
authors.forename: F O
authors.initials: FO
authors.lastname: Ranelletti
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D015703:Antigens, CD / Q000032:analysis; D051546:Cyclooxygenase 2; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D007527:Isoenzymes / Q000032:analysis*; D008565:Membrane Proteins; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011451:Prostaglandin-Endoperoxide Synthases / Q000032:analysis*; D011817:Rabbits; D017154:Stromal Cells / Q000201:enzymology; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000201:enzymology* / Q000401:mortality / Q000473:pathology
chemical_list: D015703:Antigens, CD; D007527:Isoenzymes; D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases