title: COX-2, MMP-9, and Noguchi classification provide additional prognostic information about adenocarcinoma of the lung. A study of 117 patients from Brazil.
abstract: We report immunohistochemical staining results for cyclooxygenase (COX)-2 and matrix metalloproteinase (MMP)-9 in primary tumors of 117 patients with resected adenocarcinoma of the lung (median follow-up, 20 months). For COX-2, we graded the degree of tumor staining according to the sum of staining intensity and the proportion of cells staining. For MMP-9, we used morphometry to quantify cytoplasmic staining. We used the Cox proportional hazards model to analyze overall survival. With only 29 patients censored at last follow-up, after controlling for the effect of pathologic stage, staining for COX-2 and MMP-9 and subtype of tumor were related significantly to survival (P < 6 x 10(-5)). The effects of COX-2 and MMP-9 were opposite. Whereas any staining for COX-2 decreased the hazard and increased survival time, increased staining for MMP-9 increased the hazard and decreased survival time. The results also suggested that staining for COX-2 decreases with dedifferentiation. Our results suggest that staining for the combination of COX-2 and MMP-9 and categorizing tumors into papillary and nonpapillary types may provide important prognostic information for patients with resected adenocarcinoma of the lung; it is possible that these 3 variables could aid decisions about postoperative adjuvant treatment.
authors.affiliation: Divisions of Respiratory Diseases and Pathology, Heart Institute, University of São Paulo.
authors.forename: Nise H
authors.initials: NH
authors.lastname: Yamaguchi
authors.forename: Ana J
authors.initials: AJ
authors.lastname: Lichtenfels
authors.forename: Lea M
authors.initials: LM
authors.lastname: Demarchi
authors.forename: Alecsander P
authors.initials: AP
authors.lastname: da Silva
authors.forename: Ana L
authors.initials: AL
authors.lastname: Garippo
authors.forename: Venancio F
authors.initials: VF
authors.lastname: Alves
authors.forename: Carolina
authors.initials: C
authors.lastname: Michelin
authors.forename: Pedro M
authors.initials: PM
authors.lastname: Azevedo
authors.forename: Tatiana
authors.initials: T
authors.lastname: Moya
authors.forename: Tereza
authors.initials: T
authors.lastname: Takagaki
authors.forename: Paulo H
authors.initials: PH
authors.lastname: Saldiva
authors.forename: Robin T
authors.initials: RT
authors.lastname: Vollmer
authors.forename: Vera L
authors.initials: VL
authors.lastname: Capelozzi
mesh_terms: D000230:Adenocarcinoma / Q000201:enzymology* / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D001938:Brazil / Q000453:epidemiology; D051546:Cyclooxygenase 2; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D007527:Isoenzymes / Q000378:metabolism*; D008175:Lung Neoplasms / Q000201:enzymology* / Q000401:mortality / Q000473:pathology; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism*; D008565:Membrane Proteins; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism*; D016019:Survival Analysis; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D007527:Isoenzymes; D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases; D020780:Matrix Metalloproteinase 9