Prognostic impact of cyclooxygenase-2 in breast cancer.
Cyclooxygenase (COX)-2, an inducible isoform of cyclooxygenases, regulates the rapid production of high levels of prostaglandins during inflammation. Cyclooxygenase-2 is overexpressed in a variety of malignant tumors. This review discusses epidemiologic and preclinical data on the role of COX-2 in the development and progression of breast cancer, and it will focus on recent studies that investigate the prognostic role of COX-2 in breast cancer. In rodent tumor models it has been shown that treatment with COX-1 or COX-2 inhibitors reduces incidence and growth of breast carcinomas. Possible mechanisms include regulation of invasion, increased proliferation, and suppression of apoptosis by COX-2. Moreover, there may be an indirect effect of prostaglandins, for example in tumor host interactions such as induction of stromal aromatase activity or enhancement of angiogenesis in tumor tissue. At least 8 different immunohistochemical studies have investigated expression of COX-2 in a total of 2392 primary breast carcinomas, of which 40% were found to be COX-2 positive. Overexpression of COX-2 is associated with indicators of poor prognosis, such as lymph node metastasis, poor differentiation, and large tumor size. Four studies have found that overexpression of COX-2 is linked to poor prognosis in breast cancer. These investigations provide the basis for further evaluation of a possible therapeutic effect of COX inhibitors in therapy of breast cancer.
Denkert
Carsten
C
Institute of Pathology, Charité Hospital, Berlin, Germany. carsten.denkert@charite.de
Winzer
Klaus-Jürgen
KJ
Hauptmann
Steffen
S
D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy / Q000201:enzymology* / Q000473:pathology; D051545:Cyclooxygenase 1; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000037:antagonists & inhibitors / Q000378:metabolism*; D008565:Membrane Proteins; D011379:Prognosis; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism*; D011453:Prostaglandins / Q000096:biosynthesis
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D008565:Membrane Proteins; D011453:Prostaglandins; D051545:Cyclooxygenase 1; D051546:Cyclooxygenase 2; C496511:PTGS1 protein, human; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases