title: Correlation of cyclooxygenase-2 (COX-2) and aromatase expression in human endometrial cancer: tissue microarray analysis.
abstract: OBJECTIVE
  The objective of this study was to compare the prevalence of cyclooxygenase-2 (COX-2), aromatase, and hormone receptor immunohistochemical (IHC) expression to well defined clinical-pathologic prognostic factors in a large group of surgically staged endometrial cancer patients.
  
  
  METHODS
  A tissue microarray (TMA) was constructed from 336 separate specimens of endometrial cancer. IHC was performed for estrogen (ER) and progesterone (PR) receptor, COX-2, COX-1, and aromatase.
  
  
  RESULTS
  The majority of tumors expressed COX-2 (59%) and aromatase (65%). COX-2 staining significantly correlated with aromatase expression ( P < .014) but did not correlate with ER and PR. COX-2 expression was correlated with worsening histologic grade ( P < .026) and approached statistical significance for deep myometrial invasion ( P < .055). After applying multivariate analysis, no single IHC or combination of IHCs correlated with intrauterine poor prognostic factors or advanced stage. Only myometrial invasion >50% (OR 6.98, P < .001) and nonendometrioid histology (OR 4.933, P < .001) were predictive of advanced stage after multivariate analysis.
  
  
  CONCLUSIONS
  COX-2 and aromatase are expressed in the majority of endometrial cancer patients. COX-2 expression was not associated with the great majority of surgical-pathologic prognostic factors. COX-2 expression did significantly correlate with aromatase expression, suggesting that intratumoral production of estrogen in endometrial cancer may be an important mechanism in tumorigenesis.
authors.affiliation: Division of Gynecologic Oncology, The Ohio State University Medical School, Columbus, OH 43210, USA. Fowler-1@medctr.osu.edu
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Fowler
authors.forename: Nilsa
authors.initials: N
authors.lastname: Ramirez
authors.forename: David E
authors.initials: DE
authors.lastname: Cohn
authors.forename: Nicole
authors.initials: N
authors.lastname: Kelbick
authors.forename: James
authors.initials: J
authors.lastname: Pavelka
authors.forename: Inbar
authors.initials: I
authors.lastname: Ben-Shachar
authors.forename: Carl
authors.initials: C
authors.lastname: Morrison
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001141:Aromatase / Q000378:metabolism*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D018269:Carcinoma, Endometrioid / Q000201:enzymology* / Q000473:pathology / Q000601:surgery; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D051546:Cyclooxygenase 2; D016889:Endometrial Neoplasms / Q000201:enzymology* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016015:Logistic Models; D008565:Membrane Proteins; D046228:Microarray Analysis; D008875:Middle Aged; D009367:Neoplasm Staging; D009924:Organ Culture Techniques; D011336:Probability; D011379:Prognosis; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism*; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D008565:Membrane Proteins; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D001141:Aromatase; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases