title: Overexpression of cyclooxygenase-2 in multiple myeloma: association with reduced survival.
abstract: Cyclooxygenases (COX) are key enzymes in the conversion of arachidonic acid to prostaglandins. Several studies have shown a relation between angiogenesis and COX-2 expression. Elevated expression of cyclooxygenase-2 (COX-2), however, has not been reported in multiple myeloma (MM) in the literature. The aim of this study is to investigate COX-2 expression in MM as well as its correlation with prognostic factors and estimated survival rates. Immunohistochemical staining of the paraffin-embedded bone marrow biopsy tissues (n = 51) was performed using isoform-specific COX-2 polyclonal antisera (Santa Cruz Biotechnology, Santa Cruz, CA). Results were correlated with recognized clinical parameters, which were retrospectively obtained from patients' files. There were 15, 19, and 17 bone marrow biopsy specimens with negative, weak-moderate, and strong COX-2 immunostaining, respectively. According to univariate analysis, beta2-microglobulin, age, stage, COX-2 expression, and serum lactate dehydrogenase levels were significant prognostic factors for survival in patients with multiple myeloma. COX-2 expression, age, and serum lactate dehydrogenase levels (greater than 1x normal level) were significant prognostic factors by multivariate analysis. Kaplan-Meier overall survival estimate of those patients with negative or weak-moderate COX-2 immunoreactivity in myeloma cells was significantly better than that of patients with strong COX-2 immunoreactivity (log-rank chi(2) = 21,43, P < 0.001). COX-2 overexpression was associated with reduced estimated survival. Poor prognostic factors such as LDH, age, and beta2-microglobulin were also correlated with COX-2 expression. Potent, specific COX-2 inhibitors showing evident antiangiogenic and antitumor effects on cancers could provide new therapeutic strategies in the treatment of MM.
authors.affiliation: Erciyes University, Faculty of Medicine, Dedeman Hospital, Department of Hematology-Oncology, Kayseri, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cetin
authors.forename: Suleyman
authors.initials: S
authors.lastname: Buyukberber
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Demir
authors.forename: Ismail
authors.initials: I
authors.lastname: Sari
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Sari
authors.forename: Kemal
authors.initials: K
authors.lastname: Deniz
authors.forename: Bulent
authors.initials: B
authors.lastname: Eser
authors.forename: Fevzi
authors.initials: F
authors.lastname: Altuntas
authors.forename: Celalettin
authors.initials: C
authors.lastname: Camci
authors.forename: Ahmet
authors.initials: A
authors.lastname: Oztürk
authors.forename: Burhan
authors.initials: B
authors.lastname: Turgut
authors.forename: Ozden
authors.initials: O
authors.lastname: Vural
authors.forename: Ali
authors.initials: A
authors.lastname: Unal
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000201:enzymology* / Q000401:mortality*; D009363:Neoplasm Proteins / Q000032:analysis; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis
chemical_list: D009363:Neoplasm Proteins