title: The prognostic significance of COX-2 and survivin expression in ovarian cancer.
abstract: We investigated the prognostic significance of cyclooxygenase-2 (COX-2) and survivin in ovarian carcinoma. Imprint smears were obtained from 100 ovarian carcinoma specimens and were studied immunocytochemically for the expression of COX-2 and survivin. The results were correlated with several clinicopathological parameters, including 5-year survival. Increased COX-2 staining pattern correlated with a non-mucinous histological type (p=0.008), increased stage (p<0.0001), high histological grade (p<0.0001), and reduced survival rates (p<0.00001). Survivin expression was strongly associated with increased stage (p<0.0001), increased histological grade (p<0.0001), and reduced survival (p<0.00001). Elevated survivin expression also correlated significantly with pre-menopausal status (p=0.033). In addition, COX-2 and survivin staining patterns correlated strongly with one another (p<0.0001). However, on multivariate analysis, an independent prognostic value was found only for tumor stage and grade. The findings of our study indicate that the increased expression of COX-2 and survivin in ovarian cancer is associated with one another and with several adverse clinicopathologic parameters, including reduced survival, thus suggesting a role of these molecules in disease progression. Further investigations of the exact prognostic and therapeutic implications of COX-2 and survivin expression are strongly warranted.
authors.affiliation: Pathology Laboratory, Cytology Department, Medical School, Athens University, 75 Mikras Asias Street, 11527 Athens, Greece. dimgrap@yahoo.gr
authors.forename: Pauline
authors.initials: P
authors.lastname: Athanassiadou
authors.forename: Dimitra
authors.initials: D
authors.lastname: Grapsa
authors.forename: Peter
authors.initials: P
authors.lastname: Athanassiades
authors.forename: Maria
authors.initials: M
authors.lastname: Gonidi
authors.forename: Anna-Maria
authors.initials: AM
authors.lastname: Athanassiadou
authors.forename: Angelos
authors.initials: A
authors.lastname: Tsipis
authors.forename: Efstratios
authors.initials: E
authors.lastname: Patsouris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D051546:Cyclooxygenase 2 / Q000032:analysis*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D051034:Inhibitor of Apoptosis Proteins; D053208:Kaplan-Meier Estimate; D008869:Microtubule-Associated Proteins / Q000032:analysis*; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis*; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000737:chemistry* / Q000201:enzymology / Q000401:mortality / Q000473:pathology / Q000628:therapy; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D000077022:Survivin; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D009363:Neoplasm Proteins; D000077022:Survivin; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human