title: Low COX2 in tumor and upregulation in stroma mark laryngeal squamous cell carcinoma progression.
abstract: OBJECTIVE
  Invasive squamous cell carcinomas (SCC) of the larynx, like most solid tumors, are surrounded by a reactive stroma, in which cancer associated fibroblasts (CAFs) are the predominant cell type. This mesenchymal reaction may affect cancer progression multiply. The proinflammatory enzyme cyclooxygenase-2 (COX-2) has been correlated with head and neck cancer. This study aims to explore the impact of epithelial and stromal COX-2 expression on SCC behavior.
  
  
  METHODS
  Retrospective case review study performed in a tertiary health center institution.
  
  
  METHODS
  Double immunohistochemistry of COX-2 and the CAF marker alpha-smooth muscle actin (alpha-SMA) was utilized in 97 laryngeal cancer patients. Follow-up data were collected in 52 cases.
  
  
  RESULTS
  Low COX-2 immunostaining in cancer cells was associated with advanced grade (P = .044) and shorter recurrence-free period (P = .035). CAF expression was positively correlated with the grade of the infiltrating tumor (P = .030).
  
  
  CONCLUSIONS
  In laryngeal SCCs, COX-2 may exert its deleterious effect by alterations in the tumor microenvironment. CAF-derived, COX-2-mediated paracrine influences on malignant cells possibly facilitate cancer progression. Overlooking the stromal remodeling could account for unsuccessful treatments of epithelial neoplasms.
authors: Department of Anatomy, Medical School of Patras, Rio, Greece. concourel@vodafone.net.gr
authors: Konstantinos
authors: K
authors: Kourelis
authors: Gerasimos
authors: G
authors: Vandoros
authors: Theodoros
authors: T
authors: Kourelis
authors: Theodoros
authors: T
authors: Papadas
authors: Panos
authors: P
authors: Goumas
authors: Georgia
authors: G
authors: Sotiropoulou-Bonikou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000401:mortality; D051546:Cyclooxygenase 2 / Q000378:metabolism*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000378:metabolism* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015854:Up-Regulation / Q000502:physiology
chemical_list: D051546:Cyclooxygenase 2