title: Cyclooxygenase-2 expression in cervical squamous cell carcinoma: the significance of expression in neoplastic cells within the lymphovascular space.
abstract: BACKGROUND
  Cyclooxygenase-2 (COX-2) activity is related to the development and progression of cervical cancer. Previous studies have shown that COX-2 expression in early stage (stage IB-IIA) cervical squamous cell carcinoma is associated with lymph node metastasis in tumors with lymphovascular space invasion (LVSI), and that COX-2 expression may facilitate lymph node metastasis after LVSI occurs. In this study, we evaluated whether COX-2 expression of neoplastic cells within lymphovascular spaces (tumor emboli) would provide additional prognostic information.
  
  
  METHODS
  Immunohistochemical stained slides for COX-2 on 150 cases of stage IB-IIA cervical squamous cell carcinoma with LVSI were evaluated for expression of COX-2 in tumor emboli. Results were correlated with overall COX-2 expression of tumor and clinicopathologic features using statistical analysis.
  
  
  RESULTS
  Expression of COX-2 was detected in 49.3% of cases. Expression of COX-2 in tumor emboli (LV-COX-2 expression) was identified in 61 cases (40.7%). LV-COX-2 expression was associated with high LVSI count (p<0.001) and had a marginal association with tumor COX-2 expression (p= 0.050) and lymph node metastasis (p= 0.063). In tumors showing high LVSI count, LV-COX-2 expression was an independent predictor for lymph node metastasis (p= 0.038, 95% CI= 1.030-2.725) whereas tumor COX-2 expression (p= 0.550) was not.
  
  
  CONCLUSIONS
  Evaluation of COX-2 expression in tumor emboli may provide additional prognostic value for lymph node metastasis in cervical squamous cell carcinomas with a high LVSI count.
authors.affiliation: Department of Pathology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
authors.forename: Jongkolnee
authors.initials: J
authors.lastname: Settakorn
authors.forename: Surapan
authors.initials: S
authors.lastname: Khunamornpong
authors.forename: Kornkanok
authors.initials: K
authors.lastname: Sukpan
authors.forename: Jatupol
authors.initials: J
authors.lastname: Srisomboon
authors.forename: Sumalee
authors.initials: S
authors.lastname: Siriaungkul
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000473:pathology; D016009:Chi-Square Distribution; D051546:Cyclooxygenase 2 / Q000378:metabolism*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016015:Logistic Models; D008207:Lymphatic Metastasis / Q000473:pathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D002583:Uterine Cervical Neoplasms / Q000378:metabolism* / Q000473:pathology
chemical_list: D051546:Cyclooxygenase 2