title: Expression of cyclooxygenase (COX)-2 as a prognostic factor in nasopharyngeal cancer.
abstract: OBJECTIVE
  To evaluate the relationship between treatment failure and COX-2 expression in nasopharyngeal cancer patients treated with chemotherapy and radiotherapy.
  
  
  METHODS
  The subjects of this study were 22 nasopharyngeal cancer patients. The patients were treated with neoadjuvant chemotherapy, followed by radiotherapy, or with radiotherapy alone. The formalin-fixed, paraffin-embedded tissues of 11 patients who developed a locoregional recurrence (n=7) or distant metastasis (n=4) were compared with those of 11 disease free patients. Prognostic factors, including histological type, stage, radiation dose and chemotherapy, were well balanced between the two groups. The COX-2 expression was determined immunohistochemically.
  
  
  RESULTS
  COX-2 expression was stronger in the patients with a locoregional recurrence or distant metastasis than in those free of disease. The COX-2 distribution scores of the control group were as follows: 0 in 7, 1 in 2 and 2 in 2 patients. In the recurrence group, the scores were as follows; 0 in 3, 1 in 1, 2 in 2 and 3 in 5 patients. COX-2 expression was shown to have a statistically significant influence on the treatment failure by the Mann-Whitney U test (p=0.024) and Mantel-Haenszel Chi-Square test (p=0.018). It also significantly influenced the treatment failure when an analysis was performed within patients with a undifferentiated histology (p=0.039 by the Mann-Whitney U test, p=0.037 by the Mantel-Haenszel Chi-Square test).
  
  
  CONCLUSIONS
  COX-2 expression is believed to be one of the important factors associated with a locoregional recurrence or distant metastasis.
authors.affiliation: Department of Therapeutic Radiology, Seoul National University College of Medicine, Korea.
authors.forename: Kyubo
authors.initials: K
authors.lastname: Kim
authors.forename: Hong-Gyun
authors.initials: HG
authors.lastname: Wu
authors.forename: Suk Won
authors.initials: SW
authors.lastname: Park
authors.forename: Chong Jai
authors.initials: CJ
authors.lastname: Kim
authors.forename: Charn Il
authors.initials: CI
authors.lastname: Park
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