title: Clinicopathologic implications of the epidermal growth factor receptor, cyclooxygenase 2 expression, and human papillomavirus status in squamous cell carcinoma of the uterine cervix in the elderly.
abstract: OBJECTIVE
  To find information on invasive squamous cervical carcinoma in the elderly, 110 invasive squamous cervical carcinomas obtained from 2 groups of patients (aged <60 and >60 years) were analyzed for human papillomavirus (HPV) status by polymerase chain reaction study, for immunohistochemical epidermal growth factor receptor (EGFR), cyclooxygenase 2 (Cox-2) expression, and clinicopathologic features.
  
  
  METHODS
  The HPV status and the expression of Cox-2 and EGFR in the younger and older women were compared and correlated with the grading, staging neoplasm, and lymph nodal status, using Fisher test and Spearman nonparametric correlation test. Overall survival curves were drawn using Kaplan-Meier estimates and were compared using log-rank tests in the whole series of 110 patients. Multinomial logistic regression was also used.
  
  
  CONCLUSIONS
  The number of neoplasms with higher staging was significantly greater than those in the younger women (P = 0.04). The mortality was higher in the older group than in the younger patients (P = 0.006).In the elderly, the presence of HPV DNA in 65% of cases, and in the absence of sexual activity, could be due to reactivation of latent HPV infection, which might be due to an impairment of host immunologic response.The overexpression of Cox-2 in a number of cases was significantly higher in the older group than in the younger group (P = 0.032, Fisher exact test), but this immunoreactivity is not related to the staging, grading, EGFR expression, or to the presence of HPV.The simultaneous expression of Cox-2 and EGFR had a poor prognostic significance, showing lower survival rates than cases without this immunoreactivity (P = 0.002), on univariate analysis.On multivariate analysis, Cox-2 and EGFR immunopositivity did not reveal any correlation between these markers and prognosis probably because the number of cases considered was not particularly high.
authors.affiliation: Department of Pathology, Parma University Parma, Italy. giovanna.giordano@unipr.it
authors.forename: Giovanna
authors.initials: G
authors.lastname: Giordano
authors.forename: Tiziana
authors.initials: T
authors.lastname: D'Adda
authors.forename: Barbara
authors.initials: B
authors.lastname: Dal Bello
authors.forename: Francesca
authors.initials: F
authors.lastname: Brigati
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bersiga
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Campanini
authors.forename: Roberto
authors.initials: R
authors.lastname: Berretta
authors.forename: Alba
authors.initials: A
authors.lastname: Rocco
authors.forename: Carla
authors.initials: C
authors.lastname: Merisio
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000378:metabolism* / Q000473:pathology / Q000821:virology; D051546:Cyclooxygenase 2 / Q000096:biosynthesis*; D066246:ErbB Receptors / Q000096:biosynthesis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009367:Neoplasm Staging; D030361:Papillomavirus Infections; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000378:metabolism* / Q000473:pathology / Q000821:virology
chemical_list: D051546:Cyclooxygenase 2; D066246:ErbB Receptors