title: Cyclooxygenase-2 is an independent predictor of poor prognosis in uterine leiomyosarcomas.
abstract: BACKGROUND
  Cyclooxygenase-2 (COX-2) is a well-known enzyme that promotes tumor growth and metastasis. Cyclooxygenase-2 is upregulated in a number of human epithelial tumors, but data about the significance of COX-2 in mesenchymal tumors are lacking. The purpose of this study was to determine COX-2 expression in uterine sarcomas and whether a relationship exists between COX-2 expression and clinicopathologic outcomes.
  
  
  METHODS
  Immunohistochemical staining for COX-2 was performed on paraffin-embedded tissue blocks of 49 uterine sarcomas (30 leiomyosarcomas, 14 endometrial stromal sarcomas, and 5 carcinosarcomas). Positive staining was defined as moderate or strong staining in 5% or more of tumor cells.
  
  
  RESULTS
  Four of 30 leiomyosarcomas, 1 of 14 endometrial stromal sarcomas, and 2 of 5 carcinosarcomas were positive for COX-2 expression. In leiomyosarcomas, COX-2 expression correlated with tumor stage with marginal significance (P = 0.058). Patients with leiomyosarcoma positive for COX-2 expression had a lower overall survival rate than those without COX-2 expression (P = 0.025). In the multivariate Cox proportional hazards regression model, COX-2 expression, tumor stage, and mitotic count were independently associated with overall survival in leiomyosarcomas.
  
  
  CONCLUSIONS
  Our data suggest that immunohistochemically determined COX-2 expression is an independent prognostic factor in uterine leiomyosarcomas. Assessment of COX-2 status might be useful for determining the prognosis in patients with uterine leiomyosarcomas.
authors.affiliation: Department of Obstetrics and Gynecology, Dongguk University, Seoul, Republic of Korea.
authors.forename: Chae Hyeong
authors.initials: CH
authors.lastname: Lee
authors.forename: Ju-Won
authors.initials: JW
authors.lastname: Roh
authors.forename: Jong-Sun
authors.initials: JS
authors.lastname: Choi
authors.forename: Sokbom
authors.initials: S
authors.lastname: Kang
authors.forename: In-Ae
authors.initials: IA
authors.lastname: Park
authors.forename: Hyun Hoon
authors.initials: HH
authors.lastname: Chung
authors.forename: Yong-Tark
authors.initials: YT
authors.lastname: Jeon
authors.forename: Jae Weon
authors.initials: JW
authors.lastname: Kim
authors.forename: Noh-Hyun
authors.initials: NH
authors.lastname: Park
authors.forename: Soon-Beom
authors.initials: SB
authors.lastname: Kang
authors.forename: Yong-Sang
authors.initials: YS
authors.lastname: Song
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism / Q000502:physiology; D051546:Cyclooxygenase 2 / Q000378:metabolism / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D007890:Leiomyosarcoma / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D008875:Middle Aged; D011379:Prognosis; D016019:Survival Analysis; D014594:Uterine Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human