Expression of COX-2 and HER-2/neu and estrogen and progesterone receptor in primary squamous cell carcinomas of the endometrium

Association of Hormone Receptor Expression with Survival in Ovarian Endometrioid Carcinoma: Biological Validation and Clinical Implications

This paper aims to validate whether hormone receptor expression is associated with longer survival among women diagnosed with ovarian endometrioid carcinoma (EC), and whether it identifies patients with stage IC/II tumors with excellent outcome that could be spared from toxic chemotherapy. Expression of estrogen receptor (ER) and progesterone receptor (PR) was assessed on 182 EC samples represented on tissue microarrays using the Alberta Ovarian Tumor Type (AOVT) cohort. Statistical analyses were performed to test for associations with ovarian cancer specific survival. ER or PR expression was present in 87.3% and 86.7% of cases, respectively, with co-expression present in 83.0%. Expression of each of the hormonal receptors was significantly higher in low-grade tumors and tumors with squamous differentiation. Expression of ER (Hazard Ratio (HR) = 0.18, 95% confidence interval 0.08–0.42, p = 0.0002) and of PR (HR = 0.22, 95% confidence interval 0.10–0.53, p = 0.0011) were significantly associated with longer ovarian cancer specific survival adjusted for age, grade, treatment center, stage, and residual disease. However, the five-year ovarian cancer specific survival among women with ER positive stage IC/II EC was 89.0% (standard error 3.3%) and for PR positive tumors 89.9% (standard error 3.2%), robustly below the 95% threshold where adjuvant therapy could be avoided. We validated the association of hormone receptor expression with ovarian cancer specific survival independent of standard predictors in an independent sample set of EC. The high ER/PR co-expression frequency and the survival difference support further testing of the efficacy of hormonal therapy in hormone receptor-positive ovarian EC. The clinical utility to identify a group of women diagnosed with EC at stage IC/II that could be spared from adjuvant therapy is limited.

The relationship of COX-2 expression with estrogen receptor, progesterone receptor and prognostic parameters in endometrial carcinomas

AIM

Endometrial cancer (EC), which is the most common gynecologic cancer, develops as a result of disruption of the delicate balance between cell proliferation and cell loss, or apoptosis through activation of oncogenesis, or loss of tumor suppressor genes. Among the biochemical factors proposed to give a more detailed characterization of EC biology, estrogen receptors (ER) and progesterone receptors (PR) play a major role. Most of the studies in the literature have shown increased expression of cyclooxygenase-2 (COX-2) in EC. Recent experiments suggest that COX-2 antagonizes cell apoptosis, increases the invasiveness of malignant cells and promotes angiogenesis. The aim of this study was to investigate the expression of COX-2 in EC, to study its correlation to established menstrual status, grade, myometrial invasion, lymph node status, stage and ER and PR status.

MATERIAL & METHODS

The study was performed on 72 ECs. Immunohistochemically was analyzed for ER, PR, and COX-2.

RESULTS

COX-2 positivity was found in 91.7% of the cases. In 61 cases (84.7%) there was ER positive staining, and in 59 cases (81.9%) PR positive staining was observed. We have not found a statistically significant relation between COX-2 and prognostic factors, ER and PR.

CONCLUSIONS

A high expression rate still suggests a probable relation with endometrial carcinogenesis. If such a relation exists, new therapeutic options might be available in the future.