Expression of cyclooxygenase-2, vascular endothelial growth factor and matrix metalloproteinase-2 in patients with primary laryngeal carcinoma: a tissue microarray study

Concentration of hypoxia-inducible factor-1, glucose transporter 1 and vascular endothelial growth factor in tissue samples and serum in patients with primary laryngeal carcinoma

BACKGROUND

Markers of tumorigenesis are essential factors which may play a major role in the early detection of head and neck carcinoma.

AIMS/OBJECTIVES

To assess concentration of HIF-1, GLUT1 and VEGF in tissue samples and blood serum and its correlation to the tumour size, nodal disease, pathologic differentiation and patients' data.

MATERIAL AND METHODS

Fifty-two patients diagnosed with laryngeal carcinoma stage I-IV in which concentration of HIF-1, GLUT1 and VEGF was assessed in tissue samples and blood serum using immunoassay method.

RESULTS

HIF-1α, GLUT1, VEGF concentration was significantly higher in cancer tissue samples than in normal tissue (p < .001) and benign laryngeal lesions. Serum levels of the factors were significantly lower in the control group. Statistically significant difference regarding tumour size was found between T2 and T4 stages in HIF-1α concentration in cancer samples and serum.

CONCLUSIONS

The results show that high concentration of HIF-1α, GLUT1 and VEGF might be suggestive of carcinogenic process when diagnosing patients with laryngeal lesions and could promote early detection of malignancy.

SIGNIFICANCE

The results of this study show importance of biochemical assessment in malignant tumours which may affect clinical decisions.

Prognostic and Clinical Significance of COX-2 Overexpression in Laryngeal Cancer: A Meta-Analysis

Objective

Several studies were conducted to explore the clinical significance of cyclooxygenase-2 (COX-2) overexpression in laryngeal cancer. However, the associations between COX-2 overexpression and clinicopathological characteristics of laryngeal cancer patients remained unclear. Here, we performed a meta-analysis to eva-TY -40luate the role of COX-2 overexpression in the risk, clinical progression, and progno\sis of laryngeal cancer.

Methods

The eligible literature was obtained from PubMed, Embase, Web of Science, and China National Knowledge Infrastructure (CNKI) databases. Odds ratio (OR), risk ratio (RR), and 95% confidence interval (CI) were calculated to assess the strength of the associations, and I² statistics were used to evaluate heterogeneity among studies. Publication bias was detected with Begg’s test and Egger’s test.

Results

A total of 47 eligible articles were included for the meta-analysis after screening. COX-2 expression levels in the laryngeal cancer patients were significantly higher than those in the normal controls (OR = 11.62, 95% CI: 6.96–19.40, P < 0.05). The pooled results also showed that there were significant correlations between COX-2 overexpression and clinicopathological characteristics (tumor stage, OR = 3.26, 95% CI: 2.13–4.98, P < 0.05; lymph node metastasis, in Asians, OR = 2.35, 95% CI: 1.53–3.60, P < 0.05; recurrence, OR = 10.71, 95% CI: 3.54–32.38, P < 0.05; T stage, in Asians, OR = 2.52, 95% CI: 1.66–3.83, P < 0.05). In addition, significant correlations between COX-2 overexpression and overall survival of laryngeal cancer were found both in Asians and in Caucasians (total, HR = 1.73, 95% CI: 1.23–2.24, P < 0.05; survival in Asians, HR = 2.59, 95% CI: 1.27–3.92, P < 0.05; survival in Caucasians, HR = 1.59, 95% CI: 1.03–2.14, P < 0.05).

Conclusions

The meta-analysis results suggested that COX-2 overexpression was significantly associated with the increased risk, worse clinicopathological progression, and poorer prognosis of laryngeal cancer.

Role of Cyclooxygenase-2 in Head and Neck Tumorigenesis

The cyclooxygenase-2 (COX-2) is a potent enzyme that converts arachidonic acid to prostaglandins (PG), including PGE2, a key mediator of inflammation and angiogenesis. Importantly, COX-2 is activated in response to inflammatory stimuli, where it is also believed to promote the development and progression of head and neck cancers (HNC). COX-2 can mediate its protumorigenic effect through various mechanisms, such as inducing cell proliferation, inhibition of apoptosis, and suppressing the host’s immune response. Furthermore, COX-2 can induce the production of vascular endothelial growth factors, hence, promoting angiogenesis. Indeed, the ability of COX-2 inhibitors to selectively restrict the proliferation of tumor cells and mediating apoptosis provides promising therapeutic targets for cancer patients. Thus, in this comprehensive review, we summarized the reported differential expression patterns of COX-2 in different stages of head and neck carcinogenesis—from potentially premalignant lesions to invasive carcinomas. Furthermore, we examined the available meta-analysis evidence for COX-2 role in the carcinogenesis of HNC. Finally, further understanding of the biological processes of COX-2 and its role in orchestrating cell proliferation, apoptosis, and angiogenesis may give therapeutically beneficial insight to develop the management plan of HNC patients and improve their clinical outcomes.

Clinicopathological and prognostic significance of cyclooxygenase-2 expression in head and neck cancer: A meta-analysis

Several studies have assessed the clinicopathological and prognostic value of cyclooxygenase-2 (COX-2) expression in patients with head and neck cancer (HNC), but their results remain controversial. To address this issue, a meta-analysis was carried out. A total of 29 studies involving 2430 patients were subjected to final analysis. Our results indicated that COX-2 expression was not statistically associated with advanced tumor stage (OR, 1.23; 95% CI, 0.98–1.55) but correlated with high risk of lymph node metastasis (OR, 1.28; 95% CI, 1.03–1.60) and advanced TNM stage (OR, 1.33; 95% CI, 1.06–1.66). Moreover, COX-2 expression had significant effect on poor OS (HR, 1.93; 95% CI, 1.29–2.90), RFS (HR, 2.02; 95% CI, 1.00–4.08) and DFS (HR, 5.14; 95% CI, 2.84–9.31). The results of subgroup analyses revealed that COX-2 expression was related with high possibility of lymph node metastasis in oral cancer (OR, 1.49; 95% CI, 1.01–2.20) and advanced TNM stage in oral cancer (OR, 1.58; 95% CI, 1.05–2.37) and no site-specific HNC (OR, 1.64; 95% CI, 1.02–2.62). However, subgroup analyses only showed a tendency without statistically significant association between COX-2 expression and survival. Significant heterogeneity was not found when analyzing clinicopathological data, but it appeared when considering survival data. No publication bias was detected in this study. This meta-analysis suggested that COX-2 expression could act as a prognostic factor for patients with HNC.

Expression of cyclooxygenase-2, 12-lipoxygenase, and inducible nitric oxide synthase in head and neck squamous cell carcinoma

AIM

The objective of this study was to investigate whether cyclooxygenase-2 (COX-2), 12-lipoxygenase (12-LOX), and inducible nitric oxide synthase (iNOS) have a role in carcinogenesis of head and neck squamous cell carcinoma (HNSCC).

MATERIALS AND METHODS

Twenty-two patients with HNSCC were included in the study. Cancer tissues and adjacent normal mucosa were obtained from each patient. Real-time PCR was used to assess the expression of COX-2, 12-LOX, and iNOS.

RESULTS

COX-2 and 12-LOX mRNA expressions are significantly increased in HNSCC compared with adjacent normal mucosa. Expression of iNOS was not significantly elevated in overall head and neck cancer tissues compared with normal mucosa. However, iNOS expression was found to be significantly elevated in patients with laryngeal cancer.

CONCLUSION

These data suggest that COX-2 and 12-LOX may play a role in carcinogenesis of head and neck cancer. iNOS as well as COX-2 and 12-LOX may play a role in carcinogenesis of laryngeal cancer.

Inflammation and cancer: how friendly is the relationship for cancer patients?

Evidence has emerged in the last two decades that at the molecular level most chronic diseases, including cancer, are caused by a dysregulated inflammatory response. The identification of transcription factors such as NF-kappaB, AP-1 and STAT3 and their gene products such as tumor necrosis factor, interleukin-1, interleukin-6, chemokines, cyclooxygenase-2, 5 lipooxygenase, matrix metalloproteases, and vascular endothelial growth factor, adhesion molecules and others have provided the molecular basis for the role of inflammation in cancer. These inflammatory pathways are activated by tobacco, stress, dietary agents, obesity, alcohol, infectious agents, irradiation, and environmental stimuli, which together account for as much as 95% of all cancers. These pathways have been implicated in transformation, survival, proliferation, invasion, angiogenesis, metastasis, chemoresistance, and radioresistance of cancer, so much so that survival and proliferation of most types of cancer stem cells themselves appear to be dependent on the activation of these inflammatory pathways. Most of this evidence, however, is from preclinical studies. Whether these pathways have any role in prevention, progression, diagnosis, prognosis, recurrence or treatment of cancer in patients, is the topic of discussion of this review. We present evidence that inhibitors of inflammatory biomarkers may have a role in both prevention and treatment of cancer.