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Wang J, Xiang C, Cai Y, Mei Z, Lu Q, Liu B, Zou L. Clinicopathological and prognostic significance of COX-2 in glioma patients: a meta-analysis. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:1254-1261. [PMID: 36580964 PMCID: PMC9800163 DOI: 10.1055/s-0042-1758864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND In recent years, cyclooxygenase-2 (COX-2) has been identified as a cancer stem cell (CSC) marker in gliomas. Nevertheless, the clinical and prognostic significance of COX-2 in glioma patients remains controversial. OBJECTIVE To evaluate the correlation of COX-2 with the prognosis in glioma patients. METHODS Eligible studies on this subject were included, and pooled odd ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (95%CIs) were estimated. Publication bias was assessed through funnel plots, and heterogeneity and sensitivity were analyzed as well. RESULTS In the present study, 11 articles with a total of 641 patients were included. The high expression of COX-2 in glioma patients was negatively associated with overall survival (OS) (n = 11; HR = 2.26; 95%CI = 1.79-2.86), and the subgroup analysis showed no differences in OS between Asian (n = 5; HR = 2.16; 95%CI = 1.57-2.97) and non-Asian (n = 6; HR = 2.39; 95%CI = 1.69-3.38) glioma patients. The Begg funnel plots test indicated that there was no evident risk of publication bias in the meta-analysis. CONCLUSION The present study suggests that COX-2 could be recommended as a useful pathological and prognostic biomarker in the clinical practice.
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Affiliation(s)
- Jun Wang
- China Three Gorges University, The People's Hospital, Yichang, Hubei Province, China.
| | - Chenyan Xiang
- China Three Gorges University, The People's Hospital, Yichang, Hubei Province, China.
| | - Yi Cai
- China Three Gorges University, College of Basic Medical Sciences, Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, Yichang, Hubei, China.,China Three Gorges University, College of Basic Medical Sciences, The Institute of Infection and Inflammation, Yichang, China.
| | - Ziyi Mei
- China Three Gorges University, College of Basic Medical Sciences, Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, Yichang, Hubei, China.,China Three Gorges University, College of Basic Medical Sciences, The Institute of Infection and Inflammation, Yichang, China.
| | - Qianqian Lu
- China Three Gorges University, College of Basic Medical Sciences, Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, Yichang, Hubei, China.,China Three Gorges University, College of Basic Medical Sciences, The Institute of Infection and Inflammation, Yichang, China.
| | - Binbin Liu
- China Three Gorges University, College of Basic Medical Sciences, Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, Yichang, Hubei, China.,China Three Gorges University, College of Basic Medical Sciences, The Institute of Infection and Inflammation, Yichang, China.
| | - Lili Zou
- China Three Gorges University, College of Basic Medical Sciences, Hubei Key Laboratory of Tumor Microenvironment and Immunotherapy, Yichang, Hubei, China.,China Three Gorges University, College of Basic Medical Sciences, The Institute of Infection and Inflammation, Yichang, China.,Address for correspondence Lili Zou
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2
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Egan KM, Nabors LB, Thompson ZJ, Rozmeski CM, Anic GA, Olson JJ, LaRocca RV, Chowdhary SA, Forsyth PA, Thompson RC. Analgesic use and the risk of primary adult brain tumor. Eur J Epidemiol 2016; 31:917-25. [PMID: 26894804 DOI: 10.1007/s10654-016-0129-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 02/13/2016] [Indexed: 12/21/2022]
Abstract
Glioma and meningioma are uncommon tumors of the brain with few known risk factors. Regular use of aspirin has been linked to a lower risk of gastrointestinal and other cancers, though evidence for an association with brain tumors is mixed. We examined the association of aspirin and other analgesics with the risk of glioma and meningioma in a large US case-control study. Cases were persons recently diagnosed with glioma or meningioma and treated at medical centers in the southeastern US. Controls were persons sampled from the same communities as the cases combined with friends and other associates of the cases. Information on past use of analgesics (aspirin, other anti-inflammatory agents, and acetaminophen) was collected in structured interviews. Logistic regression was used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) for analgesic use adjusted for potential confounders. All associations were considered according to indication for use. A total of 1123 glioma cases, 310 meningioma cases and 1296 controls were included in the analysis. For indications other than headache, glioma cases were less likely than controls to report regular use of aspirin (OR 0.69; CI 0.56, 0.87), in a dose-dependent manner (P trend < 0.001). No significant associations were observed with other analgesics for glioma, or any class of pain reliever for meningioma. Results suggest that regular aspirin use may reduce incidence of glioma.
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Affiliation(s)
- Kathleen M Egan
- Division of Population Sciences, Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612-9416, USA.
| | - Louis B Nabors
- Neuro-Oncology Program, University of Alabama at Birmingham, FOT 1020, 510 20th St. South, Birmingham, AL, 35294, USA
| | - Zachary J Thompson
- Division of Population Sciences, Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612-9416, USA
| | - Carrie M Rozmeski
- Division of Population Sciences, Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612-9416, USA
| | - Gabriella A Anic
- Division of Population Sciences, Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612-9416, USA
| | - Jeffrey J Olson
- Department of Neurosurgery, Emory University School of Medicine, 1365-B Clifton Rd., NE, Ste. 2200, Atlanta, GA, 30322, USA
| | - Renato V LaRocca
- Department of Hematology-Oncology, Norton Cancer Institute, 315 E. Broadway, Louisville, KY, 40202, USA
| | - Sajeel A Chowdhary
- Neuro-Oncology Program, Lynn Cancer Institute and the Boca Raton Regional Hospital, 701 NW 13th Street, Boca Raton, FL, 33486, USA
| | - Peter A Forsyth
- Department of Neuro-Oncology, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, FL, 33612, USA
| | - Reid C Thompson
- Department of Neurological Surgery, Vanderbilt University Medical Center, 691 Preston Building, Nashville, TN, 37232, USA
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3
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Wang X, Chen Y, Zhang S, Zhang L, Liu X, Zhang L, Li X, Chen D. Co-expression of COX-2 and 5-LO in primary glioblastoma is associated with poor prognosis. J Neurooncol 2015; 125:277-85. [PMID: 26334317 DOI: 10.1007/s11060-015-1919-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 08/29/2015] [Indexed: 12/27/2022]
Abstract
Cyclooxygenase-2 (COX-2) and 5-lipoxygenase (5-LO) are important factors in tumorigenesis and malignant progression; however, studies of their roles in glioblastoma have produced conflicting results. To define the frequencies of COX-2 and 5-LO expression and their correlation with clinicopathological features and prognosis, tumor tissues from 76 cases of newly diagnosed primary ordinary glioblastoma were examined for COX-2 and 5-LO expression by immunohistochemistry. The expression levels of COX-2 and 5-LO and the relationships between the co-expression of COX-2/5-LO and patient age and gender, edema index (EI), Karnofsky Performance Scale and overall survival (OS) were analyzed. COX-2 and 5-LO were expressed in 73.7 % (56/76) and 92.1 % (70/76) of the samples, respectively. Among the clinicopathological characteristics, only age (>60 years) exhibited a significant association with the high expression of COX-2. No statistically significant correlations were found in the 5-LO cohort. A significant positive correlation was revealed between the COX-2 and 5-LO scores (r = 0.374; p = 0.001). The elevated co-expression of COX-2 and 5-LO was observed primarily in the patients over the age of 60 years. Patients with a high expression of COX-2 had a significantly shorter OS (p < 0.01), whereas the immunoexpression of 5-LO was not associated with the OS of patients with glioblastoma. Survival analysis indicated that simultaneous high levels of COX-2 and 5-LO expression were significantly correlated with poor OS and, conversely, that a low/low expression pattern of these two proteins was significantly associated with better OS (p < 0.05). Moreover, the Cox multivariable proportional hazard model showed that a high expression of COX-2, high co-expression of COX-2 and 5-LO, and a high Ki-67 index were significant predictors of shorter OS in primary glioblastoma, independent of age, gender, EI, 5-LO expression and p53 status. The hazard ratios for OS were 2.347 (95 % CI 1.30-4.25, p = 0.005), 1.900 (95 % CI 1.30-2.78, p = 0.001), and 2.210 (95 % CI 1.19-4.09, p = 0.011), respectively. These results suggest that COX-2 and 5-LO play roles in tumorigenesis and the progression of primary glioblastoma and that the co-expression pattern of COX-2/5-LO may be used as an independent prognostic factor in this disease.
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Affiliation(s)
- Xingfu Wang
- Department of Pathology, The First Affiliated Hospital of Fujian Medical University, No. 20 Chazhong Road, Taijiang Ditrict, Fuzhou City, 350005, China.
| | - Yupeng Chen
- Department of Pathology, The First Affiliated Hospital of Fujian Medical University, No. 20 Chazhong Road, Taijiang Ditrict, Fuzhou City, 350005, China.
| | - Sheng Zhang
- Department of Pathology, The First Affiliated Hospital of Fujian Medical University, No. 20 Chazhong Road, Taijiang Ditrict, Fuzhou City, 350005, China.
| | - Lifeng Zhang
- Department of Endocrinology, Fujian Province Governmental Hospital, No. 67 Guping Road, Gulou Ditrict, Fuzhou City, 350003, China.
| | - Xueyong Liu
- Department of Pathology, The First Affiliated Hospital of Fujian Medical University, No. 20 Chazhong Road, Taijiang Ditrict, Fuzhou City, 350005, China.
| | - Li Zhang
- Department of Pathology, The First Affiliated Hospital of Fujian Medical University, No. 20 Chazhong Road, Taijiang Ditrict, Fuzhou City, 350005, China.
| | - Xiaoling Li
- Department of Pathology, The First Affiliated Hospital of Fujian Medical University, No. 20 Chazhong Road, Taijiang Ditrict, Fuzhou City, 350005, China.
| | - Dayang Chen
- Department of Pathology, The First Affiliated Hospital of Fujian Medical University, No. 20 Chazhong Road, Taijiang Ditrict, Fuzhou City, 350005, China.
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4
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Jankovsky JM, Newkirk KM, Ilha MR, Newman SJ. COX-2 and c-kit expression in canine gliomas. Vet Comp Oncol 2011; 11:63-9. [DOI: 10.1111/j.1476-5829.2011.00302.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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5
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Moussa O, Ciupek A, Watson DK, Halushka PV. Urinary thromboxane B2 and thromboxane receptors in bladder cancer: opportunity for detection and monitoring. Prostaglandins Other Lipid Mediat 2011; 96:41-4. [PMID: 21983220 PMCID: PMC3215826 DOI: 10.1016/j.prostaglandins.2011.09.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 09/20/2011] [Accepted: 09/22/2011] [Indexed: 11/25/2022]
Abstract
We have previously found increased expression of thromboxane synthase (TXAS) and thromboxane receptor (TP) beta isoform in the tissues of patients with bladder cancer. Studies in cell lines and mice have indicated a potential significant role of the thromboxane signaling pathway in the pathogenesis of human bladder cancer. This study was designed to determine if the changes observed in the tissues of patients with bladder cancer were mirrored by changes in the urine of these patients. We found increased levels of thromboxane B(2) (TXB(2)) the major metabolite of TXAS and increased levels of the TPβ receptor. These results raised the possibility that patients with bladder cancer may be followed for progression or remission of their disease by quantitation of these substances in their urine.
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Affiliation(s)
- Omar Moussa
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, 173 Ashley Avenue, Charleston, SC29425
- Hollings Cancer Center, Medical University of South Carolina, 173 Ashley Avenue, Charleston, SC29425
| | - Andrew Ciupek
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, 173 Ashley Avenue, Charleston, SC29425
- Hollings Cancer Center, Medical University of South Carolina, 173 Ashley Avenue, Charleston, SC29425
| | - Dennis K. Watson
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, 173 Ashley Avenue, Charleston, SC29425
- Hollings Cancer Center, Medical University of South Carolina, 173 Ashley Avenue, Charleston, SC29425
| | - Perry V. Halushka
- Departments of Pharmacology and Medicine, Medical University of South Carolina, 173 Ashley Avenue, Charleston, SC29425
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6
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De Armas R, Durand K, Guillaudeau A, Weinbreck N, Robert S, Moreau JJ, Caire F, Acosta G, Pebet M, Chaunavel A, Marin B, Labrousse F, Denizot Y. mRNA levels of enzymes and receptors implicated in arachidonic acid metabolism in gliomas. Clin Biochem 2010; 43:827-35. [PMID: 20382140 DOI: 10.1016/j.clinbiochem.2010.03.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2009] [Revised: 03/24/2010] [Accepted: 03/31/2010] [Indexed: 01/07/2023]
Abstract
BACKGROUND Gliomas are tumors of the central nervous system derived from glial cells. They show cellular heterogeneity and lack specific diagnostic markers. Although a possible role for the eicosanoid cascade has been suggested in glioma tumorigenesis, the relationship between enzymes and receptors implicated in arachidonic acid metabolism, with histological tumor type has not yet been determined. DESIGN AND METHODS Quantitative real-time reverse transcription-polymerase chain reaction was performed to measure and compare transcript levels of enzymes and receptors implicated in both lipoxygenase and cyclooxygenase pathways between oligodendrogliomas, astrocytomas, glioblastomas and mixed oligoastrocytomas. RESULTS Arachidonic acid metabolism-related enzymes and receptor transcripts (i) were underexpressed in classical oligodendrogliomas compared to astrocytomas and/or glioblastomas, (ii) differed between astrocytomas and glioblastomas and (iii) had an intermediate expression in mixed oligoastrocytomas. CONCLUSIONS mRNA levels of enzymes and receptors implicated both in lipoxygenase and cyclooxygenase pathways differed significantly in gliomas according to the histological type.
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Affiliation(s)
- Rafael De Armas
- Department of Pathology, CHU Dupuytren, 2 Av. Martin Luther King, 87042 Limoges, France
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7
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Onguru O, Gamsizkan M, Ulutin C, Gunhan O. Cyclooxygenase-2 (Cox-2) expression and angiogenesis in glioblastoma. Neuropathology 2008; 28:29-34. [PMID: 18181832 DOI: 10.1111/j.1440-1789.2007.00828.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cyclooxygenase-2 (Cox-2), the key enzyme that catalyzes the first steps in the biosynthesis of the prostaglandins from arachidonic acid, appears to play a role in the regulation of progression, invasiveness and angiogenesis of various neoplasms. We analyzed the immunohistochemical expression of Cox-2 and angiogenic parameters (microvessel density (MVD) and vascular patterns) in 54 glioblastomas. We also examined their relation with prognosis. Cox-2 immunohistochemical expression was observed in 48 tumors (89%). There was no staining in six tumors (11%). On univariate analysis, MVD was correlated with a poor outcome (MVD > 70; hazard ratio, 0.441; 95% confidence interval, 0.200-0.975, P = 0.041). But MVD showed no prognostic impact on multivariate analysis. Neither Cox-2 expression nor vascular pattern showed prognostic value. The difference in Cox-2 expression between the classical and bizarre vascular pattern in glioblastomas was statistically significant (P = 0.047). However, no correlation was found between Cox-2 expression and MVD. These findings suggest that Cox-2 is heterogeneously expressed in glioblastomas without a significant association with MVD. However, Cox-2 expression may be related to vascular pattern in glioblastomas.
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Affiliation(s)
- Onder Onguru
- Department of Pathology, Gulhane Military Medical Academy, Ankara, Turkey.
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8
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Grossman SA, Olson J, Batchelor T, Peereboom D, Lesser G, Desideri S, Ye X, Hammour T, Supko JG. Effect of phenytoin on celecoxib pharmacokinetics in patients with glioblastoma. Neuro Oncol 2008; 10:190-8. [PMID: 18287342 DOI: 10.1215/15228517-2007-055] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Cyclooxygenase-2 (COX-2) expression has been linked to the prognosis, angiogenesis, and radiation sensitivity of many malignancies. Celecoxib, a selective COX-2 inhibitor, is predominantly eliminated by hepatic metabolism. This study was conducted to determine the effects of hepatic enzyme-inducing antiseizure drugs (EIASDs) on the pharmacokinetics of celecoxib. The safety of celecoxib administered with radiation for glioblastoma and the effect of the combined treatment on survival were also evaluated. Patients were stratified based on concomitant use of EIASDs. Celecoxib (400) mg was administered orally twice a day until tumor progression or dose-limiting toxicity. Standard radiation was administered without adjuvant chemotherapy. Sampling was performed to define the plasma concentration/time profile for the initial dose of celecoxib and steady-state trough concentrations. Thirty-five patients (22 +EIASD, 13 -EIASD) were enrolled. There were no significant differences in age, performance status, extent of surgery, or Mini Mental State Exam scores between the two cohorts. The treatment was well tolerated. All patients in the +EIASD arm were taking phenytoin. There were no significant differences in any celecoxib pharmacokinetic parameters between 15 +EIASD and 12 -EIASD patients. With 31 of 35 patients deceased, estimated median survival time for all patients was 12 months (+EIASD, 11.5 months; - EIASD, 16 months; p = 0.11). The pharmacokinetics of celecoxib is not significantly affected by the concomitant administration of phenytoin. Celecoxib administered during and after radiation is well tolerated. The potential difference in survival between the +EIASD and -EIASD groups deserves further evaluation.
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Affiliation(s)
- Stuart A Grossman
- NABTT CNS Consortium, 1550 Orleans Street, Baltimore, MD 21231, USA.
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Abstract
Cohesive scientific evidence from molecular, animal, and human investigations supports the hypothesis that aberrant induction of COX-2 and up-regulation of the prostaglandin cascade play a significant role in carcinogenesis, and reciprocally, blockade of the process has strong potential for cancer prevention and therapy. Supporting evidence includes the following: [1] expression of constitutive COX-2-catalyzed prostaglandin biosynthesis is induced by most cancer-causing agents including tobacco smoke and its components (polycylic aromatic amines, heterocyclic amines, nitrosamines), essential polyunsaturated fatty acids (unconjugated linoleic acid), mitogens, growth factors, proinflammatory cytokines, microbial agents, tumor promoters, and other epigenetic factors, [2] COX-2 expression is a characteristic feature of all premalignant neoplasms, [3] COX-2 expression is a characteristic feature of all malignant neoplasms, and expression intensifies with stage at detection and cancer progression and metastasis, [4] all essential features of carcinogenesis (mutagenesis, mitogenesis, angiogenesis, reduced apoptosis, metastasis, and immunosuppression) are linked to COX-2-driven prostaglandin (PGE-2) biosynthesis, [5] animal studies show that COX-2 up-regulation (in the absence of genetic mutations) is sufficient to stimulate the transformation of normal cells to invasive cancer and metastatic disease, [6] non-selective COX-2 inhibitors, such as aspirin and ibuprofen, reduce the risk of human cancer and precancerous lesions, and [7] selective COX-2 inhibitors, such as celecoxib, reduce the risk of human cancer and precancerous lesions at all anatomic sites thus far investigated. Results confirming that COX-2 blockade is effective for both cancer prevention and therapy have been tempered by observations that some COX2 inhibitors pose a risk to the cardiovascular system, and more studies are needed in order to determine if certain of these drugs can be taken at dosages that prevent cancer without increasing cardiovascular risk. It is emphasized that the "inflammogenesis model of cancer" is not mutually exclusive and may in fact be synergistic with the accumulation of somatic mutations in tumor suppressor genes and oncogenes or epigenetic factors in the development of cancer.
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Affiliation(s)
- Randall E Harris
- College of Medicine and School of Public Health, Center of Molecular Epidemiology and Environmental Health, The Ohio State University Medical Center, 310 West 10th Avenue, Columbus, Ohio 43210-1240, USA
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Buccoliero AM, Castiglione F, Rossi Degl'Innocenti D, Arganini L, Taddei A, Ammannati F, Mennonna P, Taddei GL. Cyclooxygenase-2 (COX-2) Overexpression in Meningiomas. Appl Immunohistochem Mol Morphol 2007; 15:187-92. [PMID: 17525632 DOI: 10.1097/01.pai.0000201807.58801.fc] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cyclooxygenase-2 (COX-2) is the inducible form of the enzyme involved in the first steps of the prostaglandins and thromboxane synthesis. COX-2 up-regulation is demonstrated in tumors where it can modulate tumoral progression, metastasis, multidrug resistance, and angiogenesis. Experimental data suggest a possible therapeutic use of the COX-inhibitors nonsteroidal antiinflammatory drugs (NSAIDs). NSAIDs can block tumor growth through many mechanisms, especially through antiangiogenic and proapoptotic effects. Moreover, NSAIDs can also improve the efficacy of radiotherapy, chemotherapy, and hormonal therapy. This study reviews the COX-2 expression as evaluated through immunohistochemistry and real time polymerase chain reaction (RT-PCR) in 23 meningiomas [14 World Health Organization (WHO) grade I; 5 WHO grade II; 3 WHO grade III; 1 oncocytic meningioma]. At immunohistochemistry all the lesions but 4 (83%) were COX-2 positive. At RT-PCR 9 meningiomas, 8 WHO grade I and 1 WHO grade II, showed a COX-2 expression greater than the reference value (average expression of all meningiomas that we studied). The association between tumor grade and immunohistochemical or RT-PCR COX-2 expression was not significant (P=0.427 and P=0.251, respectively). In conclusion, even if further studies on larger series are necessary, the common COX-2 overexpression in meningiomas may suggest considering the COX-2 inhibitors, alone or in combination with radiotherapy, a potential area of therapeutic intervention in some selected meningiomas.
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Affiliation(s)
- Anna Maria Buccoliero
- Department of Human Pathology and Oncology, University of Florence, Florence, Italy.
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11
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Perdiki M, Korkolopoulou P, Thymara I, Agrogiannis G, Piperi C, Boviatsis E, Kotsiakis X, Angelidakis D, Diamantopoulou K, Thomas-Tsagli E, Patsouris E. Cyclooxygenase-2 expression in astrocytomas. Relationship with microvascular parameters, angiogenic factors expression and survival. Mol Cell Biochem 2006; 295:75-83. [PMID: 16868662 DOI: 10.1007/s11010-006-9275-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2006] [Accepted: 06/26/2006] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Cyclooxygenase-2 (COX-2) is the enzyme isoform involved in the synthesis of prostaglandins (PGs) and thromboxane from arachidonic acid. The role of the up-regulation of COX-2 in the formation and progression of gliomas has been dealt with in earlier reports, which describe increased levels of PGs within gliomas. In the present study, we examined the expression of COX-2 in diffuse gliomas of astrocytic origin in relation to microvascular parameters, angiogenic factors and survival. MATERIALS AND METHODS A total of 83 cases of diffuse astrocytomas (grade II-IV) were analyzed by immunohistochemistry for the presence of COX-2. RESULTS COX-2 expression was detected in 79 cases (95%) with an increased expression in grade IV as compared to grades II/III (p=0.024). A positive correlation occurred between COX-2 and angiogenic factors such as vascular endothelial growth factor (VEGF) (p<0.0001) and hypoxia inducible factor (HIF)-1alpha (p=0.005), as well as the tumours' proliferative activity (expressed as the percentage of Ki-67 positive cells) (p=0.032), and total vascular area (TVA) (p=0.040). In univariate analysis, COX-2 was associated with shortened survival (p = 0.050). Multivariate survival analysis showed that the interaction model of COX-2 with grade along with age were the only significant prognostic indicators. CONCLUSION These results implicate COX-2 in the angiogenesis and biological aggressiveness of diffuse astrocytomas, and suggest that it would be worthwhile to examine how the inhibition of COX-2 expression may influence astrocytoma patients' survival.
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Affiliation(s)
- Marina Perdiki
- Department of Pathology, National and Kapodistrian University of Athens, Athens, Greece.
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12
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Fischer I, Gagner J, Law M, Newcomb EW, Zagzag D. Angiogenesis in gliomas: biology and molecular pathophysiology. Brain Pathol 2006; 15:297-310. [PMID: 16389942 PMCID: PMC8096031 DOI: 10.1111/j.1750-3639.2005.tb00115.x] [Citation(s) in RCA: 250] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Glioblastoma multiforme (GBM) is characterized by exuberant angiogenesis, a key event in tumor growth and progression. The pathologic mechanisms driving this change and the biological behavior of gliomas remain unclear. One mechanism may involve cooption of native blood vessels by glioma cells inducing expression of angiopoietin-2 by endothelial cells. Subsequently, vascular apoptosis and involution leads to necrosis and hypoxia. This in turn induces angiogenesis that is associated with expression of hypoxia-inducible factor (HIF)-1alpha and vascular endothelial growth factor (VEGF) in perinecrotic pseudopalisading glioma cells. Here we review the molecular and cellular mechanisms implicated in HIF-1-dependent and HIF-1-independent glioma-associated angiogenesis. In GBMs, both tumor hypoxia and genetic alterations commonly occur and act together to induce the expression of HIF-1. The angiogenic response of the tumor to HIF-1 is mediated by HIF-1-regulated target genes leading to the upregulation of several proangiogenic factors such as VEGF and other adaptive response molecules. Understanding the roles of these regulatory processes in tumor neovascularization, tumor growth and progression, and resistance to therapy will ultimately lead to the development of improved antiangiogenic therapies for GBMs.
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Affiliation(s)
- Ingeborg Fischer
- Microvascular and Molecular Neuro‐oncology Laboratory, New York University School of Medicine
- Department of Pathology, New York University School of Medicine
- Division of Neuropathology, New York University School of Medicine
| | - Jean‐Pierre Gagner
- Microvascular and Molecular Neuro‐oncology Laboratory, New York University School of Medicine
- Department of Pathology, New York University School of Medicine
- Division of Neuropathology, New York University School of Medicine
| | - Meng Law
- Department of Radiology, New York University School of Medicine
- Department of Neurosurgery, New York University School of Medicine
- New York University Cancer Institute, New York University School of Medicine
| | - Elizabeth W. Newcomb
- Department of Pathology, New York University School of Medicine
- New York University Cancer Institute, New York University School of Medicine
| | - David Zagzag
- Microvascular and Molecular Neuro‐oncology Laboratory, New York University School of Medicine
- Department of Pathology, New York University School of Medicine
- Division of Neuropathology, New York University School of Medicine
- Department of Neurosurgery, New York University School of Medicine
- New York University Cancer Institute, New York University School of Medicine
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Sminia P, Stoter TR, van der Valk P, Elkhuizen PHM, Tadema TM, Kuipers GK, Vandertop WP, Lafleur MVM, Slotman BJ. Expression of cyclooxygenase-2 and epidermal growth factor receptor in primary and recurrent glioblastoma multiforme. J Cancer Res Clin Oncol 2005; 131:653-61. [PMID: 16133570 DOI: 10.1007/s00432-005-0020-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2005] [Accepted: 05/15/2005] [Indexed: 10/25/2022]
Abstract
PURPOSE To investigate the pattern and level of cyclooxygenase-2 (COX-2) expression in a series of high grade primary and recurrent glioblastoma multiforme (GBM) and correlation with time to recurrence and patients' survival following therapy. The relationship between COX-2 and epidermal growth factor receptor (EGFR) immunoreactivities was evaluated. MATERIALS AND METHODS Specimens of 14 primary and 14 recurrent GBMs (eight pairs) following surgery and full course radiation therapy were processed for immunostaining on COX-2 and EGFR. Tumor cell positivity was semi-quantitatively scored. COX-2 scores of the primary tumor and recurrence were correlated with the time to radiological tumor progression and patients' survival. RESULTS COX-2 positive tumor cells were disseminated throughout the tumor parenchyma. The intensity and pattern of COX-2 expression were heterogeneous, with predominant expression in areas surrounding tumor necrosis. Scoring of COX-2 positivity revealed values between 1 and 80% of the cells. Primary GBMs with COX-2 expression levels between 25% and 70% of the tumor cells showed a shorter time to radiological recurrence than GBMs with <10% COX-2 positive tumor cells (respectively, 219 +/- 50 and 382 +/- 77 days). No correlation was found between the COX-2 expression in the primary tumor and patients' survival (r (s) = -0.073) following therapy. No correlation was found either between COX-2 and EGFR immunoreactivity. CONCLUSIONS Immunohistochemical expression of COX-2 in GBM showed large variation. Hence, determination of COX-2 expression in tumor specimen for each individual might be relevant for selection of those patients, who could benefit from adjuvant therapy with selective COX-2 inhibitors.
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Affiliation(s)
- Peter Sminia
- Department of Radiation Oncology, VU University Medical Center, Amsterdam, The Netherlands.
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