Cyclooxygenase-2 Expression in Squamous Cell Carcinoma of the Head and Neck

Cyclooxygenases-2(COX) expression in cancer tissues is associated with worse prognosis of cancers. We studied cyclooxigenase-2 expression among patients with head and neck squamous cell carcinoma (HNSCC).
In a cross-sectional study performed in two university hospitals in Isfahan City, Iran, between the years 2011 and 2015, patients with newly pathological diagnosis of HNSCC were evaluated. Real-time polymerase chain reaction (real-time PCR) was used to evaluate the expression of cyclooxigenase-2 in surgical excised cancer tissues. Patients were followed-up for one year regarding recurrence and mortality. Association of cyclooxigenase-2 expression with clinicopathologic data and prognosis were analyzed.
Findings: Thirty cases of HNSCC with mean age of 59.6 years (70% men) were studied. Only 4 cases (13.3%) were cyclooxigenase-2 positive. Compared with cyclooxigenase-2 negative cases, those with cyclooxigenase-2 expression were relatively, but not significantly, older (71.0 ± 12.5 vs. 57.8±12.0 years, P = 0.054) and had larger tumor size (2.70 ± 1.19 vs. 1.76 ± 0.84 cm, P = 0.061), more frequent moderately/poorly differentiated tumors (50.0 vs. 15.3 percent, P = 0.190), and more frequent involvement of the lymph nodes (50.0 vs. 7.6 percent, P = 0.075). One of the cyclooxigenase-2 positive cases had metastasis. After one year follow-up, recurrence rate was 75.0% and 9.5% in cyclooxigenase-2 positive and negative cases, respectively (P = 0.005).
We found that cyclooxigenase-2 expression in HNSCC patients is associated with worse clinicopathologic characteristics and prognosis. It may be used as a prognostic factor for HNSCC and also a target for treatment. Further studies with larger sample size are warranted in this regard.