Background: Cyclooxygenase (Cox-2) enzyme catalyses the
formation of prostaglandins, which can affect cell proliferation and alter the
response of the immune system to malignant cells. Squamous cell carcinoma (SCC)
of larynx is widely prevalent in India and is one of the leading cancers in
males. Cox-2 expression can be used as a prognostic and predictive marker in
laryngeal SCC.
Aim: The primary objective of the present study was to
determine the association between tumor Cox-2 expression and clinico-pathological
characteristics and treatment outcome in patients with LSCC. Secondly, to
evaluate the clinical utility of Cox-2 expression as a tool, to decide
treatment strategy for LSCC.
Methods: A total of 72 surgically treated patients of
laryngeal carcinoma enrolled in this study over a time period of 5 years. Tumor
Cox-2 expression was analysed by immunohistochemistry using standard
Streptavidin biotin method.
Results: Thirty seven patients had pathological node
involvement, ipsilateral in 35 and bilateral in two. Cox-2 was intensely
expressed in patients with advanced (N2/N3) nodal disease and perineural
invasion. There was no significant difference in 5 year disease free survival
and overall survival when Cox-2 was correlated with perineural invasion, extra
capsular spread and the T and N stage of the disease. The potential of Cox-2 as
a prognostic factor and as a target for therapeutic intervention was evaluated
in many studies on head and neck cancers. But studies specifically in advanced
laryngeal cancers are infrequent. In this study, out of the 35 cases of intense
expression of Cox-2, 22 (62.9%) were in T4 stage, showing an increasing trend
of its expression as the primary stage advances.
Conclusions: Preoperative Cox-2 analysis can be used to
individualize need for routine neck dissection in cases of locally advanced
laryngeal carcinoma.
Author(s) Details:
Elizabeth Mathew Iype,
Department of Surgical Oncology, Regional Cancer Centre,
Thiruvananthapuram, Kerala, India.
Rajan
Balakrishnan,
Department
of Radiation Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala,
India.
Lakshmi Subhadradevi,
Division of Cancer Research, Regional Cancer Centre,
Thiruvananthapuram, Kerala, India.
Jissa Vinoda Thulaseedharan,
Division of Epidemiolgy, Sreechitra Thirunal Institute of Medical
Science and Technology, Thiruvanathapuram, Kerala, India.
Rajesh Singh,
Department
of Surgical Oncology, Regional Cancer Centre, Thiruvananthapuram, Kerala,
India.
Jayasree
K.,
Division
of Pathology, Regional Cancer Centre, Thiruvananthapuram, Kerala, India.
Please see the link here: https://stm.bookpi.org/ANUMS-V6/article/view/13362
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