Cyclooxygenase-2 expression in non-metastatic triple-negative breast cancer patients

• Published in: Molecular and clinical oncology 2014-09, Vol.2 (5), p.845-850
• Main Authors: MOSALPURIA, KAILASH, HALL, CAROLYN, KRISHNAMURTHY, SAVITRI, LODHI, ASHUTOSH, HALLMAN, D. MICHAEL, BARANIUK, MARY S, BHATTACHARYYA, ANIRBAN, LUCCI, ANTHONY
• Format: Article
• Language: English
• Subjects: African Americans; Age; Biopsy; Body mass index; Breast cancer; Cancer; Cancer therapies; Chemotherapy; Confidence intervals; cyclooxygenase-2; Development and progression; Enzyme activation; Epidermal growth factor; Estrogens; Genetic aspects; Lymphatic system; Metastasis; Number systems; Oncology; Oncology, Experimental; Patients; Protein expression; Regression analysis; Rodents; Studies; triple-negative breast cancer; Tumors
• ISSN: 2049-9450; 2049-9469
• DOI: 10.3892/mco.2014.327

Triple-negative breast cancer (TNBC) is characterised by lack of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER)2/neu gene amplification. TNBC patients typically present at a younger age, with a larger average tumor size, higher grade and higher rates of lymph node positivity compared to patients with ER/PR-positive tumors. Cyclooxygenase (COX)-2 regulates the production of prostaglandins and is overexpressed in a variety of solid tumors. In breast cancer, the overexpression of COX-2 is associated with indicators of poor prognosis, such as lymph node metastasis, poor differentiation and large tumor size. Since both TNBC status and COX-2 overexpression are known poor prognostic markers in primary breast cancer, we hypothesized that the COX-2 protein is overexpressed in the primary tumors of TNBC patients. The purpose of this study was to determine whether there exists an association between TNBC status and COX-2 protein overexpression in primary breast cancer. We prospectively evaluated COX-2 expression levels in primary tumor samples obtained from 125 patients with stage I-III breast cancer treated between February, 2005 and October, 2007. Information on clinicopathological factors was obtained from a prospective database. Baseline tumor characteristics and patient demographics were compared between TNBC and non-TNBC patients using the Chi-square and Fisher's exact tests. In total, 60.8% of the patients were classified as having ER-positive tumors, 51.2% were PR-positive, 14.4% had HER-2/neu amplification and 28.0% were classified as TNBC. COX-2 overexpression was found in 33.0% of the patients. TNBC was associated with COX-2 overexpression (P=0.009), PR expression (P=0.048) and high tumor grade (P=0.001). After adjusting for age, menopausal status, body mass index (BMI), lymph node status and neoadjuvant chemotherapy (NACT), TNBC was an independent predictor of COX-2 overexpression (P=0.01). In conclusion, the association between TNBC and COX-2 overexpression in operable breast cancer supports further investigation into COX-2-targeted therapy for patients with TNBC.