Immunohistochemical expression of cyclooxygenase 2 in follicular carcinomas of the thyroid

Department of Anatomic Pathology, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Archives of pathology & laboratory medicine (Impact Factor: 2.84). 07/2005; 129(6):736-41. DOI: 10.1043/1543-2165(2005)129[736:IEOCIF]2.0.CO;2
Source: PubMed


Cyclooxygenase 2 (COX-2) has been shown to be up-regulated and/or overexpressed in a variety of human neoplasms. However, limited data exist on the role of COX-2 in follicular carcinomas of the thyroid. Studies in this area are potentially significant, since therapeutic agents that inhibit COX-2 are currently available and could play a role in treatment.
A retrospective clinicopathologic review with COX-2 immunohistochemical staining of 34 follicular carcinomas and 7 follicular adenomas with incomplete capsular penetration was performed.
The study included 41 patients (25 women; mean age, 50.9 years). All patients underwent gross total resection of the neoplasm. Fifteen carcinoma patients received adjuvant radiotherapy. Seven patients with follicular carcinomas developed recurrent disease: 3 patients were alive (mean follow-up, 10.1 years) and 4 patients died of metastatic disease (mean follow-up, 3.5 years). All remaining patients were disease free (mean follow-up, 5.9 years). Only 1 follicular adenoma with incomplete capsular penetration recurred (patient alive at 9 years). The remaining patients were disease free (mean follow-up, 4.9 years). The COX-2 staining was positive in 11 tumors (9 of 34 follicular carcinomas, 2 of 7 follicular adenomas with incomplete capsular penetration). A greater percentage of recurrences (36% COX-2 positive vs 13% COX-2 negative) and fatal tumors (18% COX-2 positive vs 7% COX-2 negative) occurred in patients who had COX-2-positive staining neoplasms.
Only a few follicular carcinomas (26%) and follicular adenomas with incomplete capsular penetration (29%) express COX-2 by immunohistochemical analysis. The data suggest that such expression of COX-2 may correlate with increased tumor recurrence and death; however, studies with larger numbers of patients will be needed to establish this.

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    • "Cyclooxygenase-2 overexpression was found in 40.9% of FTC and 20% of FTA but without any statistical significance in COX-2 expression between those two clinical entities. Cyclooxygenase-2 overexpression was also found in the study of Haynik et al. [54]; that study included 34 patients with FTC and demonstrated increased COX-2 expression in 26% of them. There was no association between positive staining for COX-2 and other prognostic indicators (vascular invasion, capsular penetration, necrosis or Hürthle cell lesion) but the authors found a higher percentage of recurrences or metastases and of tumours that caused death in cases with COX-2-positive staining [54]. "
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