The Expression Of HER-2/neu And COX-2 In Epithelial Ovarian Cancer And Their Clinical Significance

ObjectiveTo determine the expression of Her-2/neu and COX-2 in epithelial ovarian cancer,and to study the relationship of their expression with clinicopathologicalcharacteristics and prognosis of ovarian cancer patients.MethodsThe expressions of Her-2/neu and COX-2 in 10 of normal ovarian tissue, 10 ofbenign ovarian tumors, 10 of borderline epithelial ovarian tumors and 77 of epithelialovarian carcinoma were examined by S-P immunohistochemistry. The correlations ofHer-2/neu and COX-2 with clinicopathological factors were analyzed by x~2 test orFisher's exact test; Overall survival rate was computed by the life table method andKaplan-Meier estimate. The log-rank test was used to compare survival curves byobtaining a x~2 value. A multivariate proportional hazard model (Cox model) was usedto test the prognostic effect of all factors on study. All data were analyzed using SPSSsoftware version 13.0.Results1.The overexpression of Her-2/neu in epithelial ovarian carcinoma was higherthan that in borderline epithelial ovarian tumors. There was no expression ofHer-2/neu in normal ovarian tissue and benign ovarian tumors; The overexpression ofHer-2/neu was higher in epithelial ovarian carcinoma than in borderline epithelialovarian tumors as well as higher in borderline epithelial ovarian tumors than innormal ovarian tissue and benign ovarian tumors, but the difference was notsignificant (P＞0.05).2.In ovarian cancer group, The overexpression of Her-2/neu in FIGOⅢ,Ⅳstageor lymph node metastasis group or residual tumor over than 2cm group is significantly higher than in FIGOⅠ,Ⅱstage or no lymph node metastasis group or residual tumorlower than 2cm group (P＜0.05) The overexpression of Her-2/neu in serouscarcinoma group or poorly differentiated group or age older than 54 years old group ishigher than in non-serous carcinoma group or well differentiated group or ageyounger than 54 years old group, but the difference was not significant (P＞0.05).3. The expression of COX-2 in epithelial ovarian carcinoma was significantlyhigher than that in benign ovarian tumors (P＜0.05), and there was no expression ofCOX-2 in normal ovarian tissue; The expression of COX-2 was higher in epithelialovarian carcinoma than in borderline epithelial ovarian tumors as well as higher inborderline epithelial ovarian tumors than in normal ovarian tissue and benign ovariantumors, but the difference was not significant (P＞0.05).4.In ovarian carcinoma group, no correlation was found between the expressionof COX-2 and age, FIGO stage, histological subtype, grade, lymph node metastasis,residual tumor (P＞0.05).5.In ovarian carcinoma group, there was positive correlation between theoverexpression of Her-2/neu and expression of COX-2 (P＜0.05).6.In univariate analysis, the overexpression of Her-2/neu, the expression ofCOX-2, FIGO stage, lymph node metastasis, residual tumor was associated with poorsurvival in epithelial ovarian carcinoma; there were no association between age,histological subtype, grade with overall survival of ovarian carcinoma patients.7.In multivariate analysis, the overexpression of Her-2/neu and residual tumorwere independent prognostic factor of epithelial ovarian carcinoma (P＜0.05).Conclusions1. Elevated overexpression of Her-2/neu was observed in ovarian carcinoma,compared with borderline epithelial ovarian tumors. There was no expression ofHer-2/neu in normal ovarian tissue and benign ovarian tumors. It suggested thatoverexpression of Her-2/neu may play a role in the carcinogenesis of ovarian carcinoma.2. The overexpression of Her-2/neu was correlated with FIGO stage, lymphnode metastasis, residual tumor, and had no correlation with age, histological subtypeand grade. It suggested that overexpression of Her-2/neu may make it easier forepithelial ovarian carcinoma to metastases, which cause poor prognosis.3. The overexpression of Her-2/neu was significantly associated with overallsurvival of epithelial ovarian carcinoma and was independent prognostic factor ofepithelial ovarian carcinoma.4. Elevated expression of COX-2 was observed in ovarian carcinoma, comparedwith benign epithelial ovarian tumors, but did not have significant difference withborderline epithelial ovarian tumors. There was no expression of COX-2 in normalovarian tissue. It suggested that expression of COX-2 may play a role in thecarcinogenesis of ovarian carcinoma.5. No significant correlations were found between the expression of COX-2 andclinicopathological characteristics of ovarian carcinoma patients.6. The expression of COX-2, FIGO stage, lymph node metastasis were notindependent prognostic factor of epithelial ovarian carcinoma. It implied that theydidn't have directly impact on ovarian carcinoma patients' prognosis.7. In epithelial ovarian carcinoma group, expression of Her-2/neu had a strongcorrelation with expression of COX-2. It suggested that Her-2/neu may be incoordinated with COX-2 in carcinogenesis and progression of epithelial ovariancarcinoma.8.Residual tumor was independent prognostic factors of the epithelial ovariancarcinoma.