Prognostic values of cyclooxygenase-2 in invasive breast cancer

Abstract

Background: Breast cancer remains a significant global health issue, notably affecting women, with high prevalence and mortality rates. Cyclooxygenase-2 (COX-2) is a key molecular contributor to breast cancer development, with increased COX-2 expression correlating with poor outcomes and treatment resistance, highlighting its prognostic value. Aim of the study: To evaluate the immunohistochemical (IHC) expression of COX-2 in breast cancer and correlate its expression with various prognostic factors. Materials and Methods: This cross-sectional study was conducted at the “Babylon Training Center for Pathology” from January to December 2023. A total of 50 invasive breast cancer cases were analyzed. The mean patient age was 53.56 years. IHC techniques were used to assess COX-2 expression. Results: COX-2 expression was positive in 80% of the patients. Histological analysis classified 90% of cases as invasive ductal carcinoma (IDC NST), with 68% being luminal A and B subtypes. No significant associations were found between COX-2 expression and histological diagnosis, In-situ component presence, or histological grade. However, significant associations were observed between COX-2 expression and hormone receptor status, with 62% positive for estrogen receptors, 58% for progesterone receptors, and 44% for HER2 receptors. Notably, COX-2 expression intensity significantly correlated with progesterone receptor expression (p = 0.005). Molecular classification analysis revealed no significant association with COX-2 expression. Conclusion: There is a statistically significant inverse relationship between COX-2 expression and hormone receptor status, particularly with estrogen and progesterone receptors. This suggests COX-2's potential role as a predictive biomarker for the aggressive nature of breast cancer, underscoring its prognostic implications.