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Prognostic Significance of Cyclooxygenase 2 mRNA Expression in Non-Small Cell Lung Cancer

Brabender, Jan MD*‡; Park, JiMin MS*; Metzger, Ralf MD; Schneider, Paul M. MD; Lord, Reginald V. MD; Hölscher, Arnulf H. MD; Danenberg, Kathleen D. MS*; Danenberg, Peter V. PhD*

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Objective To investigate cyclooxygenase-2 (COX-2) mRNA expression in curatively resected non-small cell lung cancer (NSCLC) and to determine its association with prognosis.

Summary Background Data Lung cancer is one of the most common malignancies in the world. Despite improvements in the diagnosis and treatment of NSCLC, the 5-year survival rate remains less than 15%. Identification of prognostic predictors based on molecular alterations could lead to additional diagnostic tools and eventually to more effective therapeutic options. Overexpression of COX-2 has been reported in several human malignancies, including lung cancer, but the prognostic importance of this overexpression has not been elucidated.

Methods COX-2 mRNA expression was analyzed using a quantitative real-time polymerase chain reaction (Taqman) method in surgically resected tumor specimens from 89 patients with curatively resected NSCLC.

Results COX-2 mRNA was detectable in all 89 (100%) tumor tissues. High COX-2 expression in tumors was significantly associated with inferior survival. Multivariate analysis showed that high COX-2 expression is an independent predictor of worse survival in patients with NSCLC.

Conclusions High COX-2 mRNA expression is an important biomarker for biologically aggressive disease in NSCLC and might be helpful in identifying patients who would benefit from additional therapies for controlling their disease.

From the *Department of Molecular Biology and Biochemistry and USC/Norris Comprehensive Cancer Center, Los Angeles, California;

the †Department of Surgery, University of Southern California Keck School of Medicine, Los Angeles, California;

and the ‡Department of Visceral and Vascular Surgery, University of Cologne, Germany

Supported by Hubert Burda Foundation for Cancer Research, Germany (J.B.), and NCI grant RO1 CA 71716 (P.V.D.).

Correspondence: Jan Brabender, MD, Department of Surgery, University of Cologne, Joseph-Stelzmann Str. 9, 50931 Cologne, Germany.

E-mail: drbrabender@cs.com

The first two authors contributed equally to the preparation of the manuscript.

Accepted for publication August 6, 2001.

© 2002 Lippincott Williams & Wilkins, Inc.