Expression of cyclooxygenase-2 mRNA in peripheral blood of head and neck cancer patients and in healthy controls. A pilot study

Abstract

Conclusions. Cyclooxygenase-2 mRNA (COX2) levels are higher in head and neck cancer (HNC) patients than in controls and this correlates with tumor size and outcome. These findings suggest the use of this parameter as a future tumor marker. Objective. We analyzed the expression of COX2 mRNA in peripheral blood cells in HNC patients and in healthy controls and its relationship with outcome and progression-free survival. Materials and methods. Blood samples were obtained from 41 consecutive HNC patients and 16 healthy controls and analyzed for COX2 mRNA with quantitative real-time polymerase chain reaction and compared with β-actin as a house-keeping gene. Results. Treatment consisted of surgery only (4 patients), chemoradiotherapy (18), chemotherapy followed by curative surgery (4) or palliative chemotherapy (15). COX2 mRNA levels were higher in patients with unfavorable outcome (mean 6.8, median 2.06) than those with favorable outcome (mean 1.2, median 1.31) (p=0.062). Both were higher than for healthy controls (mean 0.74, median 0.72; p<0.001). In bulky tumors, the percentage of level over 6 in unfavorable outcome cases was higher than in the favorable outcome cases (p=0.005). In chemotherapy patients with level ≤1 no relapse or progression was observed (n=7), and progression-free survival was significantly better than those with level >1 (n=19) (p=0.0138).