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Original article / research
Year: 2023 Month: October Volume: 12 Issue: 4 Page: PO09 - PO13

COX-2 Expression as a Prognostic Inflammatory Marker in Head and Neck Squamous Cell Carcinoma: A Cross-sectional Study

 
Correspondence Kanimozhi Sundararajan, Veeraraghavan Gurusamy, Sudha Venkatesh, M Saraswathi,
Dr. Veeraraghavan Gurusamy,
5/79, E Type, 9th Street, SIDCO Nagar, Villivakkam, Chennai, Tamil Nadu, India.
E-mail: gvrvishwa@gmail.com
:
Introduction: Head and Neck Squamous Cell Carcinoma (HNSCC) ranks as the sixth leading cause of cancer worldwide. HNSCC is an aggressive neoplasm involving multistep carcinogenesis. As it is associated with an increased risk of recurrence, morbidity and mortality, many studies are being undertaken to understand its pathophysiology at the molecular level, identify newer prognostic factors and develop novel therapeutic agents.

Aim: To assess the clinicopathological features of all cases of HNSCC, including age, sex, site and risk factors and to demonstrate the expression of the Cyclooxygenase-2 (COX-2) marker in various grades of the tumour in a subset of cases.

Materials and Methods: A cross-sectional study was conducted on HNSCC at the Institute of Pathology, Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India for a period of one year from July 2014 to June 2015. A total of 50 cases (representing different grades) were randomly selected, 25 each from the oral cavity/oropharynx and upper respiratory tract. Immunohistochemistry (IHC) was performed using the COX-2 marker and the results were tabulated in an MS Excel sheet to assess the incidence among different age groups, genders, various risk factors, and sites. Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) 21.0 software, using the Chi-square test to assess the significant expression of COX-2 in varying grades of the tumour. A p-value <0.05 was considered significant.

Results: The study results (total cases=50) showed an increased incidence of HNSCC among males (n=39; 78%) compared to females (n=11; 22%). Additionally, HNSCC most commonly affected patients in the 5th to 6th decade (n=24; 48%) of life. The occurrence was most commonly noted in the tongue (n=8; 16%) and hypopharynx (n=13; 26%) among all Squamous Cell Carcinoma (SCC) cases of the oral cavity and upper respiratory tract, respectively. Out of the 50 cases included to analyse COX-2 expression, 41 cases (82%) of HNSCC showed COX-2 expression, and its association with different grades was evident by a significant p-value of 0.027.

Conclusion: This study demonstrated significant expression of COX-2 in all grades of HNSCC, supporting the role of inflammation in multistep carcinogenesis. Furthermore, molecular targeted therapy against COX-2 could be implemented as an adjunctive therapy with chemoradiation to hinder the progression and aggressive behaviour of the tumour
 
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