Association between overexpression of cyclooxygenase-2 and suppression of apoptosis in advanced cancer of the uterine cervix after cyclic balloon-occluded arterial infusion

Recent advances in cancer chemotherapy have drawn the attention of investig ators to the usefulness of chemotherapy for cancer of the uterine cervix in general, and we ourselves have previously reported satisfactory therapeuti c results of cisplatin-based cyclic balloon-occluded arterial infusion chem otherapy (BOAI), which enabled treatment by hysterectomy in patients with a dvanced cervical cancer. Nevertheless, there have been some patients in who m CDDP therapy by BOAI was ineffective, and hysterectomy was impracticable. In the present study we investigated the expression of cyclooxygenase-2 (C OX-2) in these cases in an attempt to identify the cause of the lack of eff icacy. The subjects of the study were 38 women with advanced cervical cance r classified as FIGO (International Federation of Gynecology and Obstetrics ) stage III or higher who were admitted to the Department of Gynecology of Osaka City University Medical School Hospital between July 1993 and April 2 000. All of these patients were treated by BOAI, and expression of COX-2, a ngiogenic factors, and cancer cell apoptosis, before and after BOAI were ex amined, and survival rates were compared. The IS patients in whom BOAI was ineffective showed significantly higher expression of COX-2 after BOAI, and cancer cell apoptosis was inhibited. The 5-year survival rate of these pat ients was 16.8%, as opposed to 54.1% in the 20 patients in whom BOAI was ef fective. These results suggest that overexpression of COX-2 inhibits cancer cell apoptosis and adversely influences the prognosis.