Analysis of cyclooxygenase-2 expression in human breast cancer: high throughput tissue microarray analysis

  • Pia Wülfing
  • Raihanatou Diallo
  • Christine Müller
  • Christian Wülfing
  • Christopher Poremba
  • Achim Heinecke
  • Achim Rody
  • Robert R. Greb
  • Werner Böcker
  • Ludwig Kiesel
Original Paper



The objective of this study was to evaluate breast carcinomas for the expression of cyclooxygenase-2 (Cox-2) using a tissue microarray (TMA) and to determine its clinical and prognostic relevance.


We analyzed Cox-2 expression in 600 samples from 200 breast carcinomas immunohistochemically performing TMA technology and semiquantitative analysis. Results were correlated with various clinicopathological variables and follow-up data. Expression of estrogen receptor, progesterone receptor, Ki-67, and Her-2/neu-oncogene was analyzed and correlated with Cox-2 status.


We observed a moderate or strong cytoplasmic staining for Cox-2 in 78 (40.6%) of breast carcinomas. Increased Cox-2 expression corresponded to higher pT stage (P=0.038), amplification of Her-2/neu (P=0.032), lymphovascular invasion (P=0.006), a high MIB-1 labeling index (LI) (P<0.001), and histological grading (P=0.013). We also observed an inverse relationship between strong Cox-2 expression and estrogen and progesterone receptor content of tumors (P=0.037 and P=0.010). However, we could not demonstrate a significant association between Cox-2 staining and overall survival or disease free survival time.


These results suggest that Cox-2 expression is significantly associated with less differentiated and more aggressive breast carcinomas and might therefore be a useful prognostic indicator as well as a target for therapy.


Tissue microarray Breast cancer Cyclooxygenase-2 Cox-2 Immunohistochemistry 



The authors thank Inka Buchroth and Judith Obernüfemann for excellent technical assistance.


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Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Pia Wülfing
    • 1
  • Raihanatou Diallo
    • 2
    • 5
  • Christine Müller
    • 1
  • Christian Wülfing
    • 3
  • Christopher Poremba
    • 2
    • 5
  • Achim Heinecke
    • 4
  • Achim Rody
    • 1
  • Robert R. Greb
    • 1
  • Werner Böcker
    • 2
  • Ludwig Kiesel
    • 1
  1. 1.Department of Obstetrics and GynecologyUniversity of MünsterMünsterGermany
  2. 2.Gerhard-Domagk-Institute of PathologyUniversity of MünsterGermany
  3. 3.Department of UrologyUniversity of MünsterGermany
  4. 4.Institute of Biomathematics and Medical InformaticsUniversity of MünsterGermany
  5. 5.Institute of PathologyHeinrich Heine-UniversityDüsseldorfGermany

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