Evaluation of the Relationship Between COX-2 and Ki-67 Expression and Tumor Grade and Cox-2, Ki-67 Expression in Astrocytomas

INTRODUCTION: In the present study, COX-2 and Ki-67 expression were investigated in astrocytomas of different grade. Difference between the expressþon levels of these two markers and their relationship with each other were evaluated.
METHODS: A total of 60 surgical materials diagnosed as 20 grade II, 20 grade III, 20 grade IV astrocytoma retrospectively were included in the study. Ki-67 and COX-2 were studied by immunohistochemical method. Data analysis was performed using SPSS for Windows, version 11.5. Shapiro Wilk test, Mann Whitney U test, Kruskal Wallis test, and multiple comparison test were used.
RESULTS: The prevalence of COX-2 staining was higher in patients with grade III and IV astrocytoma than grade II (p <0.001 and p <0.001). There was no significant difference between grade III and IV astrocytomas in terms of COX-2 staining prevalence (p = 0.087). The number of cases stained with COX-2 in grade IV was higher than those of grade II and grade III (p <0.001 and p = 0.030). There was no significant difference between Grade II and Grade III astrocytomas in terms of COX-2 staining intensity (p = 0.198).Ki-67 index was higher in grade III and grade IV tumors compared to grade II and in grade IV tumors compared to grade III (p = 0.007, p <0.001, p <0.001). The Ki-67 index of the strongly stained group was higher than the group without COX-2 staining and weak staining group (p = 0.004 and p = 0.004). Ki-67 index was similar between unstained and poorly stained groups (p = 0.096).
DISCUSSION AND CONCLUSION: We conclude that COX-2 expression may play a role in the progression of astrocytomas, may be associated with more aggressive gliomas, and COX-2 inhibitors may have a therapeutic role in addition to the existing treatment protocols of astrocytomas, and Ki-67 immunostaining might be effective in differentiating tumors of different grades.

Astrositomalarda COX-2 ve Ki-67 Ekspresyonu ve Tümör Grade’i ile COX-2, Ki-67 Ekspresyonu Arasýndaki Ýliþkinin Deðerlendirilmesi

GÝRÝÞ ve AMAÇ: Bu çalýþmada farklý grade’deki astrositomalarda COX-2 ve Ki-67 ekspresyonu incelendi. Bu iki belirteçin grade’ler arasýndaki ekspresyon farklýlýðý ve birbiri ile olan iliþkisi deðerlendirildi
YÖNTEM ve GEREÇLER: Çalýþmaya retrospektif olarak 20 grade II, 20 grade III, 20 grade IV astrositoma tanýsý almýþ toplam 60 operasyon materyali dahil edildi. Ýmmünhistokimyasal yöntemle Ki-67 ve COX-2 çalýþýldý. Verilerin analizi SPSS for Windows 11.5 paket programýnda yapýldý. Shapiro Wilk testi, Mann Whitney U testi, Kruskal Wallis testi, çoklu karþýlaþtýrma testi kullanýldý.
BULGULAR: Grade II’ye göre grade III ve IV astrositomalý olgularda COX-2 boyanma yaygýnlýðý daha yüksek olarak bulundu (p<0.001 ve p<0.001). Grade III ile grade IV astrositomalý olgular arasýnda COX-2 boyanma yaygýnlýðý açýsýndan anlamlý farklýlýk yoktu (p=0.087). Grade II’ye ve grade III’e göre grade IV’te COX-2 ile kuvvetli boyanan olgu sayýsý fazla idi (p<0.001 ve p=0.030). Grade II ile grade III astrositomalý olgular arasýnda COX-2 boyanma yoðunluðu açýsýndan anlamlý farklýlýk yoktu (p=0.198). Grade II’ye göre grade III ve grade IV tümörlerde ayrýca grade III’e göre grade IV tümörlerdeki Ki-67 indeksi daha yüksek olarak bulundu (p=0.007, p<0.001, p<0.001). COX-2 boyanmasý olmayan gruba ve zayýf boyanan gruba göre kuvvetli boyanan grubun Ki-67 indeksi daha yüksek olarak bulundu (p=0.004 ve p=0.004). Boyanmayan ve zayýf boyanan grup arasýnda Ki-67 indeksi benzerdi (p=0.096).
TARTIÞMA ve SONUÇ: COX-2 ekspresyonunun astrositomalarýn progresyonunda rol oynayabileceði, daha agresif tümörleri yansýtabileceði, astrositomalarýn tedavisinde COX-2 inhibitörlerinin mevcut tedavi protokollerine ek terapötik role sahip olabileceði, farklý grade’e sahip tümörleri birbirinden ayýrt etmede Ki-67’nin kullanýlabileceði düþünüldü.