Elevated levels of urinary prostaglandin e metabolite indicate a poor prognosis in ever smoker head and neck squamous cell carcinoma patients.

Abstract

Cyclooxygenase (COX)-derived prostaglandin E(2) (PGE(2)) plays a role in the development and progression of several tumor types including head and neck squamous cell carcinoma (HNSCC). Measurements of urinary PGE metabolite (PGE-M) can be used as an index of systemic PGE(2) production. In ever smokers, increased levels of urinary PGE-M reflect increased COX-2 activity. In this study, we determined whether baseline levels of urinary PGE-M were prognostic for ever smoker HNSCC patients. A retrospective chart review of ever smoker HNSCC patients treated with curative intent was done. Fifteen of 31 evaluable patients developed progressive disease (recurrence or a second primary tumor) after a median follow-up of 38 months. There were no statistically significant differences between patients with (n = 15) or without disease progression (n = 16) with regard to stage, site, treatment received, smoking status, and aspirin use during follow-up. Median urinary PGE-M levels were significantly higher in HNSCC patients with disease progression (21.7 ng/mg creatinine) compared with patients without (13.35 ng/mg creatinine; P = 0.03). Importantly, patients with high baseline levels of urinary PGE-M had a significantly greater risk of disease progression (hazard ratio, 4.76, 95% CI, 1.31-17.30; P < 0.01) and death (hazard ratio, 9.54; 95% CI, 1.17-77.7; P = 0.01) than patients with low baseline levels of urinary PGE-M. These differences were most evident among patients with early-stage disease. Taken together, our findings suggest that high baseline levels of urinary PGE-M indicate a poor prognosis in HNSCC patients. Possibly, HNSCC patients with high COX-2 activity manifested by elevated urinary PGE-M will benefit from treatment with a COX-2 inhibitor.

• Authors: Vikram D Kekatpure, Jay O Boyle, Xi Kathy Zhou, Anna J Duffield-Lillico, Neil D Gross, Nancy Y Lee, Kotha Subbaramaiah, Jason D Morrow, Ginger Milne, Scott M Lippman, Andrew J Dannenberg
• Journal: Cancer prevention research (Philadelphia, Pa.) (Cancer Prev Res (Phila)) Vol. 2 Issue 11 Pg. 957-65 (Nov 2009) ISSN: 1940-6215 [Electronic] United States
• PMID: 19843689 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers, Tumor
• Cyclooxygenase 2 Inhibitors
• Prostaglandins
• 7-hydroxy-5,11-dioxotetranorprostane-1,16-dioic acid
• Cyclooxygenase 2
• PTGS2 protein, human

Topics

• Aged
• Aged, 80 and over
• Biomarkers, Tumor (urine)
• Carcinoma, Squamous Cell (etiology, urine)
• Cyclooxygenase 2 (chemistry, metabolism)
• Cyclooxygenase 2 Inhibitors (pharmacology)
• Female
• Head and Neck Neoplasms (etiology, urine)
• Humans
• Male
• Middle Aged
• Neoplasm Staging
• Prognosis
• Prostaglandins (urine)
• Retrospective Studies
• Smoking (adverse effects)
• Survival Rate