Immunohistochemical Analysis of Cyclooxygenase-2 in Non-Melanocytic Skin Cancer: Correlation With Morphological Subtype and Histologic Grade

BACKGROUND: Basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs) are known as non-melanoma skin cancers (NMSCs), and they account for approximately 90% of all skin cancers. Cyclooxygenase-2 (COX-2) is expressed in NMSC and in premalignant cutaneous lesions (actinic keratosis). METHODS: Immunohistochemistry was performed with COX-2 antibodies in skin biopsies (paraffin tissue archival blocks) from 28 cases with SCC and 33 cases with BCC. RESULTS: COX-2 was immunostained in a total of 61 cases. There was no staining or weakly positive staining in 73.8% of the cases (45 cases), and there was moderate or strong positive staining in 26.3% of the cases (16 cases). COX-2 was expressed in 42.4% of the BCC cases and in 57.1% of the SCC cases. There was a significant relationship between positive COX-2 staining and SCC (P = 0.016). CONCLUSIONS: In this study, SCCs were significantly correlated with the expression of COX-2. In addition, COX-2 was more frequently expressed in SCC than in BCC. The largest diameters of the SCC were significantly correlated with the expression of COX-2. There were no significant associations between COX-2 staining and clinicopathologic features such as the ulceration of the tumor, its anatomic localization, patient gender, the histologic grade of the SCC and the morphological subtype of the BCC.