Immunohistochemical expression of nuclear factor kappa-B/p65 and cyclooxygenase-2 in non-small cell lung cancer patients: Prognostic value and impact on survival

IntroductionNuclear factor kappa B/p65 (NF-κB/p65) regulates the expression of various molecules important in tumorigenesis as cyclooxygenase-2 (COX-2).AimTo study the immunohistochemical expression of NF-κB/p65 and COX-2 in NSCLC, investigate the relationship between their expression and the clinicopathological parameters, evaluate their prognostic value and clarify their impact on survival.Patients and methodsFifty NSCLC patients were enrolled in this study and subjected to: full medical history and physical examination, routine laboratory tests and CT chest. Fiberoptic bronchoscopy was done and biopsies were taken from visible masses and 20 mucosal biopsies of the same patients (as control); sent for histopathological and immunohistochemical examination using anti-COX2 and anti-NF-κB/p65 antibodies. The median follow up of patients was 13 (range 4–22 months).ResultsThirty six (72%) showed positive NF-κB/p65 expression, it was higher in squamous cell carcinoma and adenocarcinoma than in normal biopsies. Adenocarcinoma showed higher NF-κB/p65 positivity compared to squamous and large cell carcinomas. A significant relationship was found between NF-κB/p65 expression and overall survival.Forty five (90%) showed positive COX-2 expression, no expression was detected in normal biopsies. COX-2 expression was significantly higher in adenocarcinoma compared to squamous and large cell carcinomas. NF-κB/p65 and COX-2 expression was significantly correlated with advanced tumor stage, lymph node metastasis and grade. A significant positive relationship was found between NF-κB/p65 and COX-2 expression.ConclusionNF-κB/P65 and COX-2 expression has a prognostic value in NSCLC, they are suitable targets for development of new lung cancer therapies; inhibition of NF-κB and COX-2 will augment the efficacy of anticancer therapy.