• Jaudah Ahmed Al-Maghrabi and Wafaey Gomaa.
• From the Department of Pathology, King Abdulaziz University, Makkah, Saudi Arabia.
• Ann Saudi Med. 2022 Nov 1; 42 (6): 359365359-365.

BackgroundThyroid carcinoma is one of the most common malignancies worldwide. More than 70%-80% are papillary thyroid carcinoma (PTC). Many factors influence the PTC pathway of development such as genetic mutations, growth factors, and radiation. More biological understanding of the genetic and molecular pathways is needed in PTC to determine tumor behavior, and initial clinical assessment.ObjectivesInvestigate the relation of COX-2 immunostaining in thyroid carcinoma with clinicopathological parameters to assess whether immunostaining results have prognostic significance.DesignRetrospective study SETTING: Pathology department, tertiary care center METHODS: Records of PTC were retrieved and tissue microarrays were constructed. Tissue sections were stained using anti-human COX-2 monoclonal antibody. Immunostaining results were recorded and analysed.Main Outcome MeasuresRelationship of COX-2 immunostaining in thyroid carcinoma with clinicopathological parameters.Sample Size139 tissue samples from 139 patients RESULTS: High versus low COX-2 immunostaining showed no significant differences for most clinicopathological parameters. However, high COX-2 immunostaining showed borderline association with tumor multifocality (P=.05), lower overall (log-rank=8.739 and P=.003), and disease-free survival (log-rank=7.033, P=.008).ConclusionThe study showed a positive association of high COX-2 immunostaining with lower survival outcomes in PTC. COX-2 immunostaining could be a potential prognostic factor for survival in PTC. Additional molecular and clinical investigations are needed for further understanding the molecular pathways of COX-2 in PTC and the feasibility of using inhibitors of COX-2 as adjuvant therapy along with current chemotherapy.LimitationsRelatively low number of PTC variants, and no testing of other thyroid carcinomas.Conflict Of InterestNone.

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