Objectives: To examine the association between cyclooxygenase-2 (COX-2) expression with epidermal growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), inducible nitric oxide synthase (iNOS), and latent membrane protein 1 (LMP-1) expression and with COX-2 promoter methylation status in primary nasopharyngeal cancer (NPC) tumors and to determine COX-2 promoter methylation status in NPC cell lines. Design: Retrospective study. Setting: Patients with NPC were referred to the Department of Otolaryngology-Head and Neck Surgery for treatment. Patients: Formalin-fixed, paraffin-embedded NPC specimens from 42 patients were obtained. Interventions: Immunohistochemical expression of COX-2, EGFR, VEGF, iNOS, and LMP-1 was performed in 42 NPC samples. COX-2 promoter methylation status was studied in 20 separate specimens and in 4 NPC cell lines. Main Outcome Measures: (1) COX-2, EGFR, VEGF, iNOS, and LMP-1 expression; and (2) COX-2 promoter methylation status. Results: COX-2 was overexpressed in 79% of NPC specimens and was associated with EGFR status (P=.03) but not with LMP-1 or iNOS. In primary NPC tissue, methylation of the COX-2 promoter was seen in 4 of 7 COX-2-negative and 1 of 13 COX-2-positive immunohistochemical cases. COX-2 promoter methylation was found in the CNE-1 cell line. Conclusions: Nasopharyngeal cancer may be a useful target for selective COX-2 inhibition. The absence of promoter methylation may be a necessary component of COX-2 overexpression, and promoter methylation may be one of the mechanisms that regulate COX-2 expression.
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