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Detection of COX-2 in liquid biopsy in patients with breast cancer
  1. Camilla Paulla de Souza1,
  2. Beatriz Alves2,
  3. Jaques Waisberg1,3,4,
  4. Fernando Fonseca2,
  5. Alipio de Oliveira Carmo5,
  6. Flavia Gehrke1,2,5
  1. 1 Departamento de Ciências da Saúde, Hospital do Servidor Público Estadual (Iamspe), São Paulo, São Paulo, Brazil
  2. 2 Laboratório de Análises Clínicas, Centro Universitário Saúde ABC (CUS-ABC), Santo André, São Paulo, Brazil
  3. 3 Program in Interdisciplinary Surgical Science, Universidade Federal de São Paulo (UNIFESP/EPM), São Paulo, São Paulo, Brazil
  4. 4 Departamento de Cirurgia, Centro Universitário Saúde ABC (CUS-ABC), Santo André, São Paulo, Brazil
  5. 5 Departamento de Farmácia, Universidade Paulista (UNIP), São Paulo, São Paulo, Brazil
  1. Correspondence to Dr Flavia Gehrke, Pathology, Centro Universitário Saúde ABC, Santo Andre, SP 09060-870, Brazil; flaviagehrke{at}


Aims To determine the expression of the cyclooxygenase-2 (COX-2) gene in patients with breast cancer attended at the Centro Universitário Saúde ABC/Faculdade de Medicina do ABC (CUS-ABC/FMABC) outpatient clinic. Breast cancer is the most common cancer in women worldwide. More than two million new cases are reported annually. An overexpression of COX-2 has been observed in many cancers. COX-2 is related to parameters of cancer aggressiveness, including tumour size, positive nodal state and lower survival, and to angiogenesis and resistance to apoptosis.

Methods 15 mL of peripheral blood was obtained from 34 patients and 21 healthy women. The extracellular RNA of QIAamp RNA was submitted to an RNA sequestration kit for RNA reverse transcriptase. Quantitative real-time PCR was performed using COX-2-specific oligonucleotides and the endogenous Glyceraldehyde-3-Phosphate Dehydrogenase gene.

Results The mean remission time was 53 years. The mean progression time was 33 months. The difference observed between the patient and control groups in median COX-2 expression (p<0.001) was significant.

Conclusions Patients with breast cancer showed a higher mean COX-2 expression in peripheral blood samples at diagnosis than the control group. Since this information could prove important in the diagnosis and prognosis of breast cancer, further research is required on larger patient samples.

  • biomarkers, tumor
  • breast neoplasms
  • inflammation
  • polymerase chain reaction

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  • Handling editor Runjan Chetty.

  • Contributors CPdS and FSG conceived the study and performed RT-PCR analysis and data analysis, and wrote the first draft. BA, JW and AdOC provided support for statistical analysis. FF and FG contributed to the interpretation of the data. All authors critically reviewed and approved the final version.

  • Funding This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was approved by the Research Ethics Committee, under protocol number 1.103.818.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data sharing not applicable as no datasets generated and/or analysed for this study. Deidentified participant data.