To investigate the expression and significance of cyclooxygenase 2 (COX-2) and survivin in breast carcinoma, precancerous lesions and usual duct hyperplasia lesions(UDH).

Immunhistochemical UltraSensitive TM S-P method was applied to detect the expression of COX-2 and survivin in two hundred and seventy-four cases of patients with breast lesions including one hundred and twenty-eight cases with invasive ductal carcinomas(IDC), eighty-nine cases with ductal carcinoma in situ(DCIS), and fifty-seven cases with atypical ductal hyperplasia(ADH). Sixty cases with UDH were selected as a control group.The multiple biological parameters including the tumor size, grade, stage were compared with the associations of COX-2 and survivin expressions in breast carcinoma.

COX-2 was mainly distributed in cytoplasm in IDC, DCIS, ADH and UDH.survivin was mainly distributed in cytoplasm in UDH, but survivin was also distributed in nucleus and cytoplasm in IDC, DCIS and ADH mammary tissues.The positive rates of COX-2 and survivin were 79.5% and 67.2% in IDC, 55.1% and 59.6 % in DCIS, and 42.1% and 57.9% in ADH, which were higher than those in UDH tissues(16.7%, 1.7%). Compared with UDH, the difference was statistically significant(P<0.05). There were significant differences in the positive expression rates of COX-2 between IDC and DCIS tissues (χ²=14.768, P<0.05), IDC and ADH (χ²=25.293, P<0.05). However, there were no significant differences of survivin expression between IDC(79.5%, 67.2%) and DCIS(55.1%, 59.6%) tissues(χ²=1.330, P>0.05), IDC(79.5%, 67.2%) and ADH(42.1%, 57.9%)(χ²=1.484, P>0.05). Positive rates of COX-2 and survivin were found insignificant between ADH and DCIS tissues (χ²=2.331, P>0.05; χ²=0.039, P>0.05, respectively). There was positive correlation in over-expression of COX-2 and survivin with histological grade, lymph node metastasis, distant metastasis and stage of IDC tumor.And the expression of the two proteins were not related with age and tumor size (P>0.05). The expression of COX-2 was correlated positively with survivin(r=0.210, χ²=5.626, P<0.05).

- survivin location changes from cell plasma to cell nucleus might participate in oncogenesis and development of breast cancer.The over-expression of COX-2 and survivin might be important biological markers for invasion and metastasis of IDC.The combined detaction of COX-2 and survivin might be the predictors for prognosis and targeting treatment of breat carcinoma.