Elevated levels of urinary PGE-M are found in tobacco users and indicate a poor prognosis for oral squamous cell carcinoma patients

Vikram D. Kekatpure, Naveen Bs, Hanhan Wang, Xi Kathy Zhou, Chandramohan Kandasamy, Sumsum P. Sunny, Amritha Suresh, Ginger L. Milne, Moni Abraham Kuriakose, Andrew J. Dannenberg

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Cyclooxygenase-2 (COX-2)-derived prostaglandin E2 (PGE2) plays a role in the development and progression of epithelial malignancies.Measurements of urinary PGE-M, a stablemetabolite of PGE2, reflect systemic PGE2 levels.Here, we investigatedwhether urinary PGE-M levels were elevated in healthy tobacco users and in patients with oral squamous cell carcinoma (OSCC). Median urinary PGE-M levels were increased in healthy tobacco quid chewers [21.3 ng/mgcreatinine (Cr); n=33; P=0.03] and smokers (32.1 ng/mg Cr; n =31; P < 0.001) compared with never tobacco quid chewers-never smokers (18.8 ng/mg Cr; n =30). Urinary PGE-M levels were also compared in OSCC patients versus healthy tobacco users. An approximately 1-fold increase inmedian urinary PGE-M level was found in OSCC patients (48.7 ng/mg Cr, n =78) versus healthy controls (24.5 ng/mg Cr, n =64; P < 0.001). We further determined whether baseline urinary PGE-M levels were prognostic in OSCC patients who underwent treatment with curative intent.A nearly 1-fold increase in baseline urinaryPGE-M levels (64.7 vs. 33.8 ng/mg Cr, P < 0.001) was found in the group of OSCC patients who progressed (n =37) compared with the group that remained progression free (n=41). Patients with high baseline levels of urinary PGE-M had both worse disease-specific survival [HR, 1.01 per unit increase; 95% confidence interval (CI), 1.01- 1.02; P < 0.001] and overall survival (HR, 1.01 per unit increase; 95% CI, 1.00-1.02; P =0.03). Taken together, our findings raise the possibility that NSAIDs, prototypic inhibitors of PGE2 synthesis, may be beneficial for reducing the risk of tobacco-related aerodigestive malignancies or treating OSCC patients with high urinary PGE-M levels. Cancer Prev Res; 9(6); 428-36.

Original languageEnglish (US)
Pages (from-to)428-436
Number of pages9
JournalCancer Prevention Research
Issue number6
StatePublished - Jun 2016

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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