Expression of NF-κB parallels COX-2 expression in oral precancer and cancer: Association with smokeless tobacco

Meenakshi Sawhney, Nidhi Rohatgi, Jatinder Kaur, Shishir Shishodia, Gautam Sethi, Siddhartha D. Gupta, Suryanaryana V.S. Deo, Nootan K. Shukla, Bharat B. Aggarwal, Ranju Ralhan

Research output: Contribution to journalArticlepeer-review

100 Scopus citations


Nuclear Factor-κB (NF-κB) activation and COX-2 overexpression have been reported in head and neck cancer, but the relationship between these proteins remains to be investigated. To determine the relationship between NF-κB and COX-2 in Smokeless Tobacco (ST) associated oral tumorigenesis, we performed immunohistochemistry in serial sections from 107 OSCCs, 78 oral precancerous lesions (OPLs) (58 hyperplasias, 20 dysplasias) and 15 histologically normal oral tissues and correlated with clinicopathological data. Significant increase in NF-κB and COX-2 immunopositivity was observed from normal oral mucosa to OPLs to OSCCs (p = 0.009 and p = 0.002 respectively). Upregulation of NF-κB and COX-2 was observed as early as in hyperplasia [p = 0.006; OR = 6.1 and p = 0.003; OR = 7.6, respectively]. Expression of both proteins was found to be significantly associated in OPLs (p = 0.000; OR = 12.6) and OSCCs (p = 0.00.1; OR = 4.0). Intriguingly, khaini consumption correlated with NF-κB immunopositivity in OPLs (p = 0.05, OR = 3.8) and OSCCs (p = 0.01, OR = 3.4) and with COX-2 expression in OPLs (p = 0.03; OR = 4.3). In vitro experimental system of ST associated oral carcinogenesis was used to demonstrate ST (khaini) and NNK mediated activation of NF-κB and COX-2, supporting the clinical data. In conclusion, this study demonstrates correlation between over expression of NF-κB and COX-2 in early precancerous stages of development of oral cancer and sustained elevation down the tumorigenic pathway, underscoring their potential as targets for early intervention. In vitro studies demonstrated that NNK may be one of the carcinogenic components of ST (khaini) inducing activation of NF-κB and COX-2 in oral precancer and cancer cells, suggesting plausible role in ST-induced oral carcinogenesis.

Original languageEnglish
Pages (from-to)2545-2556
Number of pages12
JournalInternational Journal of Cancer
Issue number12
StatePublished - Jun 15 2007


  • COX-2
  • Clinical correlation
  • NF-kappaB
  • Oral cancer
  • Oral precancerous lesions
  • Smokeless tobacco


Dive into the research topics of 'Expression of NF-κB parallels COX-2 expression in oral precancer and cancer: Association with smokeless tobacco'. Together they form a unique fingerprint.

Cite this