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COX-2, MMP-9, p53 and VEGF play an important role in the invasion and metastasis of tumor, and their roles are known to interact with each other. In this study, we investigated the relationship between gene protein expression and clinical parameters including synchronicity to the progression and metastasis in the head and neck squamous cell carcinoma. Subjects and Method:Tissue samples and clinical data were obtained from 69 head and neck squamous cell carcinoma patients who underwent surgery as initial treatment except nasopharngeal carcinoma from January 1999 to December 2003. Their primary sites were: oral cavity (12), pharynx (18) and larynx (39). Immunohistochemical stain was performed to evaluate the expression rate of COX-2, MMP-9, p53, VEGF and then expression patterns and clinical data were analysed. Results:The expressions of COX-2, MMP-9, p53 and VEGF immunoreactivities were observed as 57.9%, 49.3%. 60.9% and 44.9%, respectively. MMP-9 was significantly correlated with T-stage (p=0.021) and COX-2 and p53 levels were significantly correlated with lymph node metastasis (p=0.019 and p=0.001, respectively). Multiple (2 kinds, 3 kinds, 4 kinds) expressions of gene protein were found in 31.9%, 21.7%, and 10.2%, respectively. There was a significant statistical difference between the multiple expression of gene protein to lymph node metastasis and a single expression of gene protein (p=0.030). Conclusion: These data suggested that COX-2, MMP-9 and p53 expression may play a role of tumor progression and metastasis in the head and neck squamous cell carcinoma. We may conclude that the synchronous gene protein expression was superior to the single gene expression in estimating progression and metastasis of the head and neck squamous cell carcinoma. (Korean J Otorhinolaryngol- Head Neck Surg 2008;51:1036-42)

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