PTGS2 and neoplasm: COX-2 is strongly associated with tumor proliferation, angiogenesis and apoptosis resistance mechanism.7 Therefore, COX-2 overexpression is associated with poor prognosis in post-menopausal women, those above 50 years of age, those in the advanced stage of the disease, those with a larger tumor size, higher grade, and metastasis of lymph nodes.