Objective: To investigate the relationship between the expression of cyclooxygenase-2 (COX-2), succinate dehydrogenase (SDHB), heat shock protein 90β (HSP90β) and the clinicopathological characteristics and prognosis of nasopharyngeal carcinoma. Methods: The expression of COX-2, SDHB and HSP90β in 78 cases of nasopharyngeal carcinoma tissue and 65 cases of chronic inflammation of nasopharynx were detected by immunohistochemistry, and the relationship between the expression of COX-2, SDHB and HSP90β and the clinicopathological characteristics of NPC was analyzed. All patients were followed up for 3 years. According to the expression of COX-2, SDHB and HSP90β, the patients were divided into COX-2 positive group, COX-2 negative group, SDHB positive group, SDHB negative group, HSP90β positive group and HSP90β negative group. Results: The positive rate of COX-2 and HSP90β in nasopharyngeal carcinoma tissue was significantly higher than that in nasopharynx, and the positive rate of SDHB was significantly lower than that in nasopharynx (P<0.05). The positive rates of COX-2 and HSP90β in nasopharyngeal carcinoma tissue with TNM stage III+IV, middle and low differentiation and cervical lymph node metastasis were significantly higher than those TNM stage I+II, high differentiation and no cervical lymph node metastasis, and the positive rates of SDHB were significantly lower than those in nasopharyngeal carcinoma tissue with TNM stage I + II, high differentiation and no cervical lymph node metastasis (P<0.05). Spearman correlation analysis showed that COX-2 expression was negatively correlated with SDHB expression (rs=-0.462, P=0.008), positively correlated with HSP90β expression (rs=0.501, P=0.000), and SDHB was negatively correlated with HSP90β expression (rs=-0.438, P=0.012). After 3 years follow-up, 49 cases survived and 29 died, with a survival rate of 62.82%. The survival rate and median survival time of patients in COX-2 negative group, SDHB positive group and HSP90β negative group were significantly better than those in COX-2 positive group, SDHB negative group and HSP90β positive group (P<0.05). Conclusion: The expression of COX-2, SDHB and Hsp90β in NPC is related to TNM stage, tumor differentiation and cervical lymph node metastasis, and its expression is closely related to the survival period of NPC patients. [ABSTRACT FROM AUTHOR]