Cyclooxygenase-2 expression: A significant prognostic indicator for patients with colorectal cancer

• Published in: Clinical cancer research 2004-12, Vol.10 (24), p.8465-8471
• Main Authors: TOGBA SOUMAORO, Labile, UETAKE, Hiroyuki, HIGUCHI, Tetsuro, TAKAGI, Yoko, ENOMOTO, Masayuki, SUGIHARA, Kenichi
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - diagnosis; Adenocarcinoma - enzymology; Antineoplastic agents; Biological and medical sciences; Biomarkers, Tumor - metabolism; Cohort Studies; Colon - metabolism; Colonic Neoplasms - diagnosis; Colonic Neoplasms - enzymology; Cyclooxygenase 1; Cyclooxygenase 2; Female; Gastroenterology. Liver. Pancreas. Abdomen; Gene Expression Regulation, Enzymologic; Gene Expression Regulation, Neoplastic; Humans; Immunoenzyme Techniques; Liver Neoplasms - enzymology; Liver Neoplasms - secondary; Lymphatic Metastasis - diagnosis; Male; Medical sciences; Membrane Proteins; Middle Aged; Neoplasm Invasiveness - diagnosis; Neoplasm Recurrence, Local - diagnosis; Neoplasm Recurrence, Local - enzymology; Pharmacology. Drug treatments; Prognosis; Prostaglandin-Endoperoxide Synthases - metabolism; Rectal Neoplasms - diagnosis; Rectal Neoplasms - enzymology; Rectum - metabolism; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Survival Rate; Tumors
• ISSN: 1078-0432; 1557-3265
• DOI: 10.1158/1078-0432.CCR-04-0653

Recent studies have shown that cyclooxygenase (Cox)-2 may be involved in colorectal carcinogenesis. We aimed to determine whether Cox-2 expression in itself can predict outcome of colorectal cancer patient after surgery. In addition, the expression of Cox-1 was also evaluated. Tissue samples of primary and secondary tumors from 288 patients undergoing surgical resections for colorectal adenocarcinoma were immunohistochemically examined for Cox-2 and Cox-1 expressions. The specimens were graded based on the intensity and extent of staining; then, the correlations between Cox-2 and Cox-1 expressions with clinicopathologic parameters and survival time were analyzed. Expression of Cox-2 was positive in 70.8% of primary tumor, 92.0% of lymph node metastases, 100.0% of hepatic metastases, and was significantly associated with tumor size, depth of invasion, lymph node metastasis, vessels invasion, stage and recurrence. In contrast, Cox-1 was positive in 42.7% of primary tumor, 84.0% of lymph node metastases, 37.5% hepatic metastases, and was associated with only tumor size. Patients with Cox-2-positive tumors had a significant shorter survival time than those with negative tumors did (P = 0.0006 by log-rank test); and, in a multivariate analysis, Cox-2 was an independent prognostic factor (P = 0.0103; relative risk 4.114; 95% confidence interval, 1.397-12.120). Cox-1 status had no statistically effect on patient survival time. Elevated Cox-2 expression, but not that of Cox-1, was significantly associated with reduced survival and recognized as an independent prognostic factor in our cohort of colorectal cancer patients.