Cyclooxygenase-2 Expression Is a Predictive Marker for Late Recurrence in Colorectal Cancer

Abstract

Introduction Cyclooxygenase-2 (COX-2) expression is elevated in colorectal cancer (CRC). However, data about the relation between COX-2 expression and the impact on the biologic behavior of recurrent disease are inconclusive as yet. The aim of this study is to investigate the relationship between the status of COX-2 expression in the primary CRC and the characteristics of recurrence after curative resection of stage I to III CRC. Materials and Methods Ninety-eight patients with recurrence in 376 CRC patients, who underwent curative surgery between January 1991 and August 2001, were retrospectively assessed. Immunohistochemical staining, performed for the presence of COX-2 on tissue microarrays, was analyzed. Results Forty-six patients showed elevated COX-2 expression, and 52 patients did not. The mean time to recurrence was significantly longer in the positive group than in the negative group (34.1 months ± 30.0 versus 21.9 months ± 17.4; P = 0.019). Positive COX-2 expression was correlated with late recurrence (>3 years after surgery) [43.5% versus 13.5%; P = 0.001]. In multivariate analysis, COX-2 expression was an independent factor associated with late recurrence (OR 4.656; 95% CI, 1.696 to 12.779; P = 0.003). Recurrence pattern and postrecurrence survival were not different between the two groups. Conclusions Elevated COX-2 expression in itself is not a prognostic factor, but COX-2 expression in tumor tissue may be an independent predictive marker of late recurrence for patients with stage I to III CRC.

Cyclooxygenase-2 and β-Catenin as Potential Diagnostic and Prognostic Markers in Endometrial Cancer

“…Cox2 expression in normal tissues is limited; however, when stimulated by cytokines, growth factors, and oncogenes, its expression is upregulated (16). Notably, cox2 is known to play a key role in the development of various tumor types (9)(10)(11)(12)14). Previous studies have indicated that cox2 could participate in the processes of cell proliferation, migration, and invasion, thus playing a key role in tumor growth and metastasis (12,14,15).…”

“…Notably, cox2 is known to play a key role in the development of various tumor types (9)(10)(11)(12)14). Previous studies have indicated that cox2 could participate in the processes of cell proliferation, migration, and invasion, thus playing a key role in tumor growth and metastasis (12,14,15). However, studies investigating the relationship between cox2 and EC are still limited, and cox2 serum levels in patients with EC have never been reported.…”

“…Cox2, which is involved in inflammatory processes, has been found to play a key role in prostaglandin biosynthesis (8,9). Generally, the cox2 protein is only expressed in a limited number of cell types, whereas overexpressed in a variety of malignant tumors, suggesting its possible role in carcinogenesis (6,(10)(11)(12)(13)(14)(15). Moreover, several mediatory factors, such as tumor promoters, proinflammatory cytokines and growth factors, have been reported to induce the upregulation of cox2 expression (16).…”

“…Moreover, several mediatory factors, such as tumor promoters, proinflammatory cytokines and growth factors, have been reported to induce the upregulation of cox2 expression (16). Emerging data have demonstrated that cox2 is involved in many signaling pathways associated with cell proliferation, metastasis, and drug resistance (12,13). Therefore, cox2 might be a potential factor affecting EC progression.…”

Expression of cyclooxygenase‑2 and mucin 1 in colorectal cancer

“…Studies carried out so fa, on populations of different races, have shown that COX-2 overexpression slightly worsens overall survival ( 6 ). In a recently published paper, Kim et al presented that in a group of Korean patients elevated COX-2 expression was not a prognostic factor, but COX-2 expression might have been an independent predictive marker of late recurrence for patients with stage I to III CRC ( 14 ). Our studies showed no correlation between the expression of COX-2 and any studied clinical variables, or prognosis.…”