COX-2 expression in rectal carcinoma: immunohistochemical pattern and clinical outcome.
BACKGROUND
Increasing evidence suggests that COX-2 promotes carcinogenesis but it is controversial as to whether COX-2 expression is a prognostic factor for rectal carcinoma.


METHODS
Data of 62 consecutive patients with rectal carcinoma in UICC-stages I-III, which were curatively resected between 1995 and 1996, were analyzed. The paraffin-embedded tumor samples were stained for COX-2 expression. A labeling index of stained cells was calculated and the median COX- 2 labeling index was used as the cut-offpoint for statistical analysis.


RESULTS
The median labeling index was 0.58 (SD +/- 0.25). The Chi-square test revealed no correlation between COX-2 overexpression and the established prognostic factors. In the univariate analysis, COX-2 did not show significance according to the endpoints, local recurrence (p=0.41), disease-specific survival (p=0.28) or overall-survival (p=0.69). In contrast increased COX-2 level was a significant prognostic factor for pulmonary metastasis (p=0.04).


CONCLUSIONS
COX-2 expression lacked significance as a prognostic factor for local control and survivaL However, there is evidence that COX-2 might be linked to an increased risk of hematogenous metastatic spread.
Petersen
Sven
S
Department of General and Abdominal Surgery, Georg Schmorl General Hospital Dresden-Friedrichstadt, Technical University of Dresden, Germany. petersen-sv@.khdf.de
Haroske
Gunter
G
Hellmich
Gunter
G
Ludwig
Klaus
K
Petersen
Cordula
C
Eicheler
Wolfgang
W
D000368:Aged; D051546:Cyclooxygenase 2; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007413:Intestinal Mucosa / Q000201:enzymology / Q000473:pathology; D007527:Isoenzymes / Q000096:biosynthesis*; D008297:Male; D008565:Membrane Proteins; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000201:enzymology*; D009367:Neoplasm Staging; D011451:Prostaglandin-Endoperoxide Synthases / Q000096:biosynthesis*; D012004:Rectal Neoplasms / Q000201:enzymology* / Q000473:pathology; D015996:Survival Rate
D007527:Isoenzymes; D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases