COX-2+ myofibroblasts may play a key role in marked stromal fibrosis in strictured colorectal carcinomas.
OBJECTIVE
To elucidate the mechanism of marked stromal fibrosis in strictured colorectal carcinomas (SC) that cause complete ileus.


RESULTS
Sixteen cases of SC and 29 cases of non-strictured colorectal carcinoma (NSC) were studied. These carcinomas showed similar clinicopathological features except for bowel stricture. The stricture index (SI) showing the degree of bowel stricture was 59.8 +/- 12.1% in SC versus 20.8 +/- 24.6% in NSC (P < 0.001). The fibrosis index (FI), defined to reflect the extent of stromal fibrosis, was 56.3 +/- 8.8% in SC versus 21.9 +/- 10.6% in NSC (P < 0.001). COX-2+ myofibroblasts were detected in 13 cases (81.3%) in SC versus eight cases (27.6%) in NSC (P < 0.01). The COX-2+ myofibroblast density was 276.7 +/- 181.1 cells/mm(2) in SC versus 26.6 +/- 52.7 cells/mm(2) in NSC (P < 0.001). When all cases were divided into two groups with and without COX-2+ myofibroblasts, the SI was 48.8 +/- 19.1% in those with COX-2+ myofibroblasts versus 24.8 +/- 29.3% in those with COX-2- myofibroblasts (P < 0.001).


CONCLUSIONS
COX-2+ myofibroblasts may play an important role in extensive bowel stricture in colorectal carcinomas.
Kasamaki
S
S
Department of Pathology, Juntendo University, School of Medicine, Tokyo, Japan. kasamaki@hh.iij4u.or.jp
Suda
K
K
Kamano
T
T
Kumasaka
T
T
Ochiai
T
T
Haraguchi
Y
Y
D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000201:enzymology* / Q000473:pathology* / Q000601:surgery; D051546:Cyclooxygenase 2; D005260:Female; D005347:Fibroblasts / Q000201:enzymology* / Q000473:pathology; D005355:Fibrosis / Q000209:etiology / Q000473:pathology*; D006801:Humans; D045823:Ileus / Q000000981:diagnostic imaging / Q000209:etiology; D007527:Isoenzymes / Q000378:metabolism*; D008297:Male; D008565:Membrane Proteins; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism*; D011859:Radiography; D012189:Retrospective Studies; D012720:Severity of Illness Index
D007527:Isoenzymes; D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases