title: Expression of cyclo-oxygenase-2 in gastrointestinal carcinoid tumors.
abstract: BACKGROUND
  Cyclo-oxygenase (COX)-2 overexpression is observed in various neoplasms and COX-2 inhibition has been attempted as prevention and/or therapy in these neoplasms. Carcinoid tumors are thought to arise from neuroendocrine cells and originate mainly in the gastrointestinal tract. Cyclo-oxygenase-2 is reportedly expressed in neuroendocrine cells of normal colorectal mucosa. The role of COX in carcinoids has not previously been investigated. The aim of the present paper was to clarify the expression of COX-1 and -2, and their role in human gastrointestinal carcinoids.
  
  
  METHODS
  Expression of COX-1 and -2 was studied immunohistochemically in 38 gastrointestinal carcinoids. Five bronchopulmonary and seven metastatic carcinoids were also examined, for comparison with gastrointestinal carcinoids. The immunohistochemical score (IHS) was calculated from staining intensity and immunoreactive cell population, and ranked according to four grades (negative to strong).
  
  
  RESULTS
  Cyclo-oxygenase-2 was expressed in all gastrointestinal carcinoids (weak, 1; moderate, 13; strong, 24) and bronchopulmonary carcinoids (weak, 1; moderate, 4), as well as their metastases (moderate, 3; strong, 4). The IHS of COX-2 in larger tumors was significantly lower than that in smaller tumors. However, the IHS of COX-2 at the advancing tumor edge was significantly higher than that at the centers of tumors >or=10 mm in size. Faint COX-1 expression was detected in only one duodenal, one rectal and four bronchopulmonary carcinoids.
  
  
  CONCLUSIONS
  Enhanced COX-2 expression was observed in gastrointestinal as well as bronchopulmonary carcinoids and their metastases, especially at the advancing edges of the tumors. Cyclo-oxygenase-2 may play a role in carcinoid progression.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Mizuno
authors.forename: Kimitoshi
authors.initials: K
authors.lastname: Kato
authors.forename: Akemi
authors.initials: A
authors.lastname: Hashimoto
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sugitani
authors.forename: Aleemuzzaman
authors.initials: A
authors.lastname: Sheikh
authors.forename: Sachiko
authors.initials: S
authors.lastname: Komuro
authors.forename: Toyoharu
authors.initials: T
authors.lastname: Jike
authors.forename: Ariyoshi
authors.initials: A
authors.lastname: Iwasaki
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Arakawa
authors.forename: Norimichi
authors.initials: N
authors.lastname: Nemoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001984:Bronchial Neoplasms / Q000201:enzymology / Q000473:pathology; D002276:Carcinoid Tumor / Q000201:enzymology* / Q000473:pathology; D051545:Cyclooxygenase 1 / Q000032:analysis / Q000378:metabolism; D051546:Cyclooxygenase 2 / Q000032:analysis / Q000378:metabolism*; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000201:enzymology* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged
chemical_list: D051545:Cyclooxygenase 1; D051546:Cyclooxygenase 2