title: Association of COX-2 expression with corresponding active and chronic inflammatory reactions in Barrett's metaplasia and progression to cancer.
abstract: OBJECTIVE
  Risk reduction for Barrett's cancer in individuals taking non-steroidal anti-inflammatory drugs has been reported. Cyclooxygenase (COX)-2, one of the inhibited enzymes, is putatively involved in Barrett's cancer pathogenesis. The aim of this study was to examine a possible association between COX-2 protein expression and the development and progression of the Barrett's metaplasia-dysplasia-carcinoma sequence and the type and degree of associated inflammatory reaction.
  
  
  RESULTS
  Squamous epithelium, metaplastic, low-grade, high-grade dysplastic lesions and tumour tissue of 49 resection specimens from patients with Barrett's adenocarcinoma were immunohistochemically analysed. Active and chronic inflammatory reactions were classified according to the Updated Sydney System. Within the Barrett's sequence, a significant progressive increase in COX-2 expression was identified (P < 0.0001). The most significant differences were detected between squamous epithelium and Barrett's metaplasia (P < 0.001) and from low- to high-grade dysplasia (P < 0.0001). Active and chronic inflammation were significantly different between squamous epithelium and Barrett's metaplasia (P < 0.0001), but not during further progression in the sequence.
  
  
  CONCLUSIONS
  Increasing COX-2 expression in Barrett's metaplasia is significantly associated with a change in the local inflammatory reaction, but not during further progression through dysplasia to cancer. This supports the potential of a chemoprevention strategy using COX-2 inhibitors independent of the extent and type of the inflammatory reaction in Barrett's oesophagus.
authors.affiliation: Department of Visceral and Vascular Surgery, University of Cologne, Cologne [corrected] Germany.
authors.forename: F C
authors.initials: FC
authors.lastname: Ling
authors.forename: S E
authors.initials: SE
authors.lastname: Baldus
authors.forename: J
authors.initials: J
authors.lastname: Khochfar
authors.forename: H
authors.initials: H
authors.lastname: Xi
authors.forename: S
authors.initials: S
authors.lastname: Neiss
authors.forename: J
authors.initials: J
authors.lastname: Brabender
authors.forename: R
authors.initials: R
authors.lastname: Metzger
authors.forename: U
authors.initials: U
authors.lastname: Drebber
authors.forename: H P
authors.initials: HP
authors.lastname: Dienes
authors.forename: E
authors.initials: E
authors.lastname: Bollschweiler
authors.forename: A H
authors.initials: AH
authors.lastname: Hoelscher
authors.forename: P M
authors.initials: PM
authors.lastname: Schneider
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000201:enzymology*; D051546:Cyclooxygenase 2 / Q000096:biosynthesis / Q000235:genetics*; D018450:Disease Progression; D004938:Esophageal Neoplasms / Q000201:enzymology* / Q000209:etiology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007249:Inflammation / Q000201:enzymology*; D008297:Male; D008565:Membrane Proteins / Q000096:biosynthesis / Q000235:genetics*; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D008565:Membrane Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human