title: Overexpressed cyclo-oxygenase-2 in the background liver is associated with the clinical course of hepatitis C virus-related cirrhosis patients after curative surgery for hepatocellular carcinoma.
abstract: BACKGROUND
  The probable role of cyclo-oxygenase-2 (COX-2) in the development of hepatocellular carcinoma (HCC) in patients with chronic liver diseases has been accepted to be relevant. The purpose of the present study was to determine whether overexpressed COX-2 in the background liver affects the clinical course of hepatitis C virus (HCV)-related cirrhosis patients after curative surgery for HCC.
  
  
  METHODS
  Twenty-nine clinical stage I HCC patients with HCV-related cirrhosis, who underwent curative surgery, were enrolled in the present study (22 men and seven women, age range 53-73 years; follow-up period; range 22-159 months, median 61 months). The COX-2 expression in the cirrhotic liver was examined by immunohistochemistry using the avidin-biotin-peroxidase complex technique on paraffin-embedded formalin-fixed tissue. The COX-2 expression was scored, then correlated with monitored alanine aminotransferase (ALT) levels during the follow-up period after surgery, response to alternative therapy aiming to improve elevated ALT levels, and recurrence/survival after surgery.
  
  
  RESULTS
  The COX-2 expression scores were significantly higher in the high-ALT group than in the low-ALT group (Mann-Whitney, P = 0.010), and were significantly higher in non-responders to the alternative therapy than in responders (Mann-Whitney, P = 0.028). The higher COX-2 expression in the cirrhotic liver was the significant independent risk factor for residual liver recurrence (Cox multivariate analysis, P = 0.014), but not for survival.
  
  
  CONCLUSIONS
  Overexpressed COX-2 in the background liver may play an important role in prolonged acceleration of necroinflammation, resistance to the alternative therapy, and recurrence/new development of HCC in HCV-related cirrhosis patients.
authors: Department of Gastrointestinal Surgery, Kanagawa Cancer Center, Asahikum, Japan. morinagas@kcch.jp
authors: Soichiro
authors: S
authors: Morinaga
authors: Kazuo
authors: K
authors: Tarao
authors: Yuji
authors: Y
authors: Yamamoto
authors: Yoshiyasu
authors: Y
authors: Nakamura
authors: Yasushi
authors: Y
authors: Rino
authors: Kaoru
authors: K
authors: Miyakawa
authors: Shinichi
authors: S
authors: Ohkawa
authors: Makoto
authors: M
authors: Akaike
authors: Yukio
authors: Y
authors: Sugimasa
authors: Shoji
authors: S
authors: Takemiya
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000201:enzymology* / Q000209:etiology / Q000601:surgery; D051546:Cyclooxygenase 2 / Q000097:blood*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006526:Hepatitis C / Q000150:complications* / Q000201:enzymology; D006801:Humans; D008099:Liver / Q000201:enzymology*; D008103:Liver Cirrhosis / Q000150:complications / Q000201:enzymology* / Q000821:virology; D008113:Liver Neoplasms / Q000201:enzymology* / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015854:Up-Regulation
chemical_list: D051546:Cyclooxygenase 2