title: Cyclo-oxygenase-2 overexpression is a feature of early and well-differentiated hepatocellular carcinoma with a favourable prognosis.
abstract: OBJECTIVE
  To determine the prognostic relevance of cyclo-oxygenase-2 (COX-2) expression in hepatocellular carcinoma (HCC) and its relationship to important clinicopathological parameters.
  
  
  METHODS
  A series of 196 patients with HCCs treated either by surgical resection (n = 106) or liver transplantation (n = 90) was investigated. Immunohistochemically confirmed COX-2 expression was correlated with a series of clinicopathologically relevant parameters as well as proliferative activity and apoptosis.
  
  
  RESULTS
  Overexpression of COX-2 correlated statistically with high histological tumour differentiation (p<0.001) and early TNM stage (p = 0.003). COX-2 overexpression was associated with lower apoptotic rates (p = 0.001), whereas proliferation activity did not differ significantly. In addition, COX-2 overexpression showed a significant correlation with favourable overall survival (p<0.001). In multivariate survival analysis, COX-2 expression qualified as an independent prognostic parameter (p = 0.030).
  
  
  CONCLUSIONS
  Overexpression of COX-2 in HCC indicates early-stage cancer with less aggressive tumour behaviour and constitutes an independent prognostic factor.
authors.affiliation: Institute of Pathology and Neuropathology, University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, Essen 45122, Germany. Klaus.Schmitz@uni-duisburg-essen.de
authors.forename: K J
authors.initials: KJ
authors.lastname: Schmitz
authors.forename: J
authors.initials: J
authors.lastname: Wohlschlaeger
authors.forename: H
authors.initials: H
authors.lastname: Lang
authors.forename: G C
authors.initials: GC
authors.lastname: Sotiropoulos
authors.forename: G M
authors.initials: GM
authors.lastname: Kaiser
authors.forename: K W
authors.initials: KW
authors.lastname: Schmid
authors.forename: H A
authors.initials: HA
authors.lastname: Baba
mesh_terms: D017209:Apoptosis; D014408:Biomarkers, Tumor / Q000378:metabolism*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D049109:Cell Proliferation; D051546:Cyclooxygenase 2 / Q000378:metabolism*; D004812:Epidemiologic Methods; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis
chemical_list: D014408:Biomarkers, Tumor; D051546:Cyclooxygenase 2