title: Cyclooxygenase-2 overexpression is associated with clinical outcome in biliary atresia.
abstract: OBJECTIVE
  The purpose of this study was to investigate the association between cyclooxygenase-2 (COX-2) expression and clinical outcome in biliary atresia (BA) patients.
  
  
  METHODS
  Six months after surgery, twenty-eight BA patients were divided into three groups according to their liver function tests: group A with satisfactory liver function (n=11), group B with moderate liver dysfunction (n=8), and group C with severe liver dysfunction (n=9). COX-2 expression was determined by immunohistochemistry. Choledochal cysts (n=5) and normal liver samples (n=4) served as controls.
  
  
  RESULTS
  Our data have shown that the intrahepatic biliary epithelium in BA specimens expressed COX-2. The mean immunoreactive score of COX-2 in BA patients was significantly higher than that in choledochal cyst and normal liver (4.0+/-0.6, 0.9+/-0.3, and 0.7+/-0.3, respectively, p<0.002). Strong expression of COX-2 was observed in BA patients with severe liver dysfunction. Subgroup analysis showed that the mean COX-2 immunoreactive scores of patients in group A, B, and C were 2.1+/-0.6, 3.6+/-1.1, and 5.9+/-0.9, respectively. The COX-2 immunoreactive score in BA patients with severe liver dysfunction was higher than in patients with satisfactory liver function (p<0.005).
  
  
  CONCLUSIONS
  Increased COX-2 expression of biliary epithelial cells at the time of Kasai operation was associated with an adverse therapeutic outcome in BA, suggesting that COX-2 could play a plausible role in the liver pathology of BA.
authors.affiliation: Faculty of Medicine, Chulalongkorn University, Biochemistry, Bangkok, Thailand. Sittisak.H@chula.ac.th
authors.forename: S
authors.initials: S
authors.lastname: Honsawek
authors.forename: N
authors.initials: N
authors.lastname: Klaikeaw
authors.forename: P
authors.initials: P
authors.lastname: Vejchapipat
authors.forename: V
authors.initials: V
authors.lastname: Chongsrisawat
authors.forename: P
authors.initials: P
authors.lastname: Ruangvejvorachai
authors.forename: Y
authors.initials: Y
authors.lastname: Poovorawan
mesh_terms: D001656:Biliary Atresia / Q000378:metabolism* / Q000601:surgery; D051546:Cyclooxygenase 2 / Q000096:biosynthesis*; D004848:Epithelium / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007223:Infant; D008297:Male
chemical_list: D051546:Cyclooxygenase 2