COX-2 is associated with proliferation and apoptosis markers and serves as an independent prognostic factor in gastric cancer.
Cyclooxygenase-2 (COX-2) is an important factor in gastric carcinogenesis, and COX-2 expression in gastric cancer patients correlates with prognosis. We have now studied the impact of COX-2 in comparison to six other tissue tumor markers, DNA index, and S-phase fraction (SPF) in a large series of gastric cancer specimens. From 342 consecutive patients, 337 archival tissue specimens were available for immunohistochemistry of COX-2, HuR, cyclin A, MMP-2, p53, p21, and Ki-67 and 313 for analysis of DNA index and S-phase fraction by flow cytometry. Associations between factors were assessed by chi-square test and survival analysis by the Kaplan-Meier method and Cox model. A significant association emerged between of COX-2 and p53 (p < 0.0001), Ki-67 (p = 0.013), DNA ploidy (p < 0.0001), and SPF (p < 0.0001). In an extended multivariate analysis, COX-2 and p53 expression were independent prognostic factors for poor survival, in addition to high stage and non-curative surgery. In gastric cancer, COX-2 expression associated with markers for apoptosis and proliferation, and furthermore, it was confirmed that COX-2 and p53 are strong prognostic indicators.
Department of Surgery, Helsinki University Central Hospital, P.O. Box 340, 00029 HUS, Helsinki, Finland.
Johanna
J
Mrena
Jan-Patrik
JP
Wiksten
Arto
A
Kokkola
Stig
S
Nordling
Ari
A
Ristimäki
Caj
C
Haglund
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis; D049109:Cell Proliferation; D051546:Cyclooxygenase 2 / Q000032:analysis*; D005434:Flow Cytometry; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis; D008875:Middle Aged; D011379:Prognosis; D013274:Stomach Neoplasms / Q000201:enzymology* / Q000401:mortality / Q000473:pathology; D016159:Tumor Suppressor Protein p53 / Q000032:analysis
D019394:Ki-67 Antigen; D016159:Tumor Suppressor Protein p53; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human