title: Comparative analysis of clinicopathological correlations of cyclooxygenase-2 expression in resectable pancreatic cancer.
abstract: OBJECTIVE
  To perform a comparative analysis of clinicopathological correlations of cyclooxygenase-2 (COX-2) expression in pancreatic cancer, examined by monoclonal and polyclonal antibodies.
  
  
  METHODS
  The COX-2 expression in 85 resection specimens of pancreatic ductal adenocarcinoma was immunohistochemically examined using both monoclonal and polyclonal antibodies. The final immunoscores were obtained by multiplying the percentage of positive cells with the numeric score reflecting the staining intensity. COX-2 expression levels were classified into three categories (0, 1+, and 2+) and the clinicopathological correlations were statistically evaluated and analyzed.
  
  
  RESULTS
  The positive tumor expression rates of COX-2 were 80.5% using monoclonal antibody and 69.4% using polyclonal antibody. In the Kaplan-Meier analysis, no significant correlations were found between levels of COX-2 expression and overall survival (OS), but trends to longer OS were found in COX-2 negative cases using monoclonal antibody. Significantly longer disease free survival was revealed in COX-2 negative cases using monoclonal antibody (P = 0.019). No correlations between COX-2 expression levels and grade (G), tumor (T) status and nodal (N) status were demonstrated. Low histological grade showed a strong association with a longer OS (P < 0.001). Correlation of survival and T status revealed a shorter OS in T3 tumors, but the results reached only marginal statistical significance (P = 0.070). In the multivariate Cox proportional hazards regression model, histological grade, T and N status remained valuable predictors of a worse survival with borderline significance for T [hazards ratio (HR) = 4.18 for G (if G = 3, P < 0.001); HR = 1.64 for T (if T = 3, P = 0.065); HR = 2.53 for N (if N = 1, P = 0.006)]. Higher grade, T or N status was associated with a worse OS.
  
  
  CONCLUSIONS
  The immunohistochemically assessed level of COX-2 expression does not seem to represent a valuable independent prognostic factor and is not superior to the conventional prognostic factors.
authors.affiliation: First Department of Pathologic Anatomy, Medical Faculty of Masaryk University and St. Anne's University Hospital, Pekarska 53, 65691 Brno, Czech Republic. marketa.hermanova@fnusa.cz
authors.forename: Marketa
authors.initials: M
authors.lastname: Hermanova
authors.forename: Petr
authors.initials: P
authors.lastname: Karasek
authors.forename: Jiri
authors.initials: J
authors.lastname: Tomasek
authors.forename: Jiri
authors.initials: J
authors.lastname: Lenz
authors.forename: Jiri
authors.initials: J
authors.lastname: Jarkovsky
authors.forename: Petr
authors.initials: P
authors.lastname: Dite
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000378:metabolism; D051546:Cyclooxygenase 2 / Q000096:biosynthesis*; D005260:Female; D015971:Gene Expression Regulation, Enzymologic; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008297:Male; D008875:Middle Aged; D010183:Pancreatic Ducts / Q000201:enzymology / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000201:enzymology* / Q000601:surgery*; D011379:Prognosis; D016016:Proportional Hazards Models
chemical_list: D000911:Antibodies, Monoclonal; D051546:Cyclooxygenase 2
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