title: Overexpression of cyclooxygenase-2 in noncancerous liver tissue increases the postoperative recurrence of hepatocellular carcinoma in patients with hepatitis B virus-related cirrhosis.
abstract: BACKGROUND
  Many previous studies have evaluated the histopathological features of tumours as risk factors for postoperative recurrence in hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC). However, there have been few large studies investigating the relationship between cyclooxygenase-2 (COX-2) expression in noncancerous regions of the liver and postoperative recurrence in the remnant liver, especially in HBV-related HCC.
  
  
  OBJECTIVE
  To evaluate the significance of COX-2 expression levels in noncancerous liver regions as a prognostic indicator of HCC in patients with HBV-related cirrhosis.
  
  
  METHODS
  A total of 124 patients who underwent curative resection for HCC were reviewed retrospectively. Immunohistochemistry was used to evaluate the expression of COX-2 in noncancerous liver tissue. Clinicopathological variables were compared between patients with high COX-2 expression (n=58 [COX-2-positive group]) and patients with low COX-2 expression (n=66; [COX-2-negative group]). Univariate and multivariate analyses were performed to identify factors that affected disease recurrence.
  
  
  RESULTS
  There was a significant correlation between COX-2 expression and alanine aminotransferase levels and vascular invasion. The recurrence-free survival rates in the COX-2-positive group were significantly lower than the rates in the COX-2-negative group. On multivariate analysis, the overexpression of COX-2 in noncancerous liver regions was found to be an unfavourable prognostic indicator for the recurrence of HCC.
  
  
  CONCLUSIONS
  The results of the current study suggest that overexpression of COX-2 in noncancerous liver regions is an independent and significant indicator predictive of early recurrence of HCC in patients with HBV-related cirrhosis.
authors.affiliation: Institute of Clinical Pharmacology, Anhui Medical University, Hefei, People's Republic of China.
authors.forename: Yi-Fu
authors.initials: YF
authors.lastname: He
authors.forename: Juan
authors.initials: J
authors.lastname: Jin
authors.forename: Wei
authors.initials: W
authors.lastname: Wei
authors.forename: Yan
authors.initials: Y
authors.lastname: Chang
authors.forename: Bing
authors.initials: B
authors.lastname: Hu
authors.forename: Chu-Shu
authors.initials: CS
authors.lastname: Ji
authors.forename: Wei-Dong
authors.initials: WD
authors.lastname: Jia
authors.forename: Xiao-Qiu
authors.initials: XQ
authors.lastname: Wang
authors.forename: Ke
authors.initials: K
authors.lastname: Chen
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D006528:Carcinoma, Hepatocellular / Q000201:enzymology* / Q000601:surgery / Q000821:virology; D016009:Chi-Square Distribution; D051546:Cyclooxygenase 2 / Q000378:metabolism*; D005260:Female; D006498:Hepatectomy; D006509:Hepatitis B / Q000150:complications* / Q000201:enzymology*; D006801:Humans; D007150:Immunohistochemistry; D008103:Liver Cirrhosis / Q000201:enzymology* / Q000821:virology*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000201:enzymology* / Q000601:surgery / Q000821:virology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D014408:Biomarkers, Tumor; D051546:Cyclooxygenase 2