title: Urinary prostaglandin E2 metabolite and risk for colorectal adenoma.
abstract: COX-2 is upregulated in most colorectal cancers. Most of the COX-2 tumor-inducing effects are believed to be mediated through overproduction of prostaglandin E(2) (PGE(2)), which can be measured using a urinary metabolite of PGE(2), PGE-M. Urinary PGE-M was assessed in a case-control study of colorectal adenoma. Included in the analysis were 224 cases with at least one advanced adenoma, 152 cases with multiple small tubular adenomas, 300 cases with only a single small tubular adenoma, and 364 polyp-free controls. There were no statistical differences in PGE-M levels between controls and cases with a single small tubular adenoma. However, cases with either an advanced adenoma or multiple small tubular adenomas had more than 25% higher levels of PGE-M than controls. Participants with the highest quartile level of PGE-M were approximately 2.5-fold more likely to have advanced or multiple small tubular adenoma in comparison with those with the lowest level of PGE-M [OR = 2.53; 95% confidence interval (CI), 1.54-4.14; P(trend) < 0.001]. The association was strongest among women. PGE-M level was associated with increased risk for multiple or advanced adenoma but not single small adenoma. Our study suggests that PGE-M may be a useful risk marker for assessing the risk of harboring clinically more important versus less important colorectal neoplasia.
authors.affiliation: Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37203, USA. martha.shrubsole@vanderbilt.edu
authors.forename: Martha J
authors.initials: MJ
authors.lastname: Shrubsole
authors.forename: Qiuyin
authors.initials: Q
authors.lastname: Cai
authors.forename: Wanqing
authors.initials: W
authors.lastname: Wen
authors.forename: Ginger
authors.initials: G
authors.lastname: Milne
authors.forename: Walter E
authors.initials: WE
authors.lastname: Smalley
authors.forename: Zhi
authors.initials: Z
authors.lastname: Chen
authors.forename: Reid M
authors.initials: RM
authors.lastname: Ness
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
mesh_terms: D000236:Adenoma / Q000209:etiology / Q000652:urine*; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000652:urine*; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000209:etiology / Q000652:urine*; D051546:Cyclooxygenase 2 / Q000378:metabolism; D015232:Dinoprostone / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011453:Prostaglandins / Q000652:urine*
chemical_list: D014408:Biomarkers, Tumor; D011453:Prostaglandins; C060526:7-hydroxy-5,11-dioxotetranorprostane-1,16-dioic acid; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D015232:Dinoprostone