title: Cyclooxygenase-2 expression as a predictor of outcome in colorectal carcinoma.
abstract: OBJECTIVE
  To correlate cyclooxygenase-2 (COX-2) expression profile with clinical and pathological variables to assess their prognostic/predictive value in colorectal carcinoma (CRC).
  
  
  METHODS
  Archival tumor samples were analyzed using immunohistochemistry for COX-2 expression in 94 patients with CRC. Patients were diagnosed and treated at the Departments of Surgery and Oncology, King Abdulaziz University Hospital, Saudi Arabia.
  
  
  RESULTS
  Fifty-six percent of the tumors showed positive cytoplasmic COX-2 expression, whereas 44% of cases were completely COX-2-negative. There were no significant correlations between COX-2 expression and sex, age, grade or tumor location. However, COX-2 expression revealed a significant correlation with tumor stage (P = 0.01) and distant metastasis (P = 0.02), and a borderline association with lymph node involvement (P = 0.07). Tumors with high COX-2 expression showed a higher recurrence rate than tumors with no expression (P < 0.009). In univariate Kaplan-Meier survival analysis, there was a significant (P = 0.026) difference in disease-free survival between COX-2-positive and negative tumors in favor of the latter. COX-2 expression did not significantly predict disease-specific survival, which was much shorter for COX-2-positive tumors. In multivariate (COX) models, COX-2 did not appear among the independent predictors of disease-free survival or disease-specific survival.
  
  
  CONCLUSIONS
  COX-2 expression seems to provide useful prognostic information in CRC, while predicting the patients at high risk for recurrent disease.
authors.affiliation: Department of Pathology, King Abdulaziz University, Jeddah 21589, Saudi Arabia. jalmaghrabi@hotmail.com
authors.forename: Jaudah
authors.initials: J
authors.lastname: Al-Maghrabi
authors.forename: Abdelbaset
authors.initials: A
authors.lastname: Buhmeida
authors.forename: Eman
authors.initials: E
authors.lastname: Emam
authors.forename: Kari
authors.initials: K
authors.lastname: Syrjänen
authors.forename: Abdulrahman
authors.initials: A
authors.lastname: Sibiany
authors.forename: Mohmmad
authors.initials: M
authors.lastname: Al-Qahtani
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Al-Ahwal
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000201:enzymology* / Q000401:mortality / Q000473:pathology; D051546:Cyclooxygenase 2 / Q000032:analysis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis
chemical_list: D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human