title: Physical activity, tumor PTGS2 expression, and survival in patients with colorectal cancer.
abstract: BACKGROUND
  Higher levels of physical activity are associated with lower colorectal carcinoma incidence and mortality, perhaps through influencing energy balance, cellular prosta7 systemic inflammation. Although evidence suggests interactive effects of energetics, sedentary lifestyle, and tumor CTNNB1 (β-catenin) or CDKN1B (p27) status on colon cancer prognosis, interactive effects of physical activity and tumor PTGS2 (the official symbol for COX-2) status on clinical outcome remain unknown.
  
  
  METHODS
  Using molecular pathological epidemiology database of 605 stage I-III colon and rectal cancers in two prospective cohort studies (the Nurse's Health Study and the Health Professionals Follow-up Study), we examined patient survival according to postdiagnosis physical activity and tumor PTGS2 status (with 382 PTGS2-positive and 223 PTGS2-negative tumors by immunohistochemistry). Cox proportional hazards models were used to calculate colorectal cancer-specific mortality HR, adjusting for clinical and other tumor variables including microsatellite instability status.
  
  
  RESULTS
  Among PTGS2-positive cases, compared with the least active first quartile, the multivariate HRs (95% confidence interval) were 0.30 (0.14-0.62) for the second, 0.38 (0.20-0.71) for the third, and 0.18 (0.08-0.41) for the fourth quartile of physical activity level (Ptrend = 0.0002). In contrast, among PTGS2-negative cases, physical activity level was not significantly associated with survival (Ptrend = 0.84; Pinteraction = 0.024, between physical activity and tumor PTGS2 status).
  
  
  CONCLUSIONS
  Postdiagnosis physical activity is associated with better survival among patients with PTGS2-positive tumors but not among patients with PTGS2-negative tumors.
  
  
  CONCLUSIONS
  Immunohistochemical PTGS2 expression in colorectal carcinoma may serve as a predictive biomarker in pathology practice, which may predict stronger benefit from exercise.
authors: Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02215, USA.
authors: Mai
authors: M
authors: Yamauchi
authors: Paul
authors: P
authors: Lochhead
authors: Yu
authors: Y
authors: Imamura
authors: Aya
authors: A
authors: Kuchiba
authors: Xiaoyun
authors: X
authors: Liao
authors: Zhi Rong
authors: ZR
authors: Qian
authors: Reiko
authors: R
authors: Nishihara
authors: Teppei
authors: T
authors: Morikawa
authors: Kaori
authors: K
authors: Shima
authors: Kana
authors: K
authors: Wu
authors: Edward
authors: E
authors: Giovannucci
authors: Jeffrey A
authors: JA
authors: Meyerhardt
authors: Charles S
authors: CS
authors: Fuchs
authors: Andrew T
authors: AT
authors: Chan
authors: Shuji
authors: S
authors: Ogino
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000401:mortality* / Q000628:therapy; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism*; D015179:Colorectal Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000628:therapy; D051546:Cyclooxygenase 2 / Q000378:metabolism*; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D051176:beta Catenin / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D051176:beta Catenin; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human
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