title: Esophageal COX-2 expression is increased in Barrett's esophagus, obesity, and smoking.
abstract: BACKGROUND
  Increased esophageal cyclooxygenase-2 (COX-2) expression has been associated with Barrett's esophagus (BE); however, it is unknown whether COX-2 expression varies among patient groups with different clinical or socio-demographic factors.
  
  
  METHODS
  We conducted a case-control study among eligible patients scheduled for elective esophagogastroduodenoscopy and patients eligible for screening colonoscopy recruited from primary clinics. We compared 39 BE tissue samples and 47 squamous tissue samples from BE cases and 240 squamous tissue samples from controls. Clinical and socio-demographic data were prospectively collected. Immunohistochemical staining for esophageal COX-2 was performed and scored.
  
  
  RESULTS
  The median COX-2 score was significantly higher in BE tissue than squamous tissue from cases or controls (p < 0.001). Median COX-2 expression levels were higher in tissue samples from participants with a waist-to-hip ratio (WHR) in the 2nd tertile [unadjusted odds ratio (OR) 2.04; 95 % confidence interval (95 % CI) 1.17-3.57] and 3rd tertile (unadjusted OR 2.24; 95 % CI 1.20-4.16) compared with the 1st tertile and from current smokers compared with former or non-smokers (unadjusted OR 1.68; 95 % CI 1.03-2.75). In the multivariate analysis, WHRs in the 2nd tertile (OR 1.92; 95 % CI 1.07-3.45) and the 3rd tertile (OR 2.14; 95 % CI 1.10-4.16) were associated with high COX-2 compared with the 1st tertile, as was current smoking (OR 1.78; 95 % CI 1.06-2.97) compared with former and non-smoking.
  
  
  CONCLUSIONS
  We found a significant association between elevated esophageal mucosa COX-2 levels and the presence of BE tissue, as well as between elevated COX-2 levels and high WHR and current tobacco smoking. This information may assist in identifying patients likely to benefit from chemoprevention with COX-2 inhibitors.
authors.affiliation: Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC 152), 2002 Holcombe Blvd., Houston, TX, 77030, USA.
authors.forename: Theresa
authors.initials: T
authors.lastname: Nguyen
authors.forename: Zhouwen
authors.initials: Z
authors.lastname: Tang
authors.forename: Mamoun
authors.initials: M
authors.lastname: Younes
authors.forename: Abeer
authors.initials: A
authors.lastname: Alsarraj
authors.forename: David
authors.initials: D
authors.lastname: Ramsey
authors.forename: Stephanie
authors.initials: S
authors.lastname: Fitzgerald
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Kramer
authors.forename: Hashem B
authors.initials: HB
authors.lastname: El-Serag
mesh_terms: D000368:Aged; D001471:Barrett Esophagus / Q000378:metabolism*; D016022:Case-Control Studies; D051546:Cyclooxygenase 2 / Q000378:metabolism*; D004947:Esophagus / Q000201:enzymology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism*; D012907:Smoking / Q000378:metabolism*
chemical_list: D051546:Cyclooxygenase 2