title: Prognostic significance of expression of cysteine-rich 61 and cyclooxygenase-2 in gastric cancer.
abstract: BACKGROUND
  This study aimed to evaluate the clinical significance of cysteine-rich 61 (Cyr-61/CCN1) and cyclooxygenase-2 (COX-2), and further explored their combined prognostic significance in gastric cancer.
  
  
  METHODS
  This retrospective study examined the expressions of Cyr-61 and COX-2 in 82 surgically removed gastric cancer specimens and 43 non-tumor gastric mucosa specimens by immunohistochemical staining to identify the abnormal expression of Cyr-61 or COX-2 in gastric cancer. Crude survival curves were constructed by the Kaplan-Meier method and Cox proportional hazards regression analysis was performed to confirm the prognostic roles of Cyr-61/COX-2 as well as sex and histological grade.
  
  
  RESULTS
  The expressions of Cyr-61 (p < 0.001) and COX-2 (p = 0.001) were both significantly up-regulated in gastric cancer samples compared with non-tumor gastric mucosa samples. The high expression of Cyr-61 or COX-2 was associated with invasion, lymph node metastasis, distant metastases, poor histological differentiation, advanced TNM stage and lower 5-year survival rate (all p < 0.05). Both Cyr-61 and COX-2 high expressions [hazard ratio (HR) = 31.8, 95 % confidence interval (CI) 4.09-246.8] was associated the higher risk of death during 5 years follow up than single Cyr-61 high expression (HR = 4.1, 95 % CI 1.5-11.6) or COX-2 high expression (HR = 2.9, 95 % CI 1.06-7.8).
  
  
  CONCLUSIONS
  Cyr-61 and COX-2 expressions are associated with the progression of gastric cancer. Additionally, combined expressions of Cyr-61 and COX-2 has a higher prognostic value than single expression.
authors.affiliation: Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, 110004, China. 02amy@sina.com.
authors.forename: Yan
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
authors.forename: Mengchun
authors.initials: M
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D051546:Cyclooxygenase 2 / Q000378:metabolism*; D055515:Cysteine-Rich Protein 61 / Q000378:metabolism*; D005260:Female; D005753:Gastric Mucosa / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology*
chemical_list: C501848:CCN1 protein, human; D055515:Cysteine-Rich Protein 61; D051546:Cyclooxygenase 2
keywords: Cyclooxygenase-2; Cysteine-rich 61; Gastric cancer; Prognostic significance