Cyclooxygenase-2 expression is associated with initiation of hepatocellular carcinoma, while prostaglandin receptor-1 expression predicts survival.
OBJECTIVE
To determine whether cyclooxygenase-2 (COX-2) and prostaglandin E1 receptor (EP1) contribute to disease and whether they help predict prognosis.


METHODS
We retrospectively reviewed the records of 116 patients with hepatocellular carcinoma (HCC) who underwent surgery between 2008 and 2011 at our hospital. Expression of COX-2 and EP1receptor was examined by immunohistochemistry of formalin-fixed, paraffin-embedded tissues using polyclonal antibodies. Possible associations between immunohistochemical scores and survival were determined.


RESULTS
Factors associated with poor overall survival (OS) were alpha-fetoprotein > 400 ng/mL, tumor size ≥ 5 cm, and high EP1receptor expression, but not high COX-2 expression. Disease-free survival was not significantly different between patients with low or high levels of COX-2 or EP1. COX-2 immunoreactivity was significantly higher in well-differentiated HCC tissues (Edmondson grade I-II) than in poorly differentiated tissues (Edmondson grade III-IV) (P= 0.003). EP1receptor immunoreactivity was significantly higher in poorly differentiated tissue than in well-differentiated tissue (P= 0.001).


CONCLUSIONS
COX-2 expression appears to be linked to early HCC events (initiation), while EP1receptor expression may participate in tumor progression and predict survival.
Hao-Jie Yang, Jing-Hang Jiang, Ya-Peng Qi, Bang-De Xiang, Le-Qun Li, Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Hao-Jie
HJ
Yang
Hao-Jie Yang, Jing-Hang Jiang, Ya-Peng Qi, Bang-De Xiang, Le-Qun Li, Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Jing-Hang
JH
Jiang
Hao-Jie Yang, Jing-Hang Jiang, Ya-Peng Qi, Bang-De Xiang, Le-Qun Li, Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Yu-Ting
YT
Yang
Hao-Jie Yang, Jing-Hang Jiang, Ya-Peng Qi, Bang-De Xiang, Le-Qun Li, Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Xiang-Di
XD
Yang
Hao-Jie Yang, Jing-Hang Jiang, Ya-Peng Qi, Bang-De Xiang, Le-Qun Li, Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Zhe
Z
Guo
Hao-Jie Yang, Jing-Hang Jiang, Ya-Peng Qi, Bang-De Xiang, Le-Qun Li, Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Ya-Peng
YP
Qi
Hao-Jie Yang, Jing-Hang Jiang, Ya-Peng Qi, Bang-De Xiang, Le-Qun Li, Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Feng-Hua
FH
Zeng
Hao-Jie Yang, Jing-Hang Jiang, Ya-Peng Qi, Bang-De Xiang, Le-Qun Li, Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Ke-Lan
KL
Zhang
Hao-Jie Yang, Jing-Hang Jiang, Ya-Peng Qi, Bang-De Xiang, Le-Qun Li, Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Neng-Zhi
NZ
Chen
Hao-Jie Yang, Jing-Hang Jiang, Ya-Peng Qi, Bang-De Xiang, Le-Qun Li, Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Bang-De
BD
Xiang
Hao-Jie Yang, Jing-Hang Jiang, Ya-Peng Qi, Bang-De Xiang, Le-Qun Li, Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China.
Le-Qun
LQ
Li
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000201:enzymology* / Q000401:mortality; D051546:Cyclooxygenase 2 / Q000096:biosynthesis* / Q000378:metabolism*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000201:enzymology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D058306:Receptors, Prostaglandin E, EP1 Subtype / Q000378:metabolism*; D012189:Retrospective Studies; D016896:Treatment Outcome
C545635:PTGER1 protein, human; D058306:Receptors, Prostaglandin E, EP1 Subtype; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human
Cyclooxygenase-2; Hepatocellular carcinoma; Liver resection; Prognosis; Prostaglandin E1 receptor