title: Expression of cyclooxygenase-2 has no impact on survival in adenocarcinoma of the esophagogastric junction but is associated with favourable clinicopathologic features.
abstract: BACKGROUND
  COX-2 expression induces carcinogenesis and is thought to be an adverse prognostic factor in gastric carcinomas while the prognostic value of DNA mismatch repair (MMR) is still controversial. Concerning adenocarcinomas of the esophagogastric junction, no comprehensive data regarding either factors are available as of yet.
  
  
  OBJECTIVE
  We assessed expression of COX-2, MLH1 and MSH2 in adenocarcinoma of the esophagogastric junction in relation to patients' survival and various clinicopathologic features.
  
  
  METHODS
  Immunohistochemical studies (using antibodies against COX-2, MLH1 and MSH2) were performed in a study population of 228 tumours. Follow-up data was available for all patients with a mean follow-up time of 42.8 months.
  
  
  RESULTS
  78 (34.2%) tumours were COX-2 negative, 148 (64.9%) showed COX-2 positivity. Assessment of COX-2 expression and clinicopathologic features revealed an inverse correlation with depth of tumour invasion and number of metastatic lymph nodes (p=0,021 and p=0,004, respectively). No correlation with other features could be demonstrated. 62 cases (27.2%) showed loss of DNA repair enzymes MLH1 and/or MSH2. MMR differed significantly between COX-2 positive and negative cases (p=0,028). Kaplan-Meier survival analyses revealed no impact on patients' survival for COX-2 expression or MMR status (p=0.837 and p=0.972, respectively).
  
  
  CONCLUSIONS
  Expression of COX-2 in adenocarcinomas of the esophagogastric junction seems to have no prognostic effect or impact on patients' survival but is associated with favourable clinicopathologic factors. MMR deficiency was more frequent in COX-2 negative tumours, but MMR status had no impact on survival and patients' outcome whatsoever.
authors.affiliation: Department of Pathology, Section of Hematopathology and Endocrine Pathology, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany. Juliana.Knief@uksh.de.
authors.forename: Juliana
authors.initials: J
authors.lastname: Knief
authors.affiliation: Department of Pathology, Section of Hematopathology and Endocrine Pathology, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Reddemann
authors.affiliation: Department of Surgery, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
authors.forename: Ekaterina
authors.initials: E
authors.lastname: Petrova
authors.affiliation: Department of Pathology, Section of Hematopathology and Endocrine Pathology, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Herhahn
authors.affiliation: Department of Surgery, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Wellner
authors.affiliation: Department of Pathology, Section of Hematopathology and Endocrine Pathology, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Thorns
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics* / Q000473:pathology; D000368:Aged; D051546:Cyclooxygenase 2 / Q000096:biosynthesis* / Q000235:genetics*; D053843:DNA Mismatch Repair; D004938:Esophageal Neoplasms / Q000235:genetics* / Q000473:pathology; D004943:Esophagogastric Junction / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D046228:Microarray Analysis; D008875:Middle Aged; D000070957:MutL Protein Homolog 1 / Q000096:biosynthesis / Q000235:genetics; D051718:MutS Homolog 2 Protein / Q000096:biosynthesis / Q000235:genetics; D011379:Prognosis; D013274:Stomach Neoplasms / Q000235:genetics* / Q000473:pathology; D016019:Survival Analysis
chemical_list: C501486:MLH1 protein, human; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; C497172:MSH2 protein, human; D000070957:MutL Protein Homolog 1; D051718:MutS Homolog 2 Protein