Brief Article
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World J Gastroenterol. Apr 21, 2012; 18(15): 1793-1799
Published online Apr 21, 2012. doi: 10.3748/wjg.v18.i15.1793
Cyclooxygenase-2 expression as a predictor of outcome in colorectal carcinoma
Jaudah Al-Maghrabi, Abdelbaset Buhmeida, Eman Emam, Kari Syrjänen, Abdulrahman Sibiany, Mohmmad Al-Qahtani, Mahmoud Al-Ahwal
Jaudah Al-Maghrabi, Eman Emam, Department of Pathology, King Abdulaziz University, Jeddah 21589, Saudi Arabia
Jaudah Al-Maghrabi, Abdelbaset Buhmeida, Mohmmad Al-Qahtani, Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah 21589, Saudi Arabia
Kari Syrjänen, Department of Oncology and Radiotherapy, Turku University Hospital, T-Hospital (Administration), FIN-20521 Turku, Finland
Abdulrahman Sibiany, Department of Surgery, King Abdulaziz University, Jeddah 21589, Saudi Arabia
Mahmoud Al-Ahwal, Department of Medicine, Scientific Chair for Colorectal Cancer, King Abdulaziz University, Jeddah 21589, Saudi Arabia
Author contributions: Al-Maghrabi J and Buhmeida A contributed equally to this work and performed the research; Emam E performed the research and immunohistochemistry; Al-Ahwal M designed the research and collected the clinical data; Sibiany A collected the clinical data; Al-Qahtani M contributed new reagents/analytic tools; Syrjänen K analyzed the data; Buhmeida A, Syrjänen K and Al-Maghrabi J drafted the manuscript.
Supported by Scientific Chair for Colorectal Cancer, King Abdul-Aziz University, Jeddah, Saudi Arabia
Correspondence to: Jaudah Al-Maghrabi, Professor, Department of Pathology King Abdulaziz University, PO Box 80205, Jeddah 21589, Saudi Arabia. jalmaghrabi@hotmail.com
Telephone: +966-2-6401000-17069 Fax: +966-2-6401000-17223
Received: May 24, 2011
Revised: September 20, 2011
Accepted: February 27, 2012
Published online: April 21, 2012
Abstract

AIM: To correlate cyclooxygenase-2 (COX-2) expression profile with clinical and pathological variables to assess their prognostic/predictive value in colorectal carcinoma (CRC).

METHODS: Archival tumor samples were analyzed using immunohistochemistry for COX-2 expression in 94 patients with CRC. Patients were diagnosed and treated at the Departments of Surgery and Oncology, King Abdulaziz University Hospital, Saudi Arabia.

RESULTS: Fifty-six percent of the tumors showed positive cytoplasmic COX-2 expression, whereas 44% of cases were completely COX-2-negative. There were no significant correlations between COX-2 expression and sex, age, grade or tumor location. However, COX-2 expression revealed a significant correlation with tumor stage (P = 0.01) and distant metastasis (P = 0.02), and a borderline association with lymph node involvement (P = 0.07). Tumors with high COX-2 expression showed a higher recurrence rate than tumors with no expression (P < 0.009). In univariate Kaplan-Meier survival analysis, there was a significant (P = 0.026) difference in disease-free survival between COX-2-positive and negative tumors in favor of the latter. COX-2 expression did not significantly predict disease-specific survival, which was much shorter for COX-2-positive tumors. In multivariate (COX) models, COX-2 did not appear among the independent predictors of disease-free survival or disease-specific survival.

CONCLUSION: COX-2 expression seems to provide useful prognostic information in CRC, while predicting the patients at high risk for recurrent disease.

Keywords: Colorectal carcinoma; Cyclooxygenase-2; Immunohistochemistry; Disease outcome; Adjuvant therapy