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Open Access Research article

Prognostic significance of cyclooxygenase-2 (COX-2) expression in patients with surgically resectable adenocarcinoma of the oesophagus

Pradeep Bhandari1*, Adrian C Bateman2, Raj L Mehta3, Bernard SF Stacey1, Penny Johnson4, Ian A Cree4, Federica Di Nicolantonio4 and Praful Patel1

Author Affiliations

1 Department of Gastroenterology, Southampton University Hospital, Southampton, SO166YD, UK

2 Department of Cellular Pathology, Southampton University Hospital, Southampton, SO166YD, UK

3 Medical Statistics, Southampton University Hospital, Southampton, SO166YD, UK

4 Translational Oncology Research Centre, Queen Alexandra Hospital, Portsmouth. PO6 3LY, UK

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BMC Cancer 2006, 6:134  doi:10.1186/1471-2407-6-134

Published: 19 May 2006

Abstract

Background

COX-2 expression in tumour cells has been associated with poor prognosis in gastrointestinal and non-gastrointestinal cancers. The aim of our study was to test the hypothesis that higher levels of COX-2 expression are prognostically related to poor clinico-pathologic features in adenocarcinoma of the oesophagus.

Methods

We reviewed the records of 100 consecutive patients undergoing resection for adenocarcinoma of the oesophagus to collect data on T-stage, N-stage, tumour recurrence and survival. T & N-stage was further confirmed by histological examination. COX-2 protein expression was assessed by immunohistochemistry in all patients and COX-2 m-RNA expression was measured by quantitative RT-PCR in a small group of patients.

Results

Higher levels of COX-2 expression were associated with higher T stage (p = 0.008), higher N stage (p = 0.049), increased risk of tumour recurrence (p = 0.01) and poor survival (p = <0.001). A COX-2 score of >200 was associated with a median survival of 10 months compared to 26 months with a score of <200 (p = <0.001).

Conclusion

Higher levels of COX-2 expression are associated with poor clinico-pathologic features and poor survival in patients with oesophageal adenocarcinoma.