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

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 eoesophagus 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 immuncihistochemistry 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 clinico-pathologic features and poor survival in patients with oesophageal adenocarcinoma. © 2006 Bhandari et al; licensee BioMed Central Ltd.