Role of COX-2 in carcinogenesis of colorectal cancer and its relationship with tumor biological characteristics and patients' prognosis

AIM: Recent clinical epidemiological studies havedemonstrated the preventive effect of non-steroidal anti-inflammatory drugs (NSAIDs) against colorectal cancer.The underlying mechanism might be the inhibition of rate-limiting enzyme cyclooxygenase-2 (COX-2) in metabolismof arachidonic acid. The role of COX-2 in carcinogenesisof colorectal cancer and its relationship with tumorbiological characteristics and patients′ prognosis stillremain unclear. This study was to investigate the role ofCOX-2 expression in carcinogenesis of colorectal cancerand its relationship with tumor biological characteristicsand patients′ prognosis.METHODS: A total of 139 colorectal cancers and 19adenomas surgically treated in School of Oncology, PekingUniversity, from January 1993 to September 2001 wereretrospectively studied. COX-2 expression was detected withtissue microarray (TMA) and immunohistochemistry (IHC)procedure. The association between COX-2 expression andclinicopathological features and its influence on patients′prognosis were studied.RESULTS: COX-2 expression was strong in colorectal cancer,moderate in adenoma and weak in normal mucosa, whichdemonstrated statistically significant difference (x2=46.997,P＜0.001). COX-2 expression had no association withclinicopathological features such as gross type,differentiation, invasion depth, vessel emboli and TNMstaging. Cox proportional hazards modeling analysis and Logrank test revealed no prognostic role of COX-2 expressionin colorectal cancer patients.CONCLUSION: COX-2 may play an important role in theearly stage of carcinogenesis, and its expression in colorectalcancer is not associated with clinicopathological features and patients′ prognosis.

COX-2 expression and tumor angiogenesis in colorectal cancer

AIM: Cyclooxygenase-2 (COX-2) is one of the rate-limiting enzymes in metabolism of arachidonic acid, and COX-2 inhibitors demonstrate preventive effects on cancer,especially on colorectal cancer. The underlying mechanism remains unclear. The aim of this study was to illustrate the relationship between angiogenesis and COX-2 in carcinogenesis of colorectal cancer.METHODS: One hundred and seventy patients with colorectal cancer were enrolled in our study from January 1993 to September 2001 in School of Oncology, PekingUniversity. COX-2 and VEGF expression were detected with the immunohistochemistry (IHC) technique. IHC assays were carried out with the aid of tissue microarray (TMA)procedure. Specimens from 35 of these patients were examined with reverse transcriptase PCR (RT-PCR).RESULTS: COX-2 and VEGF expressions were stronger in colorectal cancer than those in the corresponding normal tissues, at both protein and mRNA levels. One hundred patients were eligible for analysis after IHC assay of COX-2 and VEGF. The positive rate of VEGF was much higher in COX-2 positive group (47/85) than in COX-2 negative group (x^2 = 4.181, P= 0.041). The result was further verified by the result of RT-PCR (x^2 = 8.517, P = 0.003). Correlation coefficient was 0.409 after Spearman correlation analysis (P=0.015).CONCLUSION: COX-2 may be involved in the course of tumor angiogenesis of colorectal cancer and acts through VEGF.