Expression of COX-2 in stomach cancers and its relation to their biological features

Background/Aim: Cyclooxygenase-2 (COX-2) is one of the key isoenzymes in the production of prostaglandins, and is believed to be involved in carcinogenesis. This study was conducted to examine the role of COX-2 in the development and biological behavior of stomach cancer. Methods: Expression of COX-2 at the mRNA and protein levels was analyzed using RT-PCR and immunoblotting assay in 50 cancerous and corresponding non-cancerous tissue specimens. Also, COX-2 expression was detected by an immunohistochemical method in 55 paraffin-embedded gastric adenocarcinoma tissues. Results: Of the 50 carcinoma tissue samples analyzed, 38 (76.0%) had overexpression of COX-2 as compared to the paired non-cancerous specimens. The overexpression of COX-2 (91.7%) was more prevalent in tumors with sizes of >5 cm than those (61.5%) of less than or equal to5 cm (p < 0.05). COX-2 overexpression was higher in tumors with >6 metastatic nodes compared to those with less than or equal to6 metastatic nodes (100.0 vs. 61.3%, p < 0.01). The rate of COX-2 overexpression in non-signet ring cell carcinoma was significantly higher compared with signet ring cell carcinoma (84.1 vs. 16.7%, p < 0.05). The rate of COX-2 overexpression (86.8 or 90.9%) in patients with a cancer invasion depth of pT3 + pT4 or with stage III + IV was significantly higher than that (41.7 or 47.1%) in patients with pT1 + pT2 or with stage I + II (both p < 0.01). Furthermore, consistent with the results at the protein and mRNA levels, immunohistochemical stain indicated that COX-2 protein was overexpressed in 39 of 55 (70.9%) carcinomas, and the 5-year survival rate (25.6%) for patients with COX-2 overexpression seemed better than that (50.0%) of patients without overexpression, though the difference was not significant (p < 0.05). Conclusion: Our results indicate that COX-2 may play a role in the development of gastric cancer and its overexpression is associated with lymphatic metastasis, tumor invasion and differentiation of gastric Copyright (C) 2003 S. Karger AG, Basel.