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Prognostic role of cyclooxygenase‐2 in neoadjuvant‐treated patients with squamous cell carcinoma of the esophagus
Author(s) -
Sivula Anna,
Buskens Christianne J.,
van Rees Bastiaan P.,
Haglund Caj,
Offerhaus G. Johan A.,
van Lanschot J. Jan B.,
Ristimäki Ari
Publication year - 2005
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.21134
Subject(s) - medicine , esophagus , chemotherapy , immunohistochemistry , proportional hazards model , oncology , neoadjuvant therapy , carcinoma , adenocarcinoma , esophageal disease , gastroenterology , cyclooxygenase , pathology , cancer , biology , biochemistry , breast cancer , enzyme
Based on our previous demonstration that elevated cyclooxygenase‐2 (COX‐2) expression is a prognostic factor for reduced survival in patients with adenocarcinoma of the esophagus, the aim of our study was to analyze the role of COX‐2 expression in esophageal squamous cell carcinoma. We analyzed COX‐2 protein expression from 117 consecutive patients by immunohistochemistry using a COX‐2 specific monoclonal antibody. Eighty‐one patients had not received any therapy before surgery whereas 36 patients received neoadjuvant chemotherapy as part of a randomized controlled trial. In the patients who received no chemotherapy, COX‐2 expression was low in 75% and high in 25% of the specimens. In this patient group, high COX‐2 expression associated with distal location of the tumor ( p = 0.02), but did not correlate with any other clinicopathological parameter tested, including overall survival. In the patient group who received neoadjuvant chemotherapy, postoperative COX‐2 expression was low in 69% and high in 31%. Interestingly, in this patient group low COX‐2 expression correlated with development of distant metastases ( p = 0.03) and to reduced overall survival ( p = 0.02). Our results show that the prognostic significance of COX‐2 depends on the histological type of esophageal carcinoma and preoperative treatment of the patient. In conclusion, COX‐2 is not a prognostic marker in squamous cell carcinoma of the esophagus, but low COX‐2 expression is associated with poor prognosis in the neoadjuvant‐treated patients. © 2005 Wiley‐Liss, Inc.