Comparison of cyclooxygenase 2 expression in adenocarcinomas of the gastric cardia and distal oesophagus
Comparison of cyclooxygenase 2 expression in adenocarcinomas of the gastric cardia and distal oesophagus
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DOI：
10.1136/gut.52.12.1678
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发表时间：
2003-12-01
期刊：
影响因子：
24.5
通讯作者：
Ristimäki, A
中科院分区：
文献类型：
--
作者：
Buskens, CJ;Sivula, A;Ristimäki, A
背景资料：贲门腺癌和食管远端腺癌目前通常被认为是一个临床实体，因为它们的发病率、预后和最佳治疗选择相当。目的：探讨贲门癌组织中环氧合酶2（cyclooxygenase 2，考克斯-2）的表达及其与临床病理参数和生存期的关系。结果进行了比较与预后价值的考克斯-2发现Barrett carcinomas.Methods：肿瘤切片的134例连续患者进行潜在的根治性手术的贲门腺癌和实质上侵犯远端食管进行了免疫化学染色使用考克斯-2单克隆抗体。结果：考克斯-2表达为阴性或弱的肿瘤占59%（“考克斯-2低”），中度或强的肿瘤占41%（“考克斯-2高”）。这显著低于Barrett癌（p< 0.0001）。考克斯-2表达与临床病理参数无关。升高的考克斯-2表达和减少生存之间的相关性，如巴雷特癌，没有确定为cardiancer.Conclusions：有一个差异，考克斯-2表达的强度和预后意义之间的贲门腺癌和远端食管。这表明这两种癌症的不同发病机制和不同的遗传构成。基于这些发现，选择性考克斯-2抑制剂在贲门腺癌治疗中的作用不如Barrett癌有希望。
Background: Adenocarcinomas of the gastric cardia and distal oesophagus are at present often considered as one clinical entity because of their comparable increasing incidence, prognosis, and optimal treatment options. However, it is still a matter of debate whether these malignancies have the same pathogenesis and genotype.Aims: The aim of this study was to analyse expression of cyclooxygenase 2 (COX-2) in cardia carcinomas, and correlate this expression with clinicopathological parameters and survival. The results were compared with the prognostic value of COX-2 found for Barrett carcinomas.Methods: Tumour sections of 134 consecutive patients undergoing potentially curative surgery for an adenocarcinoma of the gastric cardia and substantially invading the distal oesophagus were immunohistochemically stained using a COX-2 monoclonal antibody. Specimens were blindly scored based on intensity and extent of COX-2 immunopositivity.Results: COX-2 expression was negative to weak in 59% ("COX-2 low'') and moderate to strong in 41% ("COX-2 high'') of tumours. This was significantly lower than in Barrett carcinomas (p< 0.0001). COX-2 expression was not correlated with any clinicopathological parameter. A correlation between elevated COX-2 expression and reduced survival, as described for Barrett carcinomas, was not identified for cardiac carcinomas.Conclusions: There is a difference in COX-2 expression with respect to intensity and prognostic significance between adenocarcinomas of the gastric cardia and distal oesophagus. This suggests a different pathogenesis and different genetic constitution of these two cancers. Based on these findings, the role of selective COX-2 inhibitors in the treatment of adenocarcinomas of the gastric cardia is less promising than in Barrett carcinomas.