Journal
TUMOR BIOLOGY
Volume 31, Issue 1, Pages 1-7Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1007/s13277-009-0001-4
Keywords
COX-2; p53; Gastric cancer; Multivariate analysis; Survival
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Funding
- Finnish Cancer Society
- Finska Lakares llskapet
- Medicinska Understodsforeningen Liv och Halsa
- Helsinki University Research Funds
- Helsinki University's Research Funds
- Academy of Finland
- Sigrid Juselius Foundation
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Cyclooxygenase-2 (COX-2) is an important factor in gastric carcinogenesis, and COX-2 expression in gastric cancer patients correlates with prognosis. We have now studied the impact of COX-2 in comparison to six other tissue tumor markers, DNA index, and S-phase fraction (SPF) in a large series of gastric cancer specimens. From 342 consecutive patients, 337 archival tissue specimens were available for immunohistochemistry of COX-2, HuR, cyclin A, MMP-2, p53, p21, and Ki-67 and 313 for analysis of DNA index and S-phase fraction by flow cytometry. Associations between factors were assessed by chi-square test and survival analysis by the Kaplan-Meier method and Cox model. A significant association emerged between of COX-2 and p53 (p<0.0001), Ki-67 (p=0.013), DNA ploidy (p<0.0001), and SPF (p<0.0001). In an extended multivariate analysis, COX-2 and p53 expression were independent prognostic factors for poor survival, in addition to high stage and non-curative surgery. In gastric cancer, COX-2 expression associated with markers for apoptosis and proliferation, and furthermore, it was confirmed that COX-2 and p53 are strong prognostic indicators.
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