Cyclooxygenase-2 expression in the Barrett's metaplasia–dysplasia–adenocarcinoma sequence


OBJECTIVE:Increased expression of the inducible cyclooxygenase 2 (COX-2) enzyme has been detected in esophageal and colonic adenocarcinoma, and intake of aspirin and nonsteroidal anti-inflammatory drugs, known COX-2 inhibitors, have been associated with reduced tumor formation. Elevated COX-2 mRNA but variable protein expression has been demonstrated in Barrett's epithelium, and we have, therefore, sought to evaluate the expression of COX-2 protein throughout the Barrett's metaplasia–dysplasia–adenocarcinoma sequence.METHODS:Paraffin-embedded esophageal biopsies from 56 different patients with Barrett's esophagus were analyzed for COX-2 expression by immunohistochemistry. Twenty contained nondysplastic intestinal and gastric metaplasia, 12 demonstrated low-grade dysplasia (LGD), 12 high-grade dysplasia (HGD), and 12 contained invasive adenocarcinoma.RESULTS:Epithelial expression of COX-2 protein was detected in 75% (15/20) of benign cases, 83% (10/12) of cases with LGD, and 100% of cases with HGD or adenocarcinoma. Using a semiquantitative analysis, median staining scores for the groups were 2, 3, 14, and 13, respectively (scale 0–16), with the expression being significantly higher in the HGD and cancer groups compared to benign and LGD groups (p < 0.001).CONCLUSIONS:This study demonstrates clear COX-2 expression in the epithelial cells in Barrett's metaplasia, confirms elevated expression in adenocarcinoma, and shows that the elevation in expression occurs in the progression from LGD to HGD.

DOI: 10.1111/j.1572-0241.2001.03599.x


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@article{Morris2001Cyclooxygenase2EI, title={Cyclooxygenase-2 expression in the Barrett's metaplasia–dysplasia–adenocarcinoma sequence}, author={Clive D. Morris and Gordon R Armstrong and Graham Bigley and Helen Green and Stephen Edwin Arthur Attwood}, journal={American Journal of Gastroenterology}, year={2001}, volume={96}, pages={990-996} }