Role of COX2 as a Biomarker for Estimating Survival of Patients With Clinical Stage I Gastric Cancer

Abstract

Background/Aim: The prognostic significance of biomarkers related to gastric cancer prognosis has not been fully elucidated. The aim of study was to use immunohistochemical biomarkers to reveal prognosis. Patients and Methods: A total of 682 patients who had undergone curative surgery were evaluated regarding the correlation of prognosis and immunohistochemical biomarkers. Results: The COX2-positive groups showed a poor 5-year overall and disease-free survival. Further analysis revealed that COX2 positivity was a significant risk factor for poorer disease-free survival in the group with clinical stage I disease (p=0.016). We also noted a marked trend between COX2 positivity and poorer overall survival. The COX2-positive group showed general postoperative pathological up-staging compared with the COX2-negative group. Conclusion: This study showed the potential of COX2 as a biomarker for gastric cancer prognosis. Preoperative evaluation of COX2 might be a useful tool for generating optimal treatment strategies in patients with clinical stage I gastric cancer.Despite the therapeutic advancements that have been made in recent years, in 2015, gastric cancer was ranked the fifth most common cancer and was third in terms of cancerrelated deaths (1). After patients with gastric cancer have received appropriate local treatment (e.g. endoscopic submucosal dissection and extended gastrectomy), it is common for the cancer to relapse, thereby necessitating further treatment. In some cases, cancer diagnosis is misjudged and underestimated, resulting in insufficient treatment (2). To overcome this issue, various biomarkers that may help to estimate prognosis regardless of pathological stage have been studied. Some gastric cancer biomarkers, mostly related to cell proliferation and apoptosis, have been identified (3,4). Since classic clinicopathological features cannot fully predict individual outcomes, it has been argued that molecular biomarkers might potentially be better prognostic traits for gastric cancer.Studies on the prognostic significance of different molecular markers have included tumor protein 53 (p53), which has been proven to have a significant association with cancer mortality rates (3, 5). Interestingly, Li et al. have shown that co-expression of two or more markers, including Ki67, a nuclear protein which is involved in proliferation, has a significant detrimental effect on the survival of patients with gastric cancer (6). Furthermore, cyclo-oxygenase-2 (COX2) has been linked to tumorigenesis, and much of the literature suggests that increased COX2 activity is related to more advanced stages of cancer (7). However, whether COX2 can be used as an independent prognostic factor in gastric cancer is still controversial (8).The use of biomarkers as a tool for preoperative prognosis prediction and its implications have not yet been fully studied. In current clinical circumstances, immunohistochemistry is the main method used to examine postoperative specimens. In this study, we reinvestigated the potential prognosti...

First study on the immunohistochemical expression of cyclooxygenase-2 and clinicopathological association in canine hepatoid gland neoplasms

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Clinical Significance of PLA2G2A Expression in Gastric Cancer Patients who Receive Gastrectomy and Adjuvant S-1

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