BACKGROUND: Cyclooxygenase-2 (COX-2) is selectively over-expressed in colorectal tumours. The mechanism of COX-2 induction in these tumours is not fully understood, although evidence suggests a possible link between nuclear factor (NF)-kB and COX-2. We hypothesised an association between COX-2 expression and NF-kB-p65, NF-kB-p50 and IkB-kinase-a (IKKa) in both epithelial and stromal cells in human colorectal cancer. METHODS: Using immunohistochemistry, we measured COX-2, NF-kB-p65, NF-kB-p65 nuclear localisation sequence (NLS), NF-kBp50, NF-kB-p50 NLS and IKKa protein expression in matched colorectal biopsy samples comprising both non-tumour and adjacent tumour tissue from 32 patients with colorectal cancer. RESULTS: We have shown that stromal cells of malignant and surrounding normal colorectal tissue express COX-2. In all cell types of malignant tissue, and in vascular endothelial cells (VECs) of neighbouring normal tissue, COX-2 expression was strongly associated with NF-kB-p65 expression (Pearson's correlation, P ¼ 0.019 for macrophages, P ¼ 0.001 for VECs, P ¼ 0.002 for fibroblasts (malignant tissue), and P ¼ 0.011 for VECs (non-malignant tissue)) but not NF-kB-p50 or IKKa. CONCLUSIONS: These data suggest that in these cells COX-2 induction may be mediated through activation of the canonical NF-kB pathway. Finally, the lack of association between COX-2, NF-kB-p65 or IKKa in stromal cells with the clinical severity of colorectal cancer as determined by Duke's stage, suggests that COX-2, NF-kB-p65 and IKKa expression are possibly early post-initiation events, which could be involved in tumour progression.