The Relationship of Cyclooxygenase -2 (COX-2) Expression with Clinical Presentation, Staging, and Degree of Differentiation in Colorectal Cancer

Ibrahim Labeda, Julianus A Uwuratuw, Berti Nelwan, Prihantono Prihantono


Colorectal cancer (CRC) is a common malignancy worldwide. Although the recent development of adjuvant treatment has developed rapidly, it has only slightly Increased the survival rate of CRC Patients in an advanced stage. The prognosis of CRC patient strongly influenced by Several factors, such as tumor stage, clinical manifestations, histopathology and molecular oncogenicity of the tumor. COX-2 is an enzyme that plays a role in converting arachidonic acid into prostaglandins. The end product of COX-2 contributes to various biological factors in triggering tumor growth. The purpose of this research is to know the relationship of COX-2 expression with the clinical presentation such as patient age, location, and size of the tumor and histopathology in CRC patients.  Fifty-eight CRC Patients included in the study; the research ranges from December 2016 to February 2017.

The assessment of the COX-2 protein using the Immunohistochemistry methods, Dako polyclonal antibody, a semi-quantitatively. We Consider positive COX-2 when the score 2-3, negative if the score is 0-1. The subjects of this study consisted of 55.2% men and 44.8% women with a mean age of 57 years. There was no significant difference between COX-2 expression and age group <65 vs.> 65 years, and tumor location with p = 0.437 and p = 0.719. There was a significant relationship between COX-2 expression and tumor size (p <0.01) in, wherein the percentage of positive COX-2 expression on tumor size> 3 cm is higher than the negative expression (100% vs. 75%, p = 0.007 ). There was a significant relationship between COX-2 expression and degree of differentiation, in the which, the percentage of positive COX-2 expression was Significantly higher in moderate differentiation and well differentiation (78.9% and 10.9%) Compared with negative expression (50.0% and 8, 3%), with p = 0.042. The relationship between CRC staging and histopathology type with COX-2 expression was not found statistically significant with p = 0.588 and p = 0.100.

This study reported a significant relationship between COX-2 expression and patient's tumor size and the degree of differentiation of CRC Patients, but not with age, tumor location and TNM stage.



Colorectal Cancer; COX-2; Immunohistochemistry; Expression; Differentiation; Stage.


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