Abdulrazaq Jimoh Ajanaku, Zakari Mohammed Aminu, Ibrahim Yusuf, Ahmad Hamza
Department of Pathology, Federal University of Health Sciences Azare, Azare 751101, Bauchi, Nigeria.
Department of Pathology, Aminu Kano Teaching Hospital, Kano 700101, Nigeria.
Ecancermedicalscience. 2024 Dec 6;18:1816. doi: 10.3332/ecancer.2024.1816. eCollection 2024.
cyclooxygenases-2 (COX-2) over-expression has been noticed in colorectal cancers (CRCs) with adverse outcomes, serving as a potential marker for prognosis, targeted therapy and as a window in CRC prevention. Unfortunately, there are scarce data regarding COX-2 expression in CRC in Africa where CRC incidence is on the increase with younger age affectation and unfavourable outcomes.
This retrospective study aims to determine the proportion of CRCs that over-express COX-2 and document any relationship between COX-2 over-expression with clinicopathological features such as histologic subtype, tumour grade, age and sex.
All the 139 CRCs that were histologically diagnosed at Aminu Kano Teaching Hospital over a 5-year period were included, but only 124 Formalin-fixed paraffin-embedded tissue blocks were sectioned and stained with COX-2 antibody. COX-2 expression was scored for distribution (no cells = 0, 1%-10% = 1, 11%-50% = 2, 51%-80% = 3, 81%-100% = 4) and intensity (no stain = 0; weak = 1; moderate = 2, strong = 3). The immunoreactive score (IRS) is a product of intensity (I) and distribution (D) as: 9-12 strongly +, 5-8 moderately +, 1-4 weakly + and 0 negative. Over-expression of COX-2 is an IRS of 5-12. Outcomes were statistically evaluated with clinicopathological data.
The CRCs occurred more commonly in males (M: F, 2:1), in the middle age group (mostly between 30 and 59 years), and 51.1% of cases occurred before 50 years and peaked in the 6th decade. Over-expression of COX-2 was observed in 46.8% (58/124) and was strongly associated with adenocarcinoma (ADC) not otherwise specified (NOS) (moderately and poorly differentiated tumours) but not with age or sex.
The over-expression of COX-2 was significantly associated with ADC NOS (moderately and poorly differentiated tumours), indicating that it may influence the outcome of CRCs with possible variation in tumour subtype.
环氧化酶-2（COX-2）在结直肠癌（CRC）中过度表达，与不良预后相关，可作为预后、靶向治疗的潜在标志物以及CRC预防的一个切入点。遗憾的是，在非洲，CRC发病率呈上升趋势，发病年龄趋于年轻化且预后不佳，关于CRC中COX-2表达的数据却很少。
这项回顾性研究旨在确定COX-2过度表达的CRC比例，并记录COX-2过度表达与组织学亚型、肿瘤分级、年龄和性别等临床病理特征之间的关系。
纳入了在5年期间于阿明努·卡诺教学医院经组织学诊断的所有139例CRC，但仅对124个福尔马林固定石蜡包埋组织块进行切片并用COX-2抗体染色。对COX-2表达进行分布评分（无细胞=0，1%-10%=1，11%-50%=2，51%-80%=3，81%-100%=4）和强度评分（无染色=0；弱=1；中度=2，强=3）。免疫反应评分（IRS）是强度（I）和分布（D）的乘积，即：9-12为强阳性，5-8为中度阳性，1-4为弱阳性，0为阴性。COX-2的过度表达是指IRS为5-12。结果与临床病理数据进行统计学评估。
CRC在男性中更为常见（男：女，2:1），发病年龄多在中年组（大多在30至59岁之间），51.1%的病例在50岁之前发病，在第六个十年达到高峰。46.8%（58/124）的病例观察到COX-2过度表达，且与未另行指定（NOS）的腺癌（ADC）（中分化和低分化肿瘤）密切相关，但与年龄或性别无关。
COX-2的过度表达与ADC NOS（中分化和低分化肿瘤）显著相关，表明它可能影响CRC的预后，肿瘤亚型可能存在差异。
