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Prognostic Value of Combined;Cox-2, Cyclin D1 and P21 Expression in Colorectal Cancer (CRC) Patients: An Immunohistochemical Study

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Open Journal of Pathology 2018年第3期8卷 106-121页

作者： Amir M. Salem Mariem A. Elfeky nashwa nawar Ahmed Z. Alattar Omar Atef Elekiabi Mostafa M. Elaidy Department of Pathology Faculty of Medicine Zagazig University Zagazig Egypt Department of Clinical Oncology and Nuclear Medicine Faculty of Medicine Zagazig University Zagazig Egypt Department of General Surgery Faculty of Medicine Zagazig University Zagazig Egypt

Background: Cyclooxygenase (COX) is a rate limiting enzyme in synthesis of prostanoids pathway and it has 2 isoforms (COX-1 and COX-2). It has many biological roles in inflammation and oncogenesis. Cox-2 was incriminated in performing disturbances in the cell cycle control in CRC, but its role of in CRC needs clarification of the mechanisms by which Cox-2 might affect the process of colorectal carcinogenesis. Cyclin D1 is an oncogene that regulates G1 phase progression to S phase of the cell cycle. Its stimulatory role on cell cycle is antagonized by Cyclin D1-dependent kinase (CDK) inhibitors like p21. P21 plays an essential role in cell cycle regulation;it may have a pro-apoptotic or an antiapoptotic role in cancer. P21 was found to have many roles in cancer;invasion metastases, cellular senescence and stem cells aging. The roles of combined expression of Cox-2, Cyclin D1 and P21 in CRC tissues and their role of prognosis and patients survival are not sufficiently clarified. Aim of the Study: To evaluate tissue expression of Cox-2, Cyclin D1 and P21 in CRC and to correlate such expression with pathological parameters, clinical and prognostic data of the patients. Methods: Cox-2, Cyclin D1 and P21 are evaluated in colon cancer tissues. Correlations between their level of expressions pathological parameters, clinical and prognostic data of patients were analyzed. Results: Cox-2, Cyclin D1 over-expression was associated with higher grade, higher incidence of occurrence of lymph node & distant metastasis and advanced stage (P = 0.000). Cox-2 was related to higher tumor recurrence rate (P = 0.04) and decreased overall patients survival rate (p = 0.002). (r correlation coefficient = +0.987). Conclusion: Cox-2 and Cyclin D1 are markers of poor prognosis colon cancer patients.

关键词： Cox-2 Cyclin D1 Colon Cancer Immunohistochemistry Prognosis

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