Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 21, 2016; 22(39): 8798-8805
Published online Oct 21, 2016. doi: 10.3748/wjg.v22.i39.8798
Cyclooxygenase-2 expression is associated with initiation of hepatocellular carcinoma, while prostaglandin receptor-1 expression predicts survival
Hao-Jie Yang, Jing-Hang Jiang, Yu-Ting Yang, Xiang-Di Yang, Zhe Guo, Ya-Peng Qi, Feng-Hua Zeng, Ke-Lan Zhang, Neng-Zhi Chen, Bang-De Xiang, Le-Qun Li
Hao-Jie Yang, Jing-Hang Jiang, Ya-Peng Qi, Bang-De Xiang, Le-Qun Li, Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Hao-Jie Yang, Feng-Hua Zeng, Ke-Lan Zhang, Neng-Zhi Chen, Department of General Surgery, The First People’s Hospital of Changde, Changde 415000, Hunan Province, China
Jing-Hang Jiang, Department of General Surgery, Second People’s Hospital of Jing Men, Jingmen 448000, Hubei Province, China
Yu-Ting Yang, Department of Chemotherapy, Affiliated Tumor Hospital of Guangxi Medical University, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Xiang-Di Yang, Department of Oncology, Chenzhou No.1 People’s Hospital, Chenzhou 423000, Hunan Province, China
Zhe Guo, Department of Thyroid and Breast Surgery, Central Hospital of Wuhan, Wuhan 430000, Hubei Province, China
Author contributions: Yang HJ, Jiang JH and Yang YT contributed equally to this work; Xiang BD and Li LQ contributed equally to this work; Xiang BD and Li LQ designed the research; Yang HJ, Jiang JH, Yang YT and Qi YP performed the research; Yang HJ, Yang YT, Zhang KL and Chen NZ evaluated the clinic records and performed the statistical analyses; Yang HJ wrote the manuscript; all authors have read and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 81260331; and Key Laboratory for High-Incidence Tumor Prevention and Treatment, Ministry of Education, No. GKE2015-ZZ05.
Institutional review board statement: The study was reviewed and approved by the Tumor Hospital of Guangxi Medical University Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Data sharing statement: Technical appendix, statistical code, and dataset are available from the corresponding author at cdsdyrmyy01@163.com. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Bang-De Xiang, Professor, Department of Hepatobiliary Surgery, Affiliated Tumor Hospital of Guangxi Medical University, 71 Hedi Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China. yhj894924067@163.com
Telephone: +86-771-5310045 Fax: +86-771-5312000
Received: June 15, 2016
Peer-review started: June 16, 2016
First decision: July 29, 2016
Revised: August 15, 2016
Accepted: August 30, 2016
Article in press: August 30, 2016
Published online: October 21, 2016
Abstract
AIM

To determine whether cyclooxygenase-2 (COX-2) and prostaglandin E1 receptor (EP1) contribute to disease and whether they help predict prognosis.

METHODS

We retrospectively reviewed the records of 116 patients with hepatocellular carcinoma (HCC) who underwent surgery between 2008 and 2011 at our hospital. Expression of COX-2 and EP1 receptor was examined by immunohistochemistry of formalin-fixed, paraffin-embedded tissues using polyclonal antibodies. Possible associations between immunohistochemical scores and survival were determined.

RESULTS

Factors associated with poor overall survival (OS) were alpha-fetoprotein > 400 ng/mL, tumor size ≥ 5 cm, and high EP1 receptor expression, but not high COX-2 expression. Disease-free survival was not significantly different between patients with low or high levels of COX-2 or EP1. COX-2 immunoreactivity was significantly higher in well-differentiated HCC tissues (Edmondson grade I-II) than in poorly differentiated tissues (Edmondson grade III-IV) (P = 0.003). EP1 receptor immunoreactivity was significantly higher in poorly differentiated tissue than in well-differentiated tissue (P = 0.001).

CONCLUSION

COX-2 expression appears to be linked to early HCC events (initiation), while EP1 receptor expression may participate in tumor progression and predict survival.

Keywords: Cyclooxygenase-2, Hepatocellular carcinoma, Liver resection, Prognosis, Prostaglandin E1 receptor

Core tip: We retrospectively reviewed the records of 116 patients with hepatocellular carcinoma (HCC) who underwent surgery between 2008 and 2011 at our hospital. Our results suggest that the factors associated with poor overall survival were alpha-fetoprotein > 400 ng/mL, tumor size ≥ 5 cm, and high prostaglandin E1 (EP1) receptor expression, but not high cyclooxygenase-2 (COX-2) expression. Disease-free survival did not differ significantly between patients with low or high levels of COX-2 or EP1. COX-2 immunoreactivity was significantly higher in well-differentiated HCC tissues (Edmondson grade I-II) than in poorly differentiated tissues (Edmondson grade III-IV) (P = 0.003). EP1 receptor immunoreactivity was significantly higher in poorly differentiated tissue than in well-differentiated tissue (P = 0.001).