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Canadian Journal of Gastroenterology
Volume 24, Issue 7, Pages 435-440
Original Article

Overexpression of Cyclooxygenase-2 in Noncancerous Liver Tissue Increases the Postoperative Recurrence of Hepatocellular Carcinoma in Patients with Hepatitis B Virus-Related Cirrhosis

Yi-Fu He,1,2 Juan Jin,1 Wei Wei,1 Yan Chang,1 Bing Hu,2 Chu-Shu Ji,2 Wei-Dong Jia,3 Xiao-Qiu Wang,4 Ke Chen,4 and Jian Chen2

1Institute of Clinical Pharmacology, Anhui Medical University Key Laboratory of Anti-inflammatory and Immune Pharmacology of the Education Ministry of China, China
2Department of Medical Oncology, Anhui Provincial Hospital affiliated to Anhui Medical University, Hefei, China
3Department of General Surgery, Anhui Provincial Hospital affiliated to Anhui Medical University, Hefei, China
4Department of Pathology, Anhui Provincial Hospital affiliated to Anhui Medical University, Hefei, China

Received 27 May 2008; Accepted 19 January 2010

Copyright © 2010 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


BACKGROUND: Many previous studies have evaluated the histopathological features of tumours as risk factors for postoperative recurrence in hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC). However, there have been few large studies investigating the relationship between cyclooxygenase-2 (COX-2) expression in non-cancerous regions of the liver and postoperative recurrence in the remnant liver, especially in HBV-related HCC.

OBJECTIVE: To evaluate the significance of COX-2 expression levels in noncancerous liver regions as a prognostic indicator of HCC in patients with HBV-related cirrhosis.

METHODS: A total of 124 patients who underwent curative resection for HCC were reviewed retrospectively. Immunohistochemistry was used to evaluate the expression of COX-2 in noncancerous liver tissue. Clinicopathological variables were compared between patients with high COX-2 expression (n=58 [COX-2-positive group]) and patients with low COX-2 expression (n=66; [COX-2-negative group]). Univariate and multivariate analyses were performed to identify factors that affected disease recurrence.

RESULTS: There was a significant correlation between COX-2 expression and alanine aminotransferase levels and vascular invasion. The recurrence-free survival rates in the COX-2-positive group were significantly lower than the rates in the COX-2-negative group. On multivariate analysis, the overexpression of COX-2 in noncancerous liver regions was found to be an unfavourable prognostic indicator for the recurrence of HCC.

CONCLUSIONS: The results of the current study suggest that over-expression of COX-2 in noncancerous liver regions is an independent and significant indicator predictive of early recurrence of HCC in patients with HBV-related cirrhosis.