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COX-2 expression of ampullary carcinoma: correlation with different histotypes and clinicopathological parameters
Giuseppe Perrone1, Daniele Santini, Mariagiovanna Zagami
1Surgical Pathology, Campus Bio-Medico University, Via Emilio Longoni, Rome, 83 00155, Italy. g.perrone@unicampus.it
Abstract:
Epidemiological studies suggest that regular intake of nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with reduced incidence of gastrointestinal cancer. Several lines of evidence indicate that the antineoplastic effect of NSAIDs is attributable to COX-2 inhibition. The aim of our study was to assess COX-2 expression in a series of primary untreated ampullary carcinomas and its possible correlation with clinicopathological parameters. In the present study, 45 surgical specimens of invasive ampullary carcinomas were histologically classified into pancreaticobiliary, intestinal, and unusual types. COX-2 expression by immunohistochemical method was analyzed. High COX-2 expression was detected in 35 (77.8%) ampullary carcinomas. Among these, 20/21 (95.2%) were classified as intestinal, 9/18 (50%) pancreaticobiliary, and 6/6 (100%) unusual type. A significant statistical difference in terms of COX-2 expression was found between pancreaticobiliary vs intestinal type (P=0.002). Furthermore, a negative significant statistical correlation was found between T factor and COX-2 expression (P=0.047). The different COX-2 expression among histopathological types supports the concept of histogenetical difference of ampullary carcinomas. Furthermore, the high rate of COX-2 expression in the intestinal subtype of ampullary carcinoma may represent the rational for a histotype-tailored therapy targeting COX-2.
Insights
Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) may lower cancer risk. This study found high COX-2 expression in ampullary carcinomas, especially the intestinal type, suggesting targeted therapies.
Area of Science:
- Oncology
- Gastroenterology
- Molecular Biology
Background:
- Epidemiological studies link nonsteroidal anti-inflammatory drug (NSAID) use to reduced gastrointestinal cancer incidence.
- The antineoplastic effects of NSAIDs are primarily attributed to cyclooxygenase-2 (COX-2) inhibition.
- COX-2 is implicated in tumor development and progression in various cancers.
Purpose of the Study:
- To investigate COX-2 expression in primary, untreated ampullary carcinomas.
- To determine the correlation between COX-2 expression and clinicopathological parameters of ampullary carcinoma.
- To explore the potential role of COX-2 in the histogenesis of ampullary carcinoma subtypes.
Main Methods:
- Analysis of 45 surgical specimens of invasive ampullary carcinomas.
- Histological classification into pancreaticobiliary, intestinal, and unusual types.
- Immunohistochemical assessment of COX-2 expression.
Main Results:
- High COX-2 expression was observed in 77.8% of ampullary carcinomas.
- COX-2 expression was significantly higher in intestinal and unusual types compared to the pancreaticobiliary type (P=0.002).
- A negative correlation was found between the T factor (tumor size/extent) and COX-2 expression (P=0.047).
Conclusions:
- Differential COX-2 expression across histopathological subtypes supports distinct histogenetic origins for ampullary carcinomas.
- The high prevalence of COX-2 expression in the intestinal subtype suggests it as a potential therapeutic target.
- Histotype-specific therapies targeting COX-2 may be beneficial for treating ampullary carcinoma.