Evaluating the expression of cyclooxygenase-2 enzyme by immunohistochemistry in normal and tumoral tissue before and after neoadjuvant chemoradiotherapy in patients with esophageal cancer in Khorasan Province
Yousef Jalalabadi1, Alireza Shirazi2, Mohammad-Reza Ghavam-Nasiri3, Seyed Amir Aledavood4, Dariush Sardari1, Bahram Memar4, Soodabeh Shahidsales4, Fatemeh VarshoeeTabrizi5, Parvane Dehghan6, Hassan Vosughiniya7
1 Department of Medical Radiation Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
2 Department of Medical Radiation Engineering, Science and Research Branch, Islamic Azad University; Department of Medical Physics and Biomedical Engineering, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
3 Iranian Society of Radiation Oncology, Tehran, Iran
4 Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
5 Reza Radiation Oncology Center, Mashhad, Iran
6 Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Mashhad, Iran
7 Department of Internal Medicine, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Dr. Alireza Shirazi
Department of Medical Radiation Engineering, Science and Research Branch, Islamic Azad University, Tehran
Source of Support: None, Conflict of Interest: None
Background: Esophageal cancer is the third most common cancer in Iran. Neoadjuvant chemoradiotherapy (NCRT) is the appropriate treatment for esophageal cancer.
Aim: This study investigated the expression of cyclooxygenase (COX)-2 enzyme in normal and tumoral tissues before any treatment in patients with esophageal cancer, this study also assessed the effect of NCRT on the expression of COX-2 enzyme in normal and tumoral tissue in samples derived by surgery furthermore, and this study investigated the relationship between expression of COX-2 enzyme and the pathologic tumor regression grade (PTRG) patients.
Materials and Methods: In this study, a total of 120 patients admitted to Omid Hospital, Imam Reza Hospitals, and Reza-Mashhad Medical Center, who were treated with NCRT, were recruited and the expression of the COX-2 enzyme in normal and tumoral tissues was assessed by immunohistochemistry before and after treatment by an expert pathologist between zero and 300. PTRG was determined by a pathologist after treatment.
Results: The mean levels of COX-2 expression, obtained from tumoral and normal tissue baseline biopsy in patients, were 177.69 and 64.29, respectively, while in surgical specimen were 177.25 and 49.84, respectively. A significant association was found between PTRG of surgical specimen and COX-2 expression in normal tissue (baseline biopsy) at diagnosis (P = 0.034).
Conclusions: The results indicated that expression of COX-2 in tumoral tissues exceeds the expression of COX-2 in normal tissue of the baseline biopsy. Patients with a high expression of COX-2 in baseline tumor biopsies had less response to treatment of pathology compared to patients with lower expression of COX-2 in baseline tumor biopsies.