This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Santini, D. Articles by Picciocchi, A. Search for Related Content PubMed PubMed Citation Articles by Santini, D. Articles by Picciocchi, A.

Cyclooxygenase-2 Overexpression Is Associated with a Poor Outcome in Resected Ampullary Cancer Patients

Authors' Affiliations: ¹ University Campus Bio-Medico; ² Department of Experimental Medicine and Pathology, University "La Sapienza"; and ³ Catholic University of the Sacred Heart, Rome, Italy

Requests for reprints: Giuseppe Tonini, Campus Bio-Medico University, Via Emilio Longoni, 83, 00155 Rome, Italy. Phone: 39-06-22541853; Fax: 39-06-22541520; E-mail: g.tonini{at}unicampus.it.

Purpose: To identify potential prognostic molecular factors in ampullary adenocarcinoma that could be of significant importance. To this end, we examined the possible prognostic significance of cyclooxygenase-2 (Cox-2) and Survivin expression and the apoptotic index in a cohort of uniformly treated patients with ampullary cancer treated with radical surgical excision.

Experimental Design: The entry criteria were that the patients have a pathologic diagnosis of ampullary cancer which had been resected. Expression analysis for Cox-2 and Survivin was done by immunohistochemical staining. Apoptotic cells were identified by the terminal deoxyribonucleotidyl transferase–mediated dUTP nick-end labeling (TUNEL) method.

Results: Thirty-nine tumor specimens from resected ampullary adenocarcinoma patients were included. By univariate analysis, overall survival was affected by Cox-2 expression and TUNEL staining (respectively, P = 0.0003 and 0.03). Survivin expression did not influence the overall survival in our patient population (P = 0.123). Patients' clinicopathologic features (gender, age, and T and N factors) did not influence outcome. In multivariate Cox regression analysis, Cox-2 expression (relative risk, 4.330; P = 0.005) was the only variable that significantly affected overall survival.

Conclusions: The results of the present article provide, for the first time, evidence that Cox-2 expression, but not Survivin expression, may represent a significant prognostic factor after surgical resection in patients affected by cancer of the ampulla of Vater. Further studies are required to determine whether Cox-2 inhibitors may be useful for the therapy or prevention of ampullary carcinoma.

Key Words: cancer of the ampulla • Cox-2 • Survivin • apoptosis • survival

This article has been cited by other articles:

				B. Vincenzi, D. Santini, G. Perrone, A. Russo, V. Adamo, S. Rizzo, F. Castri, A. Antinori, R. Alloni, P. F. Crucitti, et al. Promyelocytic leukemia (PML) gene expression is a prognostic factor in ampullary cancer patients Ann. Onc., January 1, 2009; 20(1): 78 - 83. [Abstract] [Full Text] [PDF]