Abstract
Background: Chronic inflammation of the bile duct is linked to an increased risk for the development of cholangiocarcinoma. Arachidonic acid and linoleic acid oxidation through cyclooxygenase and lipoxygenase - two major pro-inflammatory pathways - have rarely been investigated in extrahepatic cholangiocarcinoma. Materials and Methods: Paraffin-embedded specimens from 51 resected adenocarcinomas of the extrahepatic bile duct were immunostained for cyclooxygenase 2 (COX-2) and 5-lipoxygenase (5-LOX) to evaluate their intracellular distribution and prognostic value. Results: Cholangiocarcinoma had significantly higher levels of 5-LOX and COX-2 expression compared with normal tissue (p=0.015). High expression of nucleus-located 5-LOX was significantly associated with intensive staining for COX-2, (p=0.023). Median disease-free survival (DFS) in patients with low expression of 5-LOX was significantly better than in patients with high expression of 5-LOX (log rank p=0.046). DFS in patients with low COX-2 expression was also significantly better than DFS in patients with high COX-2 expression (log rank p=0.0187). Conclusion: The present study demonstrates that 5-LOX and COX-2 protein expression was increased in cholangiocarcinoma suggesting that these two enzymes might be of prognostic value and offer a potential additional adjuvant therapeutic approach to this disease.
- Received October 26, 2007.
- Revision received December 14, 2007.
- Accepted January 8, 2008.
- Copyright© 2008 International Institute of Anticaner Research (Dr. John G. Delinassios), All rights reserved