Expression of Cyclooxygenase-2 (COX-2) in Colorectal Adenocarcinoma: an Immunohistochemical and Histopathological Study

  • Mahmoud, Abla Sayed (Department of Oral Maxillofacial Sciences, Alfarabi College of Dentistry) ;
  • Umair, Ayesha (Department of Oral Maxillofacial Sciences, Alfarabi College of Nursing and Dentistry) ;
  • Azzeghaiby, Saleh Nasser (Department of Oral Maxillofacial Sciences, Alfarabi College of Nursing and Dentistry) ;
  • Alqahtani, Fahad Hussain (Department of Oral Maxillofacial Sciences, Alfarabi College of Nursing and Dentistry) ;
  • Hanouneh, Salah (Department of Oral Maxillofacial Sciences, Alfarabi College of Nursing and Dentistry) ;
  • Tarakji, Bassel (Department of Oral Maxillofacial Sciences, Alfarabi College of Nursing and Dentistry)
  • Published : 2014.08.30


Background: The aim of this study was to evaluate cyclooxygenase-2 (COX-2) immunoreactivity in colorectal adenocarcinomas and to find correlations with different pathological features. Materials and Methods: This study included 35 cases of colorectal carcinoma foir which surgical colectomy specimens were collected. Immunohistochemical staining of COX-2 (cyclooxygenase-2) is done by using the Streptavidin-biotin technique. Results: This work reveals that COX-2 is positive in most cases of colorectal carcinoma and negative in normal colon tissue with statistically non significant relations between COX-2 immunostaining and different pathological features. Conclusions: Our data suggest over expression of COX-2 protein in colorectal carcinoma in contrast to normal mucosa, with a possible role in cell proliferation in carcinogenesis.


COX-2;antibodies;colorectal adenocarcinoma;immunohistochemistry


  1. Al-Maghrabi J, Buhmeida A, Emam E, et al (2012). Cyclooxygenase-2 expression as a predictor of outcome in colorectal carcinoma. World J Gastroenterol, 18, 1793-9.
  2. Bottone FG, Martinez, JM, Alston-Mills B, Eling TE (2004). Gene modulation by Cox-1 and Cox-2 specific inhibitors in human colorectal carcinoma cancer cells. Carcinogenesis, 25, 349-57.
  3. Christudoss P, Selvakumar R, Pulimood AB, et al (2013). Protective role of aspirin, vitamin C, and zinc and their effects on zinc status in the DMH-induced colon carcinoma model. Asian Pac J Cancer Prev, 8, 4627-34.
  4. Dempke W, Rie C, Grothey A (2001). Cyclooxygenase-2: A novel target for cancer chemotherapy. J Cancer Res Clin Oncol, 127, 411-7.
  5. Elzagheid A, Emaetig F, Alkikhia L, et al (2013). High cyclooxygenase-2 expression is associated with advanced stages in colorectal cancer. Anticancer Res, 33, 3137-43.
  6. Fatemi SR, Malek FN, Shivarani S, et al (2010). Prevalence of colorectal cancer in relatives of Iranian patients diagnosed with colorectal cancer. Asian Pac J Cancer Prev, 1, 91-3.
  7. Fux R, Schwab M, Thon KP, Gleiter CH, Fritz P (2005). Cyclooxygenase-2 expression in human colorectal cancer is unrelated to overall patient survival. Clin Cancer Res, 11, 4754-60.
  8. Harris RE (2007): Cyclooxygenase-2 (COX-2) and the inflammogenesis of cancer. Subcell Biochem, 42, 93-126.
  9. Jemal A, Bray F, Center MM, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90.
  10. Kim JY, Lim SJ, Park K (2004). Cyclooxygenase-2 and c-erbB-2 expression in colorectal carcinoma assessed using tissue microarrays. Appl Immunohistochem Mol Morphol, 1, 67-70.
  11. Karahan N, Guney M, Baspinar S, et al (2007). Expression of gelatinase (MMP-2 and MMP-9) and cyclooxygenase-2 (COX-2) in endometrial carcinoma. Eur J Gynaeol Oncol, 28, 184-8.
  12. Kawamori T, Uchiya N, Sugimura (2003). Enhancement of colon carcinogenesis by prostaglandin E2 administration. Carcinogenesis, 24, 985-90.
  13. Sameer AS, Shah ZA, Syeed N, et al (2010). NAD(P) H:quinoneoxidoreductase 1 (NQO1) Pro187Ser polymorphism and colorectal cancer predisposition in the ethnic Kashmiri population. Asian Pac J Cancer Prev, 11, 209-13.
  14. Shalaby MA, Nounou HA, Ms A, et al (2014). Associations between single nucleotide polymorphisms of COX-2 and MMP-2 genes and colorectal cancer susceptibility in the Saudi population. Asian Pac J Cancer Prev, 12, 4989-94
  15. Sonoshita M, Takaku K, Oshima M (2002). Cyclooxygenase-2 expression in fibroblasts and endothelial cells of intestinal polyps. Cancer Res, 62, 6846-9.
  16. Soumaoro LT, Uetake H, Higuchi T (2004).Cyclooxygenase-2 expression, Asignificant prognostic indicator for patients with colorectal cancer. Clin Cancer Res, 10, 8465-71.
  17. Smyrk TC (2002). Colorectal cancer pathology. In Gastrointestinal oncology principles and practice. Lippincott Williams and Wilkins, Philadelphia, 717-30.
  18. Tsujii M, Kawano S, Tsuji S, et al (1998). Cyclooxygenase regulates angiogenesis induced by colon cancer cells. Cell, 93, 705-16.
  19. Tomozawa S, Tsuno NH, Sunami E (2000). Cyclooxygenase -2 overexpression correlates with tumour recurrence, especially haematogenous metastasis of colorectal cancer. Br J Cancer, 83, 324-8.
  20. Tuynman JB, Buskens, Kemper K(2005). Neo-adjuvant selective cox-2 inhibition down-regulates important oncogenic pathway with esophageal adenocarcinoma. Ann Sur, 242, 840-9.
  21. Wu AW, Gu J, Ji JF, Li ZF, Xu GW (2003). Role of COX-2 in carcinogenesis of colorectal cancer and its relationship with tumor biological characteristics and patients' prognosis. World J Gastroenterol, 9, 1990-4.
  22. Xu YS, Zhao B, Long CY, et al (2014).Cyclooxygenase-2 promoter 765C increase of digestive tract cancer risk in the Chinese population: a meta-analysis. Asian Pac J Cancer Prev, 11, 4563-6.
  23. Zhou LH, Hu Q, Sui H, et al (2012). Tanshinone II--a inhibits angiogenesis through down regulation of COX-2 in human colorectal cancer. Asian Pac J Cancer Prev, 13, 4453-8.
  24. Zhang H, Sun XF (2002). Overexpression of cyclooxygenase-2 correlates with advanced stages of colorectal cancer. Am J Gastroenterol, 97, 1037-41.

Cited by

  1. Seminal cyclooxygenase relationship with oxidative stress in infertile oligoasthenoteratozoospermic men with varicocele vol.48, pp.2, 2015,