High expression of cyclooxygenase 2 is an indicator of prognosis for patients with esophageal squamous cell carcinoma after Ivor Lewis esophagectomy

BACKGROUND The poor prognosis of esophageal squamous cell carcinoma (ESCC) is attributed to a high recurrence rate after surgery. Cyclooxygenase 2 (COX2) is an important regulator of cell growth, differentiation, apoptosis, and transformation. COX2 overexpression is significantly associated with the tumorigenesis and progression of diverse cancers; however, its expression and significance in ESCC remains unclear. METHODS We enrolled 118 patients with ESCC who had undergone Ivor-Lewis esophagectomy. The expression profile of COX2 was examined by immunohistochemistry. RESULTS A high expression of COX2 correlated with a higher T staging (P = 0.014), lower differentiation degree (P = 0.002), lymph node metastasis (P = 0.009), recurrence status (P = 0.004), and tumor node metastasis (TNM) stage (P = 0.001). Cox regression analysis showed that TNM stage (P = 0.001), differentiation degree (P = 0.001), and high COX2 expression (P = 0.004) were independent risk factors of prognosis. CONCLUSION Our data indicated that COX2 expression level is associated with key clinicopathological features and could be an effective biomarker to predict ESCC prognosis.