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Immediate and long-term prognoses of acute myocardial infarction: analysis of determinants of prognosis.

In order to investigate the immediate and long-term prognoses of acute myocardial infarction, we followed up 790 consecutive patients who were admitted to the Sakurabashi Watanabe Hospital within 24 hours after the onset of infarction from January 1975 to December 1984 and evaluated early mortality, cumulative survival rate after discharge, cause of death and occurrence of recurrent myocardial infarction during follow-up. Early mortality (within 30 days after the onset) in all patients was 17.6% and declined serially in the most recent five years. Pump failure was the most common cause of death, followed by cardiac rupture and arrhythmias. Age, gender (female), presence of a previous infarct and anterior infarction were important contributing factors to the immediate prognosis. One hundred and thirty-five of the 651 patients who survived one month after the onset of infarct died during the follow-up period (mean follow-up interval: 41.0 +/- 29.9 (SD) months). Cumulative survival rates calculated by the life-table method at one and 5 years after the onset were 91.0% and 76.0%, respectively, and the average annual mortality in the first 5 years was 4.8%. Age and reinfarction were the important determining factors of long-term prognosis. Recurrent myocardial infarction, pump failure and sudden cardiac death were common causes of late death. One hundred and two reinfarctions in 93 patients occurred during the follow-up period. Thirty-two of 93 patients (34.4%) died due to fatal reinfarction. These results indicate that the immediate prognosis of acute myocardial infarction has improved serially, but the long-term prognosis is still poor.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Age-adjusted heart rate variability as an index of the severity and prognosis of heart failure.

The age-adjusted, heart rate variability (HRV) was evaluated as a parameter for the severity of heart failure and its prognosis. HRV was obtained by 24-h Holter monitoring in patients with left ventricular dysfunction (LVD). New York Heart Association (NYHA) functional classification, echocardiography, radioisotope ventriculography, and blood examination were performed, and compared between patients and normal subjects. The evaluation was repeated during the follow-up period. Finally, using the lower limit of HRV, patients were divided into either normal or abnormal group for each low-frequency power (LF) and high-frequency power (HF) (age-adjusted HRV). Other parameters of heart failure and prognosis were compared between these 2 groups. HRV tended to be lower in patients with LVD. HF decreased at the early stage of heart failure, but did not decrease progressively. LF decreased progressively. HRV change paralleled the change of NYHA. The abnormal HRV group showed a poor prognosis for cardiac death, but not for sudden cardiac death. In patients with LVD, HRV was decreased compared with the normal subjects. Change in HRV correlated with the change in NYHA classification. Age-adjusted HRV correlated with cardiac-death prognosis, but not for sudden cardiac death.

Aged↗

Prognosis for canine malignant mammary tumors based on TNM and histologic classification.

The 2-year prognosis of malignant mammary tumors seen in 175 bitches in the Tokyo metropolitan area was assessed based on their TNM clinical staging and histological classification. The larger the tumor size became (T category), the poorer was the clinical prognosis. The 2-year survival rates of the animals with regional lymph node metastasis of tumor cells (N1, N2 category) and/or distant metastasis (M1 category) were markedly lower than those of the animals without such involvement. As the grade of TNM staging increased, the prognosis was poorer, however, there were no significant differences in survival rates among subtypes of adenocarcinomas (tubular, papillary and papillary cystic) determined by WHO histological classification. It was also noticed that animals having carcinomas without tubular formation or myoepithelial cell proliferation had a lower survival rate than animals having carcinomas with those characteristics; and invasive carcinomas into adjacent skin or lymphatic/vascular vessels implied a poorer prognosis than non-invasive ones. The results suggest that a combined practice of TNM system and our evaluation on the above-mentioned 4 histologic features could be useful for prognostic determination of canine mammary cancers.

Adenocarcinoma↗

The assessment of prognosis in Perthes' disease.

Seventy children who had suffered from Perthes' disease were reviewed clinically and radiologically three to eight years from the onset of the condition in order to determine retrospectively the most satisfactory method of assessing the prognosis and the correlation between the clinical and radiological result. In younger children the femoral head was more likely to be spherical at the conclusion of the pathological process but not necessarily of normal proportions nor normally covered by the acetabulum. The prognosis was significantly poorer for girls than for boys. Clinical factors were not an aid to prognosis in the individual cases, but overall there was a close correlation between the clinical and the radiological end-results. The most reliable radiological factors indicating the prognosis were the extent of uncovering of the femoral head, the Catterall grouping, the presence of calcification lateral to the outer limit of the acetabulum and lateral displacement of the femoral head, as measured by comparing the head to tear-drop distances on each side.

Age Factors↗

Does preoperative transbronchial biopsy worsen the postsurgical prognosis of lung cancer? A propensity score-adjusted analysis.

STUDY OBJECTIVES: Our aim was to clarify the hypothesis that the postsurgical prognosis of patients with non-small cell lung cancer (NSCLC) proven by preoperative diagnostic transbronchial biopsy (TBLB) was worse than that of the patients with NSCLC determined at the time of surgery. DESIGN: We entered the propensity score as a continuous variable in the Cox proportional hazards model, along with the success/failure of TBLB and other covariates that were adjusted for the bias inherent to the success/failure of the TBLB examination. PATIENTS: Five hundred ninety-nine consecutive patients with NSCLC undergoing complete resection were divided into two groups. Pathologic diagnosis by TBLB was preoperatively determined in patients belonging to group 1 (n = 367). TBLB was unsuccessful and exploratory thoracotomy or thoracoscopy was followed by surgical resection in patients belonging to group 2 (n = 232). The overall recurrence-free survival rate was examined as the surgical outcomes. RESULTS: The postsurgical recurrence-free rate was significantly higher in group 2 than in group 1. Group 2 patients showed better prognosis than group 1 patients, even when the data between the two groups were adjusted by propensity score. When the groups were subdivided by the pathologic stage of disease, the subgroup consisting of group 2 patients with stage IA and IB lung cancer still showed a higher recurrence-free rate than those in group 1 by propensity score analysis. CONCLUSIONS: The postsurgical prognosis of the patients with NSCLC was significantly better if the preoperative TBLB was unsuccessful. This result suggested that advanced NSCLC had a tendency to be diagnosed with TBLB and, possibly, that the TBLB procedure might worsen the prognosis of patients with resectable NSCLC. We suggest that intraoperative diagnosis followed by the consecutive resection of NSCLC may be beneficial for improving the surgical outcomes of NSCLC patients.

Adenocarcinoma↗

Nosocomial pneumonia. A multivariate analysis of risk and prognosis.

One hundred and twenty consecutive episodes of nosocomial pneumonia (NP) in 118 nonneutropenic adults admitted to a 1,000-bed teaching hospital were studied in order to investigate the prognosis and risk factors. The overall fatality rate was 36.6 percent. The identification of a "high-risk" microorganism (Pseudomonas aeruginosa, Enterobacteriaceae, and other Gram-negative bacilli, Streptococcus faecalis, Staphylococcus aureus, Candida sp, Aspergillus sp, and episodes of polymicrobial pneumonia), bilateral involvement on chest x-ray examination, the presence of respiratory failure, inappropriate antibiotic therapy, and age older than 60 years or an underlying condition ultimately or rapidly fatal were those factors selected by a stepforward logistic regression analysis as independently worsening the prognosis. A series of variables frequently quoted as predisposing to NP was determined to be either present or absent in the same 120 cases of NP and in an equal number of randomly selected control subjects. After adjusting for confounding, factors significantly predisposing to NP were tracheal intubation, depressed level of consciousness, underlying chronic lung disease, thoracic or upper abdominal surgery, prior episode of a large volume aspiration, and age older than 70 years. Since some of the factors influencing the risk or the prognosis of NP are amenable to medical intervention, a percentage of NP might be prevented and its prognosis can be improved.

Adult↗

E- and A-type cyclins as markers for cancer diagnosis and prognosis.

Cyclin-dependent kinase (CDK)2 interacting cyclins perform essential functions for DNA replication and cellular proliferation. The human genome encodes two E-type cyclins (E and E2) and two A-type cyclins (A1 and A2). Dysregulation of the CDK2-bound cyclins plays an important role in the pathogenesis of cancer. Cyclin A2 is associated with cellular proliferation and can be used for molecular diagnostics as a proliferation marker. In addition, cyclin A2 expression is associated with a poor prognosis in several types of cancer. Cyclin A1 is a tissue-specific cyclin that is highly expressed in acute myeloid leukemia and in testicular cancer. High levels of cyclin E expression are found in many types of cancer. Overexpression of cyclin E at the mRNA level can be based on gene amplification and transcriptional mechanisms. In addition, proteolytically cleaved forms of cyclin E that show oncogenic functions have been described. Cyclin E plays a critical role for G1/S transition. Its overexpression is not only associated with proliferation but rather indicates a more malignant phenotype which is likely to be linked to the induction of chromosomal instability. These biological functions of cyclin E relate to a poor prognosis when high cyclin E levels are found. The link between cyclin E and poor prognosis is well established in breast and lung cancer but is likely to be observed in other cancers as well. The second E-type cyclin, cyclin E2, has been shown to be overexpressed in breast cancers although the potential role as a diagnostic or prognostic marker is unknown. This review provides an overview of the potential of cyclins E and A as markers for diagnosis and prognosis in human cancer.

Biomarkers, Tumor↗

Prognosis of the pancreatic cancer in terms of the regional lymph node reaction.

In order to elucidate the immunological defense mechanism in tumor bearing hosts against pancreatic cancer, tissue reactions of the regional lymph nodes were investigated in terms of extension and prognosis of pancreatic cancer. As the site for investigation of lymph nodes, the paracortical area, germinal center and sinus histiocyte systems were selected. In each case paracortical hyperplasia, germinal center hyperplasia and sinus histiocytosis were graded and the relationship between grade and prognosis of resected pancreatic cancer was studied with the following results. The grades of each tissue reaction in cases without lymph node metastasis were higher than that observed in cases with metastasis. There was a significant difference in sinus histiocytosis (p less than 0.01). Higher grade tissue reactions were observed in cases with primary lesion histologic type classified as papillary adenocarcinoma or as well-differentiated tubular adenocarcinoma as compared to those in cases of poorly differentiated histologic type. In pancreatic cancer the prognosis was better in cases with higher grade of tissue reactions of the regional lymph nodes. In cases with pancreatic cancer both cellular immunity and humoral immunity are involved in the host defense mechanism. It was considered that sinus histiocytosis is significant as an indicator for good prognosis and a factor to inhibit progression in pancreatic cancer.

Adenocarcinoma↗

Clinical value of color Doppler ultrasonography measurements of full-term newborns with perinatal asphyxia and hypoxic ischemic encephalopathy in the first 12 hours of life and long-term prognosis.

The cerebral blood flow velocities (CBFV) of infants with perinatal asphyxia and hypoxic ischemic encephalopathy (HIE) in the first 12 hours of their lives have been the chief focus of our concern in this study. Cerebral ischemia which can develop in the earlier hours of HIE, and the detection and diagnosis of this condition with color Doppler ultrasonography (cD-USG) will be put into discussion. Twenty-three full-term newborn infants who had perinatal asphyxia and HIE together with a control group constituting twenty full-term newborn infants who produced no problems, were included in our study. All of the infants underwent cD-USG in the postpartum period of the first 12 hours (mean 8.4 hours). Measurements being based upon peak systolic velocity (PSV), end diastolic velocity (EDV) and Pouecelout's resistive index (RI) in anterior and middle cerebral arteries were conducted. The infants, having been discharged from the unit they were followed up for mean 9.8 months in the outpatient clinic. PSV and EDV counts in the postpartum first 12 hours of 23 infants who were detected to have HIE were found to be significantly lower compared to the control group, whereas RI counts were found to be significantly higher (p < 0.05). The counts obtained from the right and left cerebral arteries of the infants with HIE were found to be corraleted with each others. The neonates in the patient group were observed to have gone through this prognosis: Three of them died, three of them had cerebral palsy, one of them had infantile spasms, and three of them had developmental retardation. When we compared the CBFV of the 10 neonates who had poor prognosis, retrospectively with the other 13 neonates who had good prognosis, PSV and EDV were found to be significantly lower and RI significantly higher (p < 0.05). In the light of the data we have obtained, cD-USG can be considered to be a highly practical device in evaluating CBVF of the infants with HIE. A skillful detection of the decrease in cerebral blood flow which can develop in the postasphyxial first 12 hours and the prospective treatments being based upon this approach would contribute to the diagnosis, treatment and prognosis of such cases.

Asphyxia Neonatorum↗

Prognosis of patients with congestive heart failure: its determinants in various heart diseases in Japan.

We investigated the prognosis of patients with congestive heart failure (CHF) and the factors which influence the prognosis of Japanese patients with this condition. From among the patients admitted to our hospital from January 1, 1978 to December 31, 1985, the 298 patients who were diagnosed having CHF were investigated. Patients with CHF had a rather poor prognosis, with the 1-year, 3-year, and 5-year cumulative survival rates being 76%, 60%, and 49%, respectively. The factors influencing the prognosis of patients with CHF were the type of underlying heart disease, the left ventricular ejection fraction, the left ventricular end-diastolic dimension, and the central venous pressure. Survival rates differed significantly depending on the type of underlying heart disease. The cumulative 5-year survival rate was 35% for coronary artery disease, 40% for dilated cardiomyopathy, 53% for rheumatic valvular heart disease, and 80% for hypertensive heart disease.

Adult↗

Fetal aqueductal stenosis diagnosed sonographically: how grave is the prognosis?

OBJECTIVE: Aqueductal stenosis is a common cause of fetal hydrocephalus. Published studies of neonates with aqueductal stenosis have noted variable outcomes, with normal development seen in 24-86% of cases. In an attempt to better assess long-term outcomes in cases diagnosed in utero and to determine what prenatal sonographic findings might be used to predict prognosis, a retrospective analysis of patients with aqueductal stenosis was done. MATERIALS AND METHODS: Fifty-three consecutive cases of aqueductal stenosis discovered in utero at two high-risk obstetrical centers in Seattle between 1980 and 1993 were studied. Parents elected to continue pregnancy in 39 of these cases. Two months to 10 years of long-term follow-up was available in 30 patients, who form our study group. Prenatal sonograms, postnatal cranial ultrasound, and head CT and MR were evaluated. Prenatal sonographic data collected included the biparietal diameter, size of the lateral and third ventricles, the ratio of the two, and thickness of the frontoparietal cortical mantle. Medical records provided an assessment of development based on physical examination, meeting of major milestones, and neuropsychological testing. The in utero diagnosis of aqueductal stenosis was confirmed by postnatal CT, MR imaging, sonography, or autopsy. RESULTS: Within the study group of 30 patients, eight died in the postnatal period and four died subsequently. Of the 22 patients with adequate postnatal follow-up, moderate or severe developmental delay was present in 16 (73%). Normal developmental milestones were met in only three (10%) of all 30 patients and in 14% of those surviving the neonatal period. Although size of the lateral and third ventricles was not a useful predictor of long-term prognosis, the ratio of the two, as well as thickness of the frontoparietal cortical mantle, was weakly associated with long-term prognosis. No correlation was found between biparietal diameter and outcome. CONCLUSION: As compared with previous reports, prenatal diagnosis of aqueductal stenosis carries a grave prognosis. Twelve of the 30 patients died, for an overall mortality of 40%. Normal development was seen in only 10%, significantly less than in prior studies.

Cerebral Aqueduct↗

Prognosis and therapy of early acute idiopathic auditory failure.

The prognostic value of some otovestibular parameters was evaluated in 46 cases of acute idiopathic hypoacusis (AIH) and 12 cases of acute idiopathic anacusis (AIA) observed within 7 days of the onset. Recovery in AIH is predicted by some otoneurological parameters as mean pure-tone hearing threshold (PTA) for 500, 1,000 and 2,000 Hz, stapedial reflex and severe vertigo. None of these measures alone seems to have prognostic value. The expected recovery rate also is reflected in the various parameters taken as a whole. Subjects with mean PTA better than 70 dB HL together with stapedius reflex present for 500 and 1,000 Hz, no decay and no vertigo have a very favourable prognosis: 86% had complete or good recovery. On the contrary, subjects with mean PTA worse than 70 dB HL and with pathological stapedius reflex have a generally unfavourable prognosis: 35% had complete or good recovery. Vertigo as a symptom does not seem in itself to have an unfavourable prognostic value. Actually, patients with severe vertigo generally have a poor recovery. Vertigo as a symptom indeed is frequently associated with a more severe sensorineural lesion. Carbogen or heparin-dextran are not an effective treatment: complete-good global recoveries obtained in AIH without any treatment, with carbogen or with heparin-dextran were, respectively, 65, 68 and 62%. As a consequence, an early therapy with these substances has no apparent value. Patients affected with AIA have a very unfavourable prognosis. All of our patients with AIA had poor recovery. For the moment we feel it is easier to reach a satisfactory prognosis rather than to institute an effective or causal therapy in acute idiopathic auditory failure.

Adolescent↗

[The importance of the host nutritional and immune status on the prognosis of urinary tract infection in the elderly].

This study was performed to evaluate the role of the nutritional and immune status on the prognosis of urinary tract infections (UTI) in the elderly. 192 patients among the 790 inpatients were diagnosed as UTI. Age-related increase in the prevalence of UTI was accompanied with poor prognosis in the patients with hypoalbuminemia (< 2.6 g/dl) and lymphocytopenia (< 700/mm3). To study the immunologic basis for susceptibility to UTI in the aged further, we compared the T-cell functions between outpatients without serious disease and inpatients with chronic UTI. The absolute numbers of lymphocyte, OKT3 (pan T-cell marker), OKT4 (Helper/Inducer marker) and Interleukin (IL)-2 as well as serum albumin concentration were decreased in the patients with UTI. A prospective study was done to confirm that these nutritional and immunological changes become risk factors in the prognosis of UTI with long-term and low-dose chemotherapy. In the patients continued with bacteriuria (Non-responders, n = 6), serum albumin concentration and IL-2 production were significantly lower than the patients who became free from bacteriuria (Responders, n = 7). These results suggest that poor nutrition-related immune dysfunction contributes to the vulnerability of elderly patients to UTI and becomes risks for he prognosis of UTI.

Adult↗

Demographics, prognosis, and therapy in 702 patients with brain metastases from malignant melanoma.

UNLABELLED: Brain metastases are a common and devastating complication in patients with malignant melanoma. Therapeutic options for these patients are limited, and the prognosis is usually poor. OBJECT: A retrospective review of 6953 patients with melanoma treated at a single institution was undertaken to identify demographic factors associated with the development of clinically significant brain metastases in 702 of these patients and to determine the factors influencing the prognosis of this population to permit more informed recommendations regarding surgical therapy. METHODS: Factors found to be associated with the development of brain metastases included male gender, primary lesions located on mucosal surfaces or on the skin of the trunk or head and neck, thick or ulcerated primary lesions, and histological findings of acral lentiginous or nodular lesions. The overall median survival time of all patients with brain metastases was 113.2 days, and these metastases contributed to the death of 94.5% of the patients in this group. Patients with primary lesions located in the head or neck region had a significantly shorter survival time relative to other patients with brain metastases, whereas patients with a single brain metastasis, patients without lung or multiple other visceral metastases, and patients whose initial presentation with melanoma included a brain metastasis had a significantly better prognosis. The small group of patients who survived for more than 3 years was characterized by the presence of a surgically treated, single brain metastasis in the absence of other visceral metastatic disease. CONCLUSIONS: Although most patients with brain metastases resulting from melanoma have a dismal prognosis, some who are likely to survive for longer periods can be identified. In these patients surgical resection can significantly prolong meaningful survival. The decision to recommend surgery should be based primarily on the resectability of the brain metastases and on the status and number of other organs with metastatic lesions.

Adult↗

Impact of simultaneous assay, the PCNA, cyclinD1, and DNA content with specimens before and after preoperative radiotherapy on prognosis of esophageal cancer-possible incorporation into clinical TNM staging system.

AIM: The aim of the present study is to use immunohistochemical methods to investigate the clinical implications of tumor markers in esophageal squamous cell carcinoma and evaluate their impact on prognosis. METHODS: From November 1990 to December 1996, 47 patients were treated with preoperative radiation followed by radical esophagectomy. All patients were confirmed pathologically as suffering from squamous cell carcinoma. Immunohistochemical stain was done for PCNA, cyclinD1 protein expression and DNA content analyzed by image cytometry. Kaplan-Meier method for single prognostic factor and log-rank test was used to test the significant difference. Cox stepwise regression model and prognosis index model were used for survival analysis with multiple prognostic factors. RESULTS: Radio-pathological change, T stage and N stage, as the traditional prognostic factors had statistical difference in 3-, 5- and 10-year survival rates. While, tumor cell proliferating marked PCNA, cyclinD1 and DNA content served as independent prognostic factors of esophageal carcinoma. There was definitely an identity between the single and multiple factor analyses. PI was more accurate to evaluate the prognosis of esophageal carcinoma. CONCLUSION: It is possible that tumor cell proliferating marked PCNA, cyclinD1 and DNA content would become the endpoints for evaluating the prognosis of esophageal carcinoma.

Adult↗

Prognosis following transcatheter arterial embolization for 121 patients with unresectable hepatocellular carcinoma with or without a history of treatment.

AIM: To retrospectively evaluate the prognosis of patients with hepatocellular carcinoma (HCC) with or without a history of therapy for HCC following transcatheter arterial embolization (TAE). METHODS: One hundred and twenty-one patients with HCC treated with TAE from 1992 to 2004 in our hospital were enrolled in this study. Eighty-four patients had a history of treatment for HCC, while 37 did not. At the time of entry, patients with extra-hepatic metastasis, portal vein tumor thrombosis, or Child-Pugh class C were excluded. TAE was repeated when recurrence of HCC was diagnosed by elevated tumor markers, or ultrasonography or dynamic computed tomography findings. RESULTS: Tumor size was larger and the number of tumors was fewer in patients without past treatment (P<0.01). However, there were no differences in tumor node metastasis (TNM) stage or survival rate between the 2 groups. A bilobular tumor and high level of alpha-fetoprotein (AFP) (>100 ng/mL) were factors related to a poor prognosis in patients with a history of HCC. CONCLUSION: The prognosis following TAE is similar between HCC patients with and without past treatment. Early diagnosis of HCC or recurrent HCC and obtaining good local control against HCC before entry to a repeated TAE course can improve prognosis.

Aged↗

Expression of MUC1 in esophageal squamous-cell carcinoma and its relationship with prognosis of patients from Linzhou city, a high incidence area of northern China.

AIM: To further characterize the possible relationship between the molecular changes and prognosis of ESC and to elucidate the possible mechanisms involved. METHODS: 114 specimens of ESC were collected from Linzhou city, and all patients were followed up for more than 5 years after resection. Histopathological analysis and immunohistochemical staining (ABC) were employed to detect the alteration of MUC1. RESULTS: The positive immunostaining rate for MUC1 was 79 % (90/114), and the high-expression rate was 63 % (72/114). The mean survival periods (months) of those with high- and low-expression rates of MUC1 were 41 (95 % CI: 35, 47) and 52 (95 % CI: 45, 59), respectively. Patients in the low-expression group obviously survived longer than those in high-expression group, and the difference was significant (P<0.05). The expression of MUC1 protein in the esophageal carcinoma specimens with metastasis was stronger than those without metastasis, the difference was also significant (P<0.05). The stepwise multivariate analysis showed that "differentiation", "expression of MUC1" and "TNM staging" were the most important factors affecting the prognosis of esophageal carcinoma patients (P<0.05). CONCLUSION: A good correlation between the alteration of MUC1 and the regional lymph node metastasis was observed. Furthermore, high-expression of MUC1 was associated with poor prognosis for esophageal cancer patients. These results indicated that MUC1 is a promising biomarker for predicting lymph node metastasis and prognosis in esophageal cancer.

Adult↗

Role of COX-2 in carcinogenesis of colorectal cancer and its relationship with tumor biological characteristics and patients' prognosis.

AIM: Recent clinical epidemiological studies have demonstrated the preventive effect of non-steroidal anti-inflammatory drugs (NSAIDs) against colorectal cancer. The underlying mechanism might be the inhibition of rate-limiting enzyme cyclooxygenase-2 (COX-2) in metabolism of arachidonic acid. The role of COX-2 in carcinogenesis of colorectal cancer and its relationship with tumor biological characteristics and patients' prognosis still remain unclear. This study was to investigate the role of COX-2 expression in carcinogenesis of colorectal cancer and its relationship with tumor biological characteristics and patients' prognosis. METHODS: A total of 139 colorectal cancers and 19 adenomas surgically treated in School of Oncology, Peking University, from January 1993 to September 2001 were retrospectively studied. COX-2 expression was detected with tissue microarray (TMA) and immunohistochemistry (IHC) procedure. The association between COX-2 expression and clinicopathological features and its influence on patients' prognosis were studied. RESULTS: COX-2 expression was strong in colorectal cancer, moderate in adenoma and weak in normal mucosa, which demonstrated statistically significant difference (chi(2)=46.997, P<0.001). COX-2 expression had no association with clinicopathological features such as gross type, differentiation, invasion depth, vessel emboli and TNM staging. Cox proportional hazards modeling analysis and Log rank test revealed no prognostic role of COX-2 expression in colorectal cancer patients. CONCLUSION: COX-2 may play an important role in the early stage of carcinogenesis, and its expression in colorectal cancer is not associated with clinicopathological features and patients' prognosis.

Adenocarcinoma↗