Systematic review: Cyclo-oxygenase-2 in human oesophageal adenocarcinogenesis.

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Systematic review: Cyclo-oxygenase-2 in human oesophageal adenocarcinogenesis.
Mehta S, Boddy A, Johnson IT, Rhodes M.
Department of Upper Gastrointestinal Surgery, Norfolk and Norwich University Hospital, Colney Lane, Norwich, UK.
BACKGROUND:
Published in vitro and animal in vivo studies have demonstrated that
cyclo-oxygenase-2 plays an important role during oesophageal
adenocarcinogenesis. However, the extent to which these studies are
directly relevant to events in the human lower oesophagus is
questionable. AIM: To perform a systematic review of all available
human studies that have evaluated levels of cyclo-oxygenase-2
expression during the progression from Barrett's metaplasia to
oesophageal adenocarcinoma.
METHODS: A literature search was performed
to identify all studies which qualitatively or quantitatively assessed
cyclo-oxygenase-2 protein or gene expression in either Barrett's,
dysplastic or adenocarcinoma tissue in humans. RESULTS: A total of 27
studies met the inclusion criteria. There was general agreement that
cyclo-oxygenase-2 was either absent or very weakly expressed in normal
oesophageal squamous mucosa, but considerable disagreement regarding
the presence of cyclo-oxygenase-2 in Barrett's and low-grade dysplasia.
All studies agreed that high-grade dysplasia and adenocarcinoma
expressed cyclo-oxygenase-2 to some extent although levels varied
considerably between tissue samples.
CONCLUSIONS: There is conflicting
evidence in the literature for cyclo-oxygenase-2 playing an important
role in early oesophageal adenocarcinogenesis. Other
non-cyclo-oxygenase-2 targets may account for the epidemiological data
supporting the use of non-steroidal anti-inflammatory drugs in the
chemoprevention of oesophageal adenocarcinoma.