Expression of COX-2 and E-cadherin in Tunisian patients with colorectal adenocarcinoma

Cyclo-oxygenase 2 (COX-2) and E-cadherin are promising biomarkers for cancer diagnosis and therapy. The aim of this study was to examine the expression of these two proteins in primary colorectal adenocarcinomas and to investigate their association with clinicopathological characteristics including survival of patients. Immunostaining of E-cadherin and COX-2 was assessed in 70 primary colorectal adenocarcinomas from Tunisian patients. Membranous E-cadherin immunostaining and cytoplasmic COX-2 expression were observed in 74.3% and 68.6% of cases respectively. A significant association was found between COX-2 expression and age at diagnosis (P = 0.02), and vessel invasion (P = 0.037). The expression of E-cadherin correlated with age at diagnosis (P = 0.01), and tumor size (P = 0.02). In addition, by multivariate analysis, we revealed a significant association with 1-year disease free survival and a tendency with distant metastasis (P = 0.017 and P = 0.065 respectively). On the other hand, tumors exhibiting COX-2+/E-cadherin-profile were larger (P = 0.006), and in an advanced stage (P = 0.001). Survival analysis showed that COX-2 over-expression confers a reduced overall survival rate (P log rank = 0.036) and is an independent factor predictive for prognosis.