Lack of influence of cyclooxygenese-2 expression in hepatocellular carcinomas on patient survival.

Recent studies suggest that cyclooxygenese-2 (COX-2) enzyme activation may play a role in hepatocarcinogenesis. However, the clinical significance of COX-2 expression in hepatocellular carcinoma (HCC) remains obscure. This study evaluated COX-2 expression in hepatitis B and hepatitis C virus related HCC and in HCC patients with an unknown etiology. Liver tissue samples of 31 patients with HCC (27 men and 4 women; age range, 48-75 years) were analyzed. COX-2 expression was evaluated by immunohistochemically in the tumor tissues. Patient data including age, sex, Child score, stage, grade of the tumor and survival were analyzed. Of these patients 19 were positive for hepatitis B virus (HBV), 6 were positive for hepatitis C virus (HCV) and 6 patients were negative for all viral markers and other etiologic factors. COX-2 staining were evaluated in 2 groups (group 1: COX-2 expression less than 25% (grades 1-2 COX-2 expression), and group 2: Cox-2 expression 25% or more (grades 3-5 COX-2 expression). COX-2 expression was shown in all HCC samples with positive or negative viral markers. No difference was found between degree of COX-2 expression and the etiology of HCC. COX-2 expression was not correlated with number of lesion or stage of the disease or grade of the tumor. COX-2 expression was not related with Child score of the patients. Median survival of all patients was 32 months. Median survival of patients did not differ according to patient's viral marker status. No difference was observed in median survival of patients in group 1 and 2. As a result, COX-2 system seem to be shared part in hepatocarcinogenesis regardless factors that initiate the disease. Although COX-2 expression appears to be independent of disease's characteristics', treatments that target this system appear to be feasible in the management of HCC.

Early diagnosis of cancer in renal transplant patients: a single center experience.

Renal transplantation confers increased survival with improvement of immune suppressive drugs, but certain types of neoplasm can arise as secondary complications. It is thus well known that recipients have significantly increased risk of developing de novo malignancy when compared with the age-matched general population. Cancer is the 4th most common cause of death in transplant patients after cardiovascular disease, infections and liver failure. Our transplantation team has performed 1,582 kidney transplantations since 1975. Fifty-nine of the patients developed malignancies in the posttransplantation period. The most common was Kaposi's sarcoma (19 patients, 32.2 %), followed by lymphomas (16 patients, 27.1 %) and skin carcinomas (13 patients, 22.0 %). Many factors can contribute to high susceptibility in these patients; age at transplantation, certain types of viral infections like Epstein-Barr virus, human herpes virus-8, human papilloma virus or chronic usage of immune suppressive agents, type of immune suppressive drugs, and ethnic characteristics. Transplant recipients generally have advanced stage cancers at the time of diagnosis with a poor prognosis. Since some neoplasms are common early detection of cancer is important to decrease cancer related mortality and morbidity. This article considers risk factors and recommendations for early diagnosis of cancer in renal transplant patients.