Cyclooxygenase-2 Expression Is Related to the Epithelial-to-Mesenchymal Transition in Human Colon Cancers

PURPOSE: Down-regulation of E-cadherin is a hallmark of the epithelial-to-mesenchymal transition (EMT). EMT progression in cancer cells is associated with the loss of certain epithelial markers and the acquisition of a mesenchymal phenotype, as well as migratory activities. Cyclooxygenase-2 (COX-2) expression is associated with tumor invasion and metastasis in colon cancer. This study investigated the relationship between E-cadherin and COX-2 in colon cancer cells and human colon tumors. MATERIALS AND METHODS: Colon cancer cell lines and immunohistochemistry were used. RESULTS: E-cadherin expression was inversely related to the expressions of COX-2 and Snail in colon cancer cells. Ectopic expression of COX-2 or Snail reduced E-cadherin and induced a scattered, flattened phenotype with few intercellular contacts in colon cancer cells. Treatment of cancer cells with phorbol 12-myristate 13-acetate increased the expressions of COX-2 and Snail, decreased 15-hydroxyprostaglandin dehydrogenase expression, and increased the cells' motility. In addition, exposure to prostaglandin E2 increased Snail expression and cell motility, and decreased E-cadherin expression. Membranous E-cadherin expression was lower in adenomas and cancers than in the adjacent, non-neoplastic epithelium. In contrast, the expressions of Snail and COX-2 were higher in cancers than in normal tissues and adenomas. The expressions of COX-2 and Snail increased in areas with abnormal E-cadherin expression. Moreover, COX-2 expression was related to higher tumor stages and was significantly higher in nodal metastatic lesions than primary cancers. CONCLUSION: This study suggests that COX-2 may have a role in tumor metastasis via EMT.

Treatment and Prognostic Factors for Traumatic Liver Injury

PURPOSE: Due to its size and locatin, the liver is frequently injured in abdominal trauma. Recently, nonoperative management for liver injuries has been extended due to the development CT imaging, intensive care units, and their equipment and techniques. Herein, patients with traumatic liver injury were analyzed to evaluate its treatment and prognostic factors. METHODS: From 2001, January to 2003, July, 65 patients at our facility were confirmed to have traumatic liver injury. The operative or nonoperative managements were decided on the basis of the systolic blood pressure if no peritoneal irritation sign was noted. If the systolic blood pressure was stable, or recovered to within the normal range following hydration and transfusion at the emergency room, patients were managed nonoperatively. Hemodynamically unstable patients were managed operatively. The data were analysed using the SPSS program (Chi-squared tests and logistic regression analyses). RESULTS: 48 patients were treated nonoperatively, with 3 mortalities. The overall mortality rate was 15.8%, but only 6.4% in the nonoperative management group, compared to 67% in operative management group. In a Multivariate analysis the systolic blood pressure was found to be a reliable factor in traumatic liver injury and the mentality and ISS (injury severity score) reliable in finding complications in the nonoperative management group. The mentality was found statistically reliable for determining mortality in the operative management group, with the exception for the systolic blood pressure. CONCLUSION: The systolic blood pressure was an important indicator when considering the treatment plan in traumatic liver injury. An extensive study will be required that incorporates both nonoperative and operative management groups.