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COX-2 mRNA Expression is Significantly Increased in Acid-exposed Compared to Nonexposed Squamous Epithelium in Gastroesophageal Reflux Disease

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Little is known about the role of cyclooxygenase (COX)-2 in gastroesophageal reflux disease (GERD) and the development of Barrett’s metaplasia. The objectives of this study were to further analyze COX-2 mRNA expression in patients with GERD compared to Barrett’s esophagus (BE) and Barrett’s cancer (BC).

Methods

Tissue samples from 110 patients with GERD (n = 43), BE (n = 20), and BC (n = 47) were obtained in routine upper GI endoscopy. Expression levels of COX-2 were measured by quantitative real-time reverse trancriptase polymerase chain reaction (RT-PCR). Also, 24-h pH monitoring was performed in all patients of the GERD study group and the DeMeester composite score was used to match COX-2 mRNA expression with the severity of acid exposure in the lower esophagus.

Results

COX-2 mRNA is progressively upregulated within the metaplasia–dysplasia–adenocarcinoma (MDA) sequence (p = 0.001). COX-2 levels of the squamous epithelium in the distal esophagus from patients with GERD and a pathologic mean DeMeester score (>14.72) were significantly higher than in patients with normal DeMeester scores (p = 0.01).

Conclusion

In summary our findings suggest that alterations in COX-2 mRNA expression occur independently of endoscopic or histologic signs of GERD in the acid-exposed squamous epithelium of the distal esophagus. However, this early COX-2 increase in GERD is further upregulated within the MDA sequence for yet unknown reasons.

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Acknowledgement

This study was supported by the Deutsche Krebshilfe/Dr. Mildred Scheel Stiftung (German Barrett Cancer Project: 70-2789-Si3, Teilprojekt G1b).

Author information

Author notes

  1. Peter H. Collet

    Present address: Section of Endoscopy and Sonography, Department of Surgery, University of Mannheim, Mannheim, Germany

  2. Huan Xi

    Present address: Department of General Surgery, Beijing Hospital, Beijing, People’s Republic of China

Authors and Affiliations

  1. Department of Visceral and Vascular Surgery, University of Cologne, Cologne, Germany

    Georg Lurje, Daniel Vallbohmer, Peter H. Collet, Huan Xi, Jan Brabender, Ralf Metzger, Michaela Heitmann, Susanne Neiss, Arnulf H. Holscher & Paul M. Schneider

  2. Institute of Pathology, University of Cologne, Cologne, Germany

    Stephan E. Baldus & Ute Drebber

  3. Institute of Pathology, Heinrich Heine University Duesseldorf, Duesseldorf, Germany

    Stephan E. Baldus

  4. Department of Visceral and Transplantation Surgery, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Paul M. Schneider

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  1. Georg Lurje
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  2. Daniel Vallbohmer
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Corresponding author

Correspondence to Paul M. Schneider.

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Lurje, G., Vallbohmer, D., Collet, P.H. et al. COX-2 mRNA Expression is Significantly Increased in Acid-exposed Compared to Nonexposed Squamous Epithelium in Gastroesophageal Reflux Disease. J Gastrointest Surg 11, 1105–1111 (2007). https://doi.org/10.1007/s11605-007-0210-3

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  • DOI: https://doi.org/10.1007/s11605-007-0210-3

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