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Wach J, Güresir Á, Vatter H, Herrlinger U, Becker A, Toma M, Hölzel M, Güresir E. Low-Dose Acetylsalicylic Acid Treatment in Non-Skull-Base Meningiomas: Impact on Tumor Proliferation and Seizure Burden. Cancers (Basel) 2022; 14:cancers14174285. [PMID: 36077817 PMCID: PMC9454729 DOI: 10.3390/cancers14174285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/26/2022] [Accepted: 08/31/2022] [Indexed: 11/16/2022] Open
Abstract
MIB-1 index is an important predictor of meningioma progression and was found to be correlated with COX-2 expression. However, the impact of low-dose acetylsalicylic acid (ASA) on MIB-1 index and clinical symptoms is unclear. Between 2009 and 2022, 710 patients with clinical data, tumor-imaging data, inflammatory laboratory (plasma fibrinogen, serum C-reactive protein) data, and neuropathological reports underwent surgery for primary cranial WHO grade 1 and 2 meningioma. ASA intake was found to be significantly associated with a low MIB-1 labeling index in female patients ≥ 60 years. Multivariable analysis demonstrated that female patients ≥ 60 years with a non-skull-base meningioma taking ASA had a significantly lower MIB-1 index (OR: 2.6, 95%: 1.0–6.6, p = 0.04). Furthermore, the intake of ASA was independently associated with a reduced burden of symptomatic epilepsy at presentation in non-skull-base meningiomas in both genders (OR: 3.8, 95%CI: 1.3–10.6, p = 0.03). ASA intake might have an anti-proliferative effect in the subgroup of elderly female patients with non-skull-base meningiomas. Furthermore, anti-inflammatory therapy seems to reduce the burden of symptomatic epilepsy in non-skull-base meningiomas. Further research is needed to investigate the role of anti-inflammatory therapy in non-skull-base meningiomas.
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Affiliation(s)
- Johannes Wach
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany
- Correspondence: ; Tel.: +49-228-287-16521
| | - Ági Güresir
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany
| | - Hartmut Vatter
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany
| | - Ulrich Herrlinger
- Division of Clinical Neurooncology, Department of Neurology and Centre of Integrated Oncology, University Hospital Bonn, 53127 Bonn, Germany
| | - Albert Becker
- Department of Neuropathology, University Hospital Bonn, 53127 Bonn, Germany
| | - Marieta Toma
- Institute of Pathology, University Hospital Bonn, 53127 Bonn, Germany
| | - Michael Hölzel
- Institute of Experimental Oncology, University Hospital Bonn, 53127 Bonn, Germany
| | - Erdem Güresir
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany
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de Carvalho GTC, da Silva-Martins WC, de Magalhães KCSF, Nunes CB, Soares AN, Tafuri LSDA, Simões RT. Recurrence/Regrowth in Grade I Meningioma: How to Predict? Front Oncol 2020; 10:1144. [PMID: 32903787 PMCID: PMC7438949 DOI: 10.3389/fonc.2020.01144] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 06/08/2020] [Indexed: 11/22/2022] Open
Abstract
The HLA-G and HLA-E molecules, Ki67, progesterone (PR), estrogen (ER) and androgen receptors (AR), p53, COX-2, and HER2 were studied to assess whether the biological behavior of grade I meningiomas is related to their expression. Tissue samples from 96 patients with grade I intracranial meningiomas were analyzed by immunohistochemistry on tissue microarray blocks (TMA) using antibodies specific for HLA-G, HLA-E, Ki67, PR, ER, AR, p53, COX-2, and HER2. Meningiomas were classified as small (≤2 cm, 1.0%), medium (>2 and ≤4 cm, 32.3%), and large (>4 cm, 66.7%). Tumor size was not related to recurrence/regrowth (p = 0.486), but was significantly correlated with peritumoral edema (p = 0.031) and intratumoral calcifications (p = 0.018). Recurrent meningiomas were observed in 14.6% of cases. Immunostaining for each marker was: HLA-G 100%; HLA-E 95.6%; PR 62%; ER 2.1%; AR 6.5%; p53 92.6%; COX-2 100%; HER2 0%; Ki67, mean 2.61 ± 2.29%, median 2.1%. Primary and recurrent meningiomas showed no significant relation with HLA-E and hormone receptors (p > 0.05), except for Ki67, where a higher median was observed in recurrent tumors than in primary (p = 0.014). The larger the tumor, the more severe the peritumoral edema, and the greater the presence of calcifications. Ki67 appears to be a good biomarker of recurrence/regrowth in grade I meningiomas.
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Affiliation(s)
- Gervásio Teles Cardoso de Carvalho
- Laboratory of Molecular Biology and Biomarkers, Santa Casa de Belo Horizonte Ensino e Pesquisa - EP/SCBH, Belo Horizonte, Brazil.,Department of Neurosurgery, Hospital Santa Casa de Belo Horizonte, Belo Horizonte, Brazil.,Faculdade de Ciências Médicas de Minas Gerais (FCMMG), Belo Horizonte, Brazil
| | | | | | - Cristiana Buzelin Nunes
- Departamento de Anatomia Patológica e Medicina Legal, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Centro Universitário de Belo Horizonte - UniBH, Belo Horizonte, Brazil
| | - Aleida Nazareth Soares
- Laboratory of Molecular Biology and Biomarkers, Santa Casa de Belo Horizonte Ensino e Pesquisa - EP/SCBH, Belo Horizonte, Brazil
| | - Luciene Simões de Assis Tafuri
- Laboratory of Molecular Biology and Biomarkers, Santa Casa de Belo Horizonte Ensino e Pesquisa - EP/SCBH, Belo Horizonte, Brazil.,Departamento de Fisiologia e Patologia, Centro de Ciências da Saúde, Universidade Federal da Paraíba, DFP/CCS/UFPB, João Pessoa, Brazil
| | - Renata Toscano Simões
- Laboratory of Molecular Biology and Biomarkers, Santa Casa de Belo Horizonte Ensino e Pesquisa - EP/SCBH, Belo Horizonte, Brazil
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Demirtaş G, Siğirci A, Öztürk M, Görkem SB, Kiliç B, Güngör S. Is cerebral spinal fluid flow associated with body mass index and head circumference in healthy children? A phase contrast magnetic resonance imaging study. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2020. [DOI: 10.1186/s43055-020-00227-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The aim of this study was to investigate the relationship between age, gender, body mass index (BMI), and head circumference (HC) and cerebral spinal fluid (CSF) flow dynamics in the pediatric population. The prospective study included a total of 137 participants, 75 boys and 62 girls, ranging in age from 2 to 204 months. Quantitative evaluation of CSF flow was made by using phase contrast magnetic resonance imaging (PC-MRI) in the axial plane at the level of the aqueductus cerebri. Flow dynamics were recorded as peak and mean velocity (cm/s); cranial, caudal, and net volume (ml); and aqueductus cerebri area (mm2). Correlation between baseline descriptive parameters, including age, gender, BMI, and HC, and the aforementioned CSF flow dynamics were investigated.
Results
The net volume was significantly lower in girls (p = 0.002). There was no association between age and aqueduct area, mean velocity, and cranial volume. The peak velocity was remarkably higher in children (p = 0.03), whereas cranial and net volume were found to be lower in infants (p = 0.04 and p = 0.03, respectively). Notably, cases with HC below normal values had lower cranial, caudal, and net volume and aqueductus cerebri area (p = 0.01, p = 0.03, p = 0.03, and p = 0.04, respectively). There was no association between BMI and indicators of CSF flow dynamics in PC-MRI.
Conclusion
BMI and HC may be associated with CSF flow dynamics in children. A smaller HC is accompanied by a lower forward flow volume, reverse flow volume, net volume, and aqueductal diameter. These points should be remembered during the design of further trials on determinants of CSF flow in children.
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Patel KS, Kejriwal S, Sun MM, Thammachantha S, Duong C, Chan A, Cherian N, Romiyo P, Gordon LK, Yong W, Wadehra M, Yang I. Identification of epithelial membrane protein 2 (EMP2) as a molecular marker and correlate for angiogenesis in meningioma. J Neurooncol 2020; 147:15-24. [PMID: 31981014 DOI: 10.1007/s11060-020-03401-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 01/13/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE Although intracranial meningiomas are the most common primary brain tumor in adults, treatment options are few and have traditionally been limited to surgical resection and radiotherapy. Additional targeted therapies and biomarkers are needed, especially as complete surgical resection is frequently not feasible in many patients. METHODS Non-pathologic brain tissue from 3 patients undergoing routine autopsies and tumor specimens from 16 patients requiring surgical resection for meningioma were collected. EMP2 protein expression was evaluated by immunohistochemistry and western blot analysis. EMP2 mRNA expression was also investigated using surgical specimens and validated by analysis of several independent NCBI GEO databases. RESULTS EMP2 mRNA expression levels were found to be higher in meningioma relative to non-pathologic meninges (P = 0.0013) and brain (P = 0.0011). Concordantly, strong EMP2 protein expression was demonstrated in 100% of meningioma specimens from all 16 patients, with no observable protein expression in normal brain tissue samples from 3 subjects (P < 0.001). EMP2 expression was confirmed by western blot analysis in five samples, with EMP2 protein intensity positively correlating with histologic staining score (R2 = 0.780; P = 0.047). No association was found between EMP2 mRNA or protein levels and WHO grade or markers of proliferation. However, EMP2 expression was positively associated with an angiomatous pattern on histologic evaluation (P = 0.0597), VEGF-A mRNA expression (P < 0.001), and clinical markers of tumor vascularity such as operative blood loss (P = 0.037). CONCLUSIONS EMP2 is not found in normal brain tissue, yet has shown consistently high mRNA and protein expression in meningiomas, and may serve as a useful molecular marker for these tumors.
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Affiliation(s)
- Kunal S Patel
- Department of Neurosurgery, University of California, Los Angeles, CA, USA
| | - Sameer Kejriwal
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, CA, USA
| | - Michel M Sun
- Department of Ophthalmology, University of California, Los Angeles, CA, USA
| | - Samasuk Thammachantha
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, CA, USA
| | - Courtney Duong
- Department of Neurosurgery, University of California, Los Angeles, CA, USA
| | - Ann Chan
- Department of Ophthalmology, University of California, Los Angeles, CA, USA
| | - Nina Cherian
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, CA, USA
| | - Prasanth Romiyo
- Department of Neurosurgery, University of California, Los Angeles, CA, USA
| | - Lynn K Gordon
- Department of Ophthalmology, University of California, Los Angeles, CA, USA
| | - William Yong
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, CA, USA
| | - Madhuri Wadehra
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, CA, USA.,Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA
| | - Isaac Yang
- Department of Neurosurgery, University of California, Los Angeles, CA, USA. .,Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA. .,Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, UCLA Jonsson Comprehensive Cancer Center, 300 Stein Plaza, Ste. 562, 5th Floor Wasserman Bldg., Los Angeles, CA, 90095-6901, USA.
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Abstract
More than 70,000 primary central nervous system tumors are diagnosed in the United States each year. Approximately 36% of these are meningiomas, making it the most common primary brain tumor. Because meningioma risk increases dramatically with age, the healthcare burden of meningioma in the developed world will continue to rise as demographics shift toward an older population. In addition to demographic factors associated with increased meningioma risk (i.e., older age, female sex, African American ethnicity), increased body mass index is a strong risk factor. A history of atopic allergies, eczema, and increased serum IgE are all consistently associated with reduced meningioma risk, suggesting a potential role for immunosurveillance. Although ionizing radiation is a strong meningioma risk factor, it accounts for very few cases at the population level. Recent studies suggest that diagnostic radiation (e.g., dental X-rays) increases meningioma risk. Because radiation dosages associated with medical imaging have decreased dramatically, the public health impact of this exposure is likely in decline. Genome-wide association studies have identified common inherited variants in the gene MLLT10 and RIC8A as low-penetrance meningioma risk alleles. To provide further insight into the etiology of meningioma, future studies will need to simultaneously examine genetic and environmental risk factors, while also stratifying analyses by subject sex.
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Affiliation(s)
- Kyle M Walsh
- Department of Neurosurgery, Duke University, Durham, NC, United States.
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Bryant JM, Bouchard M, Haque A. Anticancer Activity of Ganoderic Acid DM: Current Status and Future Perspective. ACTA ACUST UNITED AC 2017; 8. [PMID: 29399381 PMCID: PMC5795599 DOI: 10.4172/2155-9899.1000535] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Ganoderma lucidum is a mushroom that has a long history of medicinal use in the Far East countries as this mushroom is revered for its supposed miracle cures and life improving properties. Recently, this mushroom has come under scientific scrutiny to examine the possibility of finding biologically active compounds that may have an impact on human physiology. The main category of biologically active compounds produced in the G. lucidum, are the triterpenoids, which are known as Ganoderic Acids. In this review, we discuss one Ganoderic Acid in particular known as Ganoderic Acid-DM (GA-DM) that is extracted from the Ganoderma lucidum mushroom. We will discuss GA-DM as a potential therapeutic candidate for treating a number of diseases yet will focus on the potential to be used as an alternative or supplemental therapeutic agent in regards to various cancer types. The urge for this promising therapeutic agent is that GA-DM is capable of inducing cell death in cancer cells while exhibiting minimal toxicity to normal bystander cells. Furthermore, this review will look at GA-DM's ability to stimulate an immune response in the tumor environment to potentially provide long-term protection from the malignant tumors. We will also discuss the known routes of administration of GA-DM and pose the advantages and disadvantages of each route in a comparative manner. Finally, we will cover current status of the roles GA-DM may have as a therapeutic agent in respect to different cancer types as wells as discuss about its future perspective as a therapeutic candidate in other diseases as well.
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Affiliation(s)
- John Matthew Bryant
- Department of Microbiology and Immunology, and Hollings Cancer Center, Medical University of South Carolina, USA
| | - Mollie Bouchard
- Department of Microbiology and Immunology, and Hollings Cancer Center, Medical University of South Carolina, USA
| | - Azizul Haque
- Department of Microbiology and Immunology, and Hollings Cancer Center, Medical University of South Carolina, USA
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Haughton V, Mardal KA. Spinal fluid biomechanics and imaging: an update for neuroradiologists. AJNR Am J Neuroradiol 2014; 35:1864-9. [PMID: 25012674 DOI: 10.3174/ajnr.a4023] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Flow imaging with cardiac-gated phase-contrast MR has applications in the management of neurologic disorders. Together with computational fluid dynamics, phase-contrast MR has advanced our understanding of spinal CSF flow. Phase-contrast MR is used to evaluate patients with Chiari I malformation who are candidates for surgical treatment. In theory, abnormal CSF flow resulting from the abnormal tonsil position causes syringomyelia and other neurologic signs and symptoms in patients with Chiari I. CSF flow imaging also has research applications in syringomyelia and spinal stenosis. To optimize MR acquisition and interpretation, neuroradiologists must have familiarity with healthy and pathologic patterns of CSF flow. The purpose of this review is to update concepts of CSF flow that are important for the practice of flow imaging in the spine.
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Affiliation(s)
- V Haughton
- From the Department of Radiology (V.H.), University of Wisconsin, Madison, Wisconsin
| | - K-A Mardal
- Center for Biological Computing (K.-A.M.), Simula, Lysaker, Norway
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8
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Kang HC, Kim IH, Park CI, Park SH. Immunohistochemical analysis of cyclooxygenase-2 and brain fatty acid binding protein expression in grades I-II meningiomas: correlation with tumor grade and clinical outcome after radiotherapy. Neuropathology 2014; 34:446-54. [PMID: 24779988 DOI: 10.1111/neup.12128] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 04/04/2014] [Accepted: 04/06/2014] [Indexed: 11/27/2022]
Abstract
This study was done to evaluate the association of cyclooxygenase 2 (COX-2) and brain fatty acid binding protein (BFABP) with tumor grade and outcome of grades I-II meningiomas treated with radiotherapy. From 1996 to 2008, 40 patients with intracranial grades I-II meningiomas were treated with radiotherapy. Immunohistochemical staining for COX-2 and BFABP were performed on formalin-fixed paraffin-embedded tissues. COX-2 expression was significantly associated with BFABP status and both COX-2 (P < 0.01) and BFABP (P = 0.01) expression were stronger in the grade II meningiomas than in grade I tumors. Among the clinicopathologic factors, age and COX-2 status were prognostic in progression-free survival. Patients with moderate or strong COX-2 expression had worse outcome than those with negative or weak COX-2 expression (P = 0.03) after controlling for potential confounders. Our results suggest that the molecular biomarker COX-2 has prognostic significance in intracranial grades I-II meningiomas following radiotherapy.
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Affiliation(s)
- Hyun-Cheol Kang
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea; Department of Radiation Oncology, Dongnam Institute of Radiological and Medical Sciences, Busan, Korea
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Tung H, Liao YC, Wu CC, Chang MH, Chen CCC, Chen PL, Chen HC. Usefulness of phase-contrast magnetic resonance imaging for diagnosis and treatment evaluation in patients with SIH. Cephalalgia 2014; 34:584-93. [PMID: 24414094 DOI: 10.1177/0333102413519513] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 10/29/2013] [Indexed: 11/15/2022]
Abstract
BACKGROUND Most diagnostic tools for spontaneous intracranial hypotension (SIH) are either invasive or occasionally inconsistent with the clinical condition. In this study, we examined the cerebrospinal fluid (CSF) dynamics in SIH using phase-contrast magnetic resonance (PC-MR) imaging. MATERIALS AND METHOD Seventeen SIH patients and 32 healthy individuals, matched by sex and age, were recruited. Each person underwent brain and PC-MR imaging using 3-Tesla MRI. We evaluated the differences in image parameters among patients during the initial and recovery stages against the status of the control group. RESULTS SIH patients had lower CSF flow-volume, flux, peak velocity, and higher systolic-to-diastolic time ratio, as well as systolic-to-diastolic volume ratio compared to the control group and the conditions when they recovered. The flow time and volume of the diastolic phase markedly increased after treatment. The discriminating power of PC-MR for SIH was good. Diffuse pachymeningeal enhancement and venous engorgement were present when their PC-MR values were lower than the cut-off values for SIH diagnosis. The headache scores correlated with the peak velocity and pituitary volume. CONCLUSION Noninvasive PC-MR could provide valid parameters for diagnosis and treatment follow-up in SIH patients. It may be more sensitive than conventional brain MRI.
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Affiliation(s)
- Hsin Tung
- Section of Neurology, Taichung Veterans General Hospital, Taiwan, ROC
| | - Yi-Chu Liao
- Section of Neurology, Taichung Veterans General Hospital, Taiwan, ROC Department of Neurology, National Yang-Ming University, School of Medicine, Taiwan, ROC
| | - Chih-Ceng Wu
- Department of Anesthesiology, Taichung Veterans General Hospital, Taiwan, ROC
| | - Ming-Hong Chang
- Section of Neurology, Taichung Veterans General Hospital, Taiwan, ROC Department of Neurology, National Yang-Ming University, School of Medicine, Taiwan, ROC
| | - Clayton Chi-Chang Chen
- Department of Radiology, Taichung Veterans General Hospital, Taiwan, ROC Department of Radiological Technology and Graduate Institute of Radiological Science, Central Taiwan University of Science and Technology, Taiwan, ROC Department of Physical Therapy, Hungkuang University of Technology, Taiwan, ROC Department of Physical Therapy and Assistive Technology, National Yang Ming University, Taiwan, ROC
| | - Po-Lin Chen
- Section of Neurology, Taichung Veterans General Hospital, Taiwan, ROC Department of Neurology, National Yang-Ming University, School of Medicine, Taiwan, ROC
| | - Hung-Chieh Chen
- Department of Radiology, Taichung Veterans General Hospital, Taiwan, ROC Department of Radiology, National Yang-Ming University School of Medicine, Taiwan, ROC
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Non-steroidal anti-inflammatory drug use and brain tumour risk: a case-control study within the Clinical Practice Research Datalink. Cancer Causes Control 2013; 24:2027-34. [PMID: 23990380 DOI: 10.1007/s10552-013-0279-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 08/17/2013] [Indexed: 12/23/2022]
Abstract
PURPOSE The aetiology of primary brain tumours is largely unknown; the role of non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin use and glioma risk has been inconclusive, but few population-based studies with reliable prescribing data have been conducted, and the association with meningioma risk has yet to be assessed. METHODS The UK Clinical Practice Research Datalink was used to assess the association between aspirin and non-aspirin NSAID use and primary brain tumour risk using a nested case-control study design. Conditional logistic regression analysis was performed on 5,052 brain tumour patients aged 16 years and over, diagnosed between 1987 and 2009 and 42,678 controls matched on year of birth, gender and general practice, adjusting for history of allergy and hormone replacement therapy use in the glioma and meningioma models, respectively. RESULTS In conditional logistic regression analysis, excluding drug use in the year preceding the index date, there was no association with non-aspirin NSAID use (OR 0.96, 95 % CI 0.81-1.13) or glioma risk comparing the highest category of daily defined dose to non-users; however, non-aspirin NSAID use was positively associated with meningioma risk (OR 1.35, 95 % CI 1.06-1.71). No association was seen with high- or low-dose aspirin use irrespective of histology. CONCLUSIONS This large nested case-control study finds no association between aspirin or non-aspirin NSAID use and risk of glioma but a slight increased risk with non-aspirin NSAIDs and meningioma.
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Lee SH, Lee YS, Hong YG, Kang CS. Significance of COX-2 and VEGF expression in histopathologic grading and invasiveness of meningiomas. APMIS 2013; 122:16-24. [DOI: 10.1111/apm.12079] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 02/22/2013] [Indexed: 01/28/2023]
Affiliation(s)
- Sung Hak Lee
- Department of Hospital Pathology; The Catholic University of Korea; College of Medicine; Seoul Korea
| | - Youn Soo Lee
- Department of Hospital Pathology; The Catholic University of Korea; College of Medicine; Seoul Korea
| | - Yong Gil Hong
- Department of Neurosurgery; The Catholic University of Korea; College of Medicine; Seoul Korea
| | - Chang Suk Kang
- Department of Hospital Pathology; The Catholic University of Korea; College of Medicine; Seoul Korea
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12
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Effect of systemic celecoxib on human meningioma after intracranial transplantation into nude mice. Acta Neurochir (Wien) 2013; 155:173-82. [PMID: 23143216 DOI: 10.1007/s00701-012-1534-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2012] [Accepted: 10/16/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Meningiomas are mostly benign, but they may have a notorious tendency to recur when total resection is not possible. Systemic chemotherapeutical treatment has been largely disappointing. The treatment of meningiomas with the cyclooxygenase-2 (COX-2) inhibitor celecoxib showed inhibitory-growth effects in vitro and in vivo after subcutaneous transplantation into mouse. So far, celecoxib has never been tested in an orthotopic model of meningioma. In this work, we tested the effects of celecoxib on the growth of human benign meningiomas after transplantation into the prefrontal cortex of nude mice after confirming the inhibitory in vitro effect on these cells. METHODS Primary cell cultures were stereotactically implanted into mice and were treated with 0, 750, or 1,500 ppm celecoxib for 3 months. The mice were then killed and blood was analyzed for celecoxib concentration. The mice brains were histologically processed for measurement of tumor volume, COX-2 expression, proliferation index (PI), intratumoral microvessel density (iMVD), and vascular endothelial growth factor (VEGF) expression. RESULTS Treatment with celecoxib had no effect on tumor volume, despite the fact that we found a dose-dependent inhibitory effect on cell cultures and there was a sufficiently high celecoxib concentration in blood plasma and brain tissue. Additionally, celecoxib had neither an effect on COX-2 and VEGF expression nor on the PI and iMVD. CONCLUSIONS Our findings suggest that celecoxib may not be effective on meningioma growth in clinical settings. In general, these results may indicate that the effect of treatment on brain tumors should not only be tested in a heterotopic environment but also in the orthotopic location of these tumors.
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Clinicopathological evaluation of cyclooxygenase-2 expression in meningioma: immunohistochemical analysis of 76 cases of low and high-grade meningioma. Brain Tumor Pathol 2012; 31:23-30. [PMID: 23250387 DOI: 10.1007/s10014-012-0127-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Accepted: 11/27/2012] [Indexed: 12/21/2022]
Abstract
Tumorigenic activity of cyclooxygenase-2 (COX-2), a rate-limiting enzyme in the production of prostaglandins (PGs), has been proved for some types of cancer, including brain tumors. We evaluated expression of COX-2 in meningioma, one of the most common intracranial tumors in adults which accounts for 24-30 % of intracranial tumors. We performed immunostaining for COX-2 in 76 cases of meningioma consisting of 44 cases of low-grade (WHO Grade I) and 32 cases of high-grade (29 cases of Grade II and 3 cases of Grade III) meningioma, and evaluated COX-2 expression levels on the basis of staining intensity and proportion in tumor cells. The expression level of COX-2 in meningioma cells was significantly correlated with WHO grade (P = 0.0153). In addition, COX-2 expression was significantly correlated with MIB-1 labeling index for all 76 cases of meningioma (P = 0.0075), suggesting tumor promotion by COX-2 in meningioma progression. Our results may indicate the therapeutic value of non-steroidal anti-inflammatory drugs against meningioma, especially for patients with elevated proliferation, to regulate the tumorigenic activity of COX-2 in meningioma cells.
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Shah S, Haughton V, del Río AM. CSF flow through the upper cervical spinal canal in Chiari I malformation. AJNR Am J Neuroradiol 2011; 32:1149-53. [PMID: 21511868 DOI: 10.3174/ajnr.a2460] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Previous studies have quantified CSF flow in patients with Chiari I at the foramen magnum with single-axial or single-sagittal PCMR. The goal of this study was to measure CSF velocities at multiple cervical spinal levels in patients with Chiari I malformation. MATERIALS AND METHODS In a patient registry, consecutive patients without surgery who had PCMR flow images in 5-8 axial planes between the foramen magnum and C4 were identified. Four contiguous regions were defined from the foramen magnum to C4. In each region, the fastest positive flow (PSV) and fastest negative flow (PDV) were tabulated. Changes in peak velocity by cervical spinal level and age and sex were tested for significance with linear mixed-effects models. RESULTS In 17 patients studied, PSV increased progressively and significantly from the foramen magnum to C4. PDVs increased slightly from the foramen magnum to C3. The changes in velocity over the 4 regions tended to be smaller in the 13 patients with tonsilar ectopia than in the 4 patients without it. Age and sex had an effect on peak velocities. CONCLUSIONS Peak diastolic and systolic CSF velocities are significantly greater below than at the foramen magnum.
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Affiliation(s)
- S Shah
- From New York Medical College, Valhalla, New York, USA
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15
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Genetic and molecular alterations in meningiomas. Clin Neurol Neurosurg 2011; 113:261-7. [DOI: 10.1016/j.clineuro.2010.12.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Revised: 12/05/2010] [Accepted: 12/09/2010] [Indexed: 11/22/2022]
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16
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Toktas ZO, Akgun E, Ozkan A, Bozkurt SU, Bekiroglu N, Seker A, Konya D, Kilic T. Relationship of Angiogenic Potential With Clinical Features in Cranial Meningiomas: A Corneal Angiogenesis Study. Neurosurgery 2010; 67:1724-32; discussion 1732. [DOI: 10.1227/neu.0b013e3181f9f310] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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17
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Atchaneeyasakul LO, Uiprasertkul M, Trinavarat A. Cyclooxygenase-2 expression in retinoblastoma: an immunohistochemical analysis. Curr Eye Res 2010; 35:242-7. [PMID: 20373884 DOI: 10.3109/02713680903477832] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Increased level of cyclooxygenase-2 (COX-2) plays a significant role in the pathogenesis of cancers. High expression of COX-2 has been demonstrated in several cancer types including retinoblastoma. However, the in vivo study did not confirm the anti-proliferative effect of COX-2 inhibitor, celecoxib, on a murine transgenic retinoblastoma model. We, therefore, aim to investigate COX-2 expression in paraffin-embedded retinoblastoma specimens in a larger study group. METHODS We reviewed 55 retinoblastoma specimens obtained during 1995 to 2005. Clinical and histopathological data were recorded. Immunohistochemical evaluation of COX-2 expression was performed using a rabbit monoclonal antibody to human cyclooxygenase-2. RESULTS Forty-four of 55 specimens (80%) showed negative immunoreactivity for COX-2 expression. For the 11 specimens (20%, 95% CI = 11.6-32.4%) with positive COX-2, all immunostainings were less than 50% of tumor area. Demographic data and treatment details were available in 53 specimens. Enucleation was performed as a primary treatment in 43 specimens (81%). Other treatments, mainly systemic chemotherapy, were given prior to enucleation in 10 specimens (19%). There was no statistical difference in COX-2 expression between the specimens identified as primary and secondary enucleation (p = 0.66). Regarding the histopathological findings, there were no significant differences between COX-2 negative and COX-2 positive groups. CONCLUSIONS It appears that COX-2 is not overexpressed in our retinoblastoma specimens, which is different from previous studies. This conflicting data reduces the possibility of introducing Cox-2 inhibitors in the treatment of retinoblastoma.
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Rossmeisl JH, Robertson JL, Zimmerman KL, Higgins MA, Geiger DA. Cyclooxygenase-2 (COX-2) expression in canine intracranial meningiomas. Vet Comp Oncol 2009; 7:173-80. [DOI: 10.1111/j.1476-5829.2009.00188.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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Pistolesi S, Boldrini L, Gisfredi S, Ursino S, Alì G, Nuti S, De Ieso K, Pieracci N, Parenti G, Fontanini G. Expression of Cyclooxygenase-2 and Its Correlation with Vasogenic Brain Edema in Human Intracranial Meningiomas. Cancer Invest 2009; 25:555-62. [DOI: 10.1080/07357900701508280] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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20
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Walsh MT, Couldwell WT. Management options for cavernous sinus meningiomas. J Neurooncol 2009; 92:307-16. [DOI: 10.1007/s11060-009-9824-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2008] [Accepted: 02/23/2009] [Indexed: 02/04/2023]
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21
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Chemotherapy, hormonal therapy, and immunotherapy for recurrent meningiomas. J Neurooncol 2008; 92:1-6. [DOI: 10.1007/s11060-008-9734-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2008] [Accepted: 11/03/2008] [Indexed: 11/26/2022]
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22
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Expression of cell adhesion proteins and proteins related to angiogenesis and fatty acid metabolism in benign, atypical, and anaplastic meningiomas. J Neurooncol 2008; 89:73-87. [PMID: 18418552 DOI: 10.1007/s11060-008-9588-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2007] [Accepted: 03/28/2008] [Indexed: 02/05/2023]
Abstract
Most meningiomas are benign tumours of arachnoidal origin, although a small number have high proliferative rates and invasive properties which complicate complete surgical resection and are associated with increased recurrence rates. Few prognostic indicators exist for meningiomas and further research is necessary to identify factors that influence tumour invasion, oedema and recurrence. Paraffin sections from 25 intracranial meningiomas were analysed for expression of the proteins vascular endothelial growth factor (VEGF), VEGF receptors Flt1 and Flk1, E-cadherin, metalloproteinases 2 and 9 (MMP2, MMP9), CD44, receptor for hyaluronic acid-mediated motility (RHAMM), hyaluronic acid (HA), CD45, cyclooxygenase 2 (COX2), brain fatty acid binding protein (BFABP), Ki67, and proliferating cell nuclear antigen (PCNA). Correlations among protein expression were found for several markers of proliferation (Ki67, PCNA, MI) and microvessel density (MVD). COX2 expression increased with increasing with tumour grade and correlated with Ki67, PCNA, MI, MVD, and BFABP. BFABP expression also correlated with Ki67 and PCNA expression. Relationships were also identified among angiogenic factors (VEGF, Flt1, Flk1) and proliferation markers. Oedema was found to correlate with MMP9 expression and MMP9 also correlated with proliferation markers. No correlations were found for MMP2, E-cadherin, or CD44 in meningiomas. In conclusion Ki67, PCNA, MI, MVD, BFABP, and COX2 were significantly correlated with meningioma tumour grade and with each other. These findings, by correlating both intracellular fatty acid transport and eicosanoid metabolism with tumour proliferation, as determined by Ki67 labelling and mitotic index, suggest fatty acids are involved in the progression of meningiomas.
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Ragel BT, Jensen RL, Couldwell WT. Inflammatory response and meningioma tumorigenesis and the effect of cyclooxygenase-2 inhibitors. Neurosurg Focus 2007; 23:E7. [PMID: 17961044 DOI: 10.3171/foc-07/10/e7] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
In this article the authors discuss the rationale and research supporting the hypothesis that meningioma tumorigenesis may, in part, be driven by overexpression of cyclooxygenase-2 (Cox-2) and that treatment with celecoxib, a selective Cox-2 inhibitor, may hold therapeutic promise. Because therapies for recurrent or aggressive meningiomas (atypical or malignant subtypes) such as chemotherapy and radiotherapy generally offer little therapeutic benefit, interest in targeting Cox-2 has grown. This rate-limiting enzyme of prostaglandin synthesis can be inhibited with nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen and celecoxib. Treatment with NSAIDs has been shown to curb the tumorigenic properties of prostaglandins in several cancer models via both Cox-2-dependent and -independent mechanisms. In addition, celecoxib is well tolerated in humans, making its use as a chronic therapy for meningiomas attractive.
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Affiliation(s)
- Brian T Ragel
- Department of Neurosurgery, University of Utah, Salt Lake City, Utah 94132, USA
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Pfister C, Ritz R, Pfrommer H, Bornemann A, Tatagiba MS, Roser F. Are there attacking points in the eicosanoid cascade for chemotherapeutic options in benign meningiomas? Neurosurg Focus 2007; 23:E8. [DOI: 10.3171/foc-07/10/e8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Object
The current treatment for recurrent or malignant meningiomas with adjuvant therapies has not been satisfactory, and there is an intense interest in evaluating new molecular markers to act as therapeutic targets. Enzymes of the arachidonic acid (AA) cascade such as cyclooxygenase (COX)–2 or 5-lipoxygenase (5-LO) are upregulated in a number of epithelial tumors, but to date there are hardly any data about the expression of these markers in meningiomas. To find possible targets for chemotherapeutic intervention, the authors evaluated the expression of AA derivatives at different molecular levels in meningiomas.
Methods
One hundred and twenty-four meningioma surgical specimens and normal human cortical tissue samples were immunohistochemically and cytochemically stained for COX-2, COX-1, 5-LO, and prostaglandin E receptor 4 (PTGER4). In addition, Western blot and polymerase chain reaction (PCR) analyses were performed to detect the presence of eicosanoids in vivo and in vitro.
Results
Sixty (63%) of 95 benign meningiomas, 21 (88%) of 24 atypical meningiomas, all five malignant meningiomas, and all normal human cortex samples displayed high COX-2 immunoreactivity. All cultured specimens and IOMM-Lee cells stained positive for COX-2, COX-1, 5-LO, and PTGER4. The PCR analysis demonstrated no changes in eicosanoid expression among meningiomas of different World Health Organization grades and in normal human cortical and dura mater tissue.
Conclusions
Eicosanoid derivatives COX-1, COX-2, 5-LO, and PTGER4 enzymes show a high universal expression in meningiomas but are not upregulated in normal human cortex and dura tissue. This finding of the ubiquitous presence of these enzymes in meningiomas offers an excellent baseline for testing upcoming chemotherapeutic treatments.
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Affiliation(s)
| | | | | | - Antje Bornemann
- 2the Institute of Brain Research, University of Tübingen, Germany
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Johnson MD, Sade B, Milano MT, Lee JH, Toms SA. New prospects for management and treatment of inoperable and recurrent skull base meningiomas. J Neurooncol 2007; 86:109-22. [PMID: 17624496 DOI: 10.1007/s11060-007-9434-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2007] [Accepted: 06/07/2007] [Indexed: 12/25/2022]
Abstract
Skull base, including optic nerve, cavernous sinus, clival and foramen magnum tumors represent a major challenge for neurosurgeons and neuro-oncologists. Growth regulatory signaling pathways for these tumors are of increasing interest as potential targets for new chemotherapy. Those differentially activated in various grades of meningiomas are currently being identified as well. This article reviews some recent findings pathways that appear to regulate meningioma growth. Potential targets for novel therapies are also discussed.
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Affiliation(s)
- Mahlon D Johnson
- Department of Pathology and Laboratory Medicine, Division of Neuropathology, University of Rochester Medical Center, 601 Elmwood Ave. Box 626, Rochester, NY 14623, USA.
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Ragel BT, Jensen RL, Gillespie DL, Prescott SM, Couldwell WT. Celecoxib inhibits meningioma tumor growth in a mouse xenograft model. Cancer 2007; 109:588-97. [PMID: 17177201 DOI: 10.1002/cncr.22441] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Treatments for recurrent meningiomas are limited. We previously demonstrated universal expression of COX-2 in meningiomas and dose-dependent growth inhibition in vitro with celecoxib, a COX-2 inhibitor. We therefore tested the effects of celecoxib on meningioma growth in a mouse xenograft model. METHODS Meningioma cell lines (IOMM-Lee, CH157-MN, WHO grade I primary cultured tumor) were transplanted into flanks of nude mice fed mouse chow with celecoxib at varying concentrations (0, 500, 1000, 1500 ppm) ad libitum. Tumors were measured biweekly and processed for MIB-1, Factor VIII, COX-2, and VEGF, and assayed with transferase-mediated dUTP-biotin nick-end labeling (TUNEL). RESULTS Celecoxib reduced growth of mean tumor volume by 66% (P < .05), 25% (P > .05), and 65% (P < .05) compared with untreated controls in IOMM-Lee, CH157-MN, and benign tumors, respectively. IOMM-Lee tumors removed from celecoxib treatment regained a growth rate similar to the control. Blood vessel density decreased and apoptotic cells increased in treated flank tumors. Diminished COX-2 expression and VEGF were observed in treated IOMM-Lee tumors. Mean plasma celecoxib levels were 845, 1540, and 2869 ng/mL, for low-, medium-, and high-dose celecoxib, respectively. CONCLUSIONS Celecoxib inhibits meningioma growth in vivo at plasma levels achievable in humans. Celecoxib-treated tumors were less vascular with increased apoptosis. IOMM-Lee tumors treated with celecoxib showed decreased COX-2 and VEGF expression. COX-2 inhibitors may have a role in the treatment of recurrent meningiomas.
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Affiliation(s)
- Brian T Ragel
- Department of Neurosurgery, University of Utah, Salt Lake City, Utah 84132, USA
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Ragel BT, Gillespie DL, Kushnir V, Polevaya N, Kelly D, Jensen RL. Calcium Channel Antagonists Augment Hydroxyurea- And Ru486-Induced Inhibition Of Meningioma Growth In Vivo And In Vitro. Neurosurgery 2006; 59:1109-20; discussion 1120-1. [PMID: 17143245 DOI: 10.1227/01.neu.0000245597.46581.fb] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Although the chemotherapy drug hydroxyurea (HU) and the antiprogesterone mifepristone (RU486) have been used to treat meningiomas for which surgical and radiation therapies have failed, results have been disappointing. The addition of calcium channel antagonists (CCAs) to chemotherapeutic drugs enhances tumor growth inhibition in other tumor types, and the authors demonstrated that CCAs can block meningioma growth in vitro and in vivo. The purpose of this study was to test the effects of the addition of a CCA to HU or RU486 on meningioma growth. METHODS Primary and malignant (IOMM-Lee) meningioma cell lines were treated with HU, RU486, or either of these plus diltiazem or verapamil. Assays for cell growth, apoptosis, and fluorescent-activated cell sorting were performed on in vitro cultures. Similar cell lines were implanted into nude mice and were treated with HU or RU486, in combination with a CCA. Tumors were analyzed by light microscopy, MIB-1, and factor VIII immunohistochemical staining studies. RESULTS The addition of diltiazem or verapamil to HU or RU486 augmented meningioma growth inhibition by 20 to 60% in vitro. In vivo, tumors treated with combination drugs were smaller; and immunohistochemical analysis of the IOMM-Lee tumors showed a 10% decrease in the MIB-1 ratio (from 0.41 to 0.30) and an approximate 75% decrease in microvascular density. CONCLUSION The addition of diltiazem or verapamil to HU or RU486 augments meningioma growth inhibition in vitro by inducing apoptosis and G1 cell-cycle arrest. The combination of HU and diltiazem inhibited the growth of meningiomas in vivo by decreasing proliferation and microvascular density. These results suggest a possible role for these drugs as an additional adjuvant therapy for recurrent or unresectable meningiomas.
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Affiliation(s)
- Brian T Ragel
- Department of Neurosurgery, University of Utah, 30 North 1900 East, Suite 3B409, Salt Lake City, UT 84132, USA
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Zhang C, Liu W, An J, Liu ZK. Effects of celecoxib on cell proliferation and expression of vascular endothelial growth factor in colonic cancer with hepatic metastasis. Shijie Huaren Xiaohua Zazhi 2005; 13:2623-2626. [DOI: 10.11569/wcjd.v13.i21.2623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To explore the role of celecoxib in the proliferation and cycle distribution of colon cancer cells cultured in vitro as well as its effect on the expression of vascular endothelial growth factor (VEGF) in the animal model of colon cancer with hepatic metastasis.
METHODS: The human colon cancer cells HT-29 and HCT-116 were employed in the study. After treatment with celecoxib, the inhibitory effect of celecoxib on the proliferation of cancer cells was determined by MTT assay, and the cell cycle distribution was detected by flow cytometry. The tumor cells were inoculated in the nude mice, and the expression of VEGF in the model was detected by immunohistochemistry.
RESULTS: Celecoxib inhibited the proliferation of the tumor cells in a time- and dose-dependent manner. The inhibitory effect on HT-29 cells was stronger than that on HCT-116 cells (P <0.01). Celecoxib changed the cell cycle distribution of both cells, and decreased the proliferation index of cells obviously (P <0.05). Celecoxib significantly inhibited the expression of VEGF in the animal model of colon cancer with hepatic metastasis (P = 0.00).
CONCLUSION: Celecoxib can inhibit the division and proliferation of the tumor cells through inhibiting the activity of COX-2, consequently it play an important role in the prevention of hepatic metastasis and relapse of colon cancer.
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