Study of Expression of COX-2 and HER2/neu in Colorectal Cancer and Their Correlation with Histological Grades
DOI:
https://doi.org/10.21276/apalm.3569Keywords:
Colorectal carcinoma, HER2/neu, COX2, immunohistochemistryAbstract
Background: Colorectal cancer (CRC) is a significant global health concern with increasing incidence and poor prognosis in advanced stages. This study evaluates HER2/neu and COX2 expression, key biomarkers in CRC, using immunohistochemistry. Their correlation with age, sex, tumor location, and histological grade is analyzed to refine diagnosis and guide personalized treatment.
Materials and Methods: Fifty resected colorectal carcinoma specimens diagnosed between January 2019 and December 2023 at J.L.N. Medical College, Ajmer, were analyzed. Immunohistochemical staining was performed using a rabbit monoclonal antibody for HER2/neu and a rabbit polyclonal antibody for COX2. Expression levels were correlated with clinicopathological parameters.
Results: Patients ranged from 20 to 82 years (mean: 55.6), with a male predominance. The rectum and caecum were the most common tumor sites. Adenocarcinoma accounted for 76% of cases, with grade II being most frequent (63.16%). HER2/neu overexpression was observed in 26% of cases, significantly correlating with serosal invasion, lymph node involvement, histological grade, and stage. COX2 overexpression occurred in 70% of cases, also showing significant associations with these factors. A strong positive correlation was noted between HER2/neu and COX2 expression.
Conclusion: HER2/neu and COX2 overexpression contribute to CRC progression, aiding in tumor invasion and metastasis. Targeting these markers, alone or with standard therapies, offers a promising strategy for personalized CRC treatment. COX2 inhibition may also play a role in prevention and therapy.
References
1. López PJ, Albero JS, Rodríguez-Montes JA. Primary and secondary prevention of colorectal cancer. Clin Med Insights Gastroenterol. 2014 Jul;7:CGast-S14039.
2. Soltani G, Poursheikhani A, Yassi M, Hayatbakhsh A, Kerachian M, Kerachian MA. Obesity, diabetes and the risk of colorectal adenoma and cancer. BMC Endocr Disord. 2019 Dec;19(1):1-10.
3. Cho YA, Lee J, Oh JH, Chang HJ, Sohn DK, Shin A, et al. Genetic risk score, combined lifestyle factors and risk of colorectal cancer. Cancer Res Treat. 2019 Jul;51(3):1033-40.
4. Xiong B, Sun TJ, Hu WD, Cheng FL, Mao M, Zhou YF. Expression of cyclooxygenase-2 in colorectal cancer and its clinical significance. World J Gastroenterol. 2005 Feb 28;11(8):1105-9.
5. Lin PC, Lin YJ, Lee CT, Liu HS, Lee JC. Cyclooxygenase-2 expression in the tumor environment is associated with poor prognosis in colorectal cancer patients. Oncol Lett. 2013 Sep;6(3):733-9.
6. Lichtenstern CR, Ngu RK, Shalapour S, Karin M. Immunotherapy, inflammation and colorectal cancer. Cells. 2020 Mar 4;9(3):618.
7. Ingold Heppner B, Behrens HM, Balschun K, Haag J, Krüger S, Becker T, et al. HER2/neu testing in primary colorectal carcinoma. Br J Cancer. 2014 Nov;111(10):1977-84.
8. Wu QB, Sun GP. Expression of COX-2 and HER-2 in colorectal cancer and their correlation. World J Gastroenterol. 2015 May 28;21(20):6206-14.
9. Dabbs DJ. Diagnostic immunohistochemistry: theranostic and genomic applications. 5th ed. China: Elsevier; 2019. p.509-41.
10. Achalla LS, Shinde RK, Jogdand S, Vodithala S. Review of the role of HER2/neu in colorectal carcinomas. Cureus. 2022 May 27;14(5):e25322.
11. Tomozawa S, Tsuno NH, Sunami E, Hatano K, Kitayama J, Osada T, et al. Cyclooxygenase-2 overexpression correlates with tumour recurrence, especially haematogenous metastasis, of colorectal cancer. Br J Cancer. 2000 Aug;83(3):324-8.
12. Perez EA, Cortés J, Gonzalez-Angulo AM, Bartlett JM. HER2 testing: current status and future directions. Cancer Treat Rev. 2014 Mar;40(2):276-84.
13. Bandhate K, Diwan AK, Mahobia V, Khan S. Changing trend in colorectal carcinomas in Central India. Asian J Med Res. 2021;10(1):5-10.
14. Li Q, Yu M, Lv H, Zhang L, Deng Y, Yu H. Burden of early-onset colorectal cancer along with attributable risk factors from 1990 to 2019: a comparative study between China and other G20 countries. BMC Public Health. 2023 Jul 31;23(1):1463.
15. Gill MK, Manjari M, Jain K, Kaur TA. Expression of Her-2/neu in colon carcinoma and its correlation with the histological grades and the lymph nodes status. J Clin Diagn Res. 2011 Dec;5(8):1564-8.
16. Tu J, Yu Y, Liu W, Chen S. Significance of human epidermal growth factor receptor 2 expression in colorectal cancer. Exp Ther Med. 2015 Jan;9(1):17-24.
17. Lee WS, Park YH, Lee JN, Baek JH, Lee TH, Ha SY. Comparison of HER2 expression between primary colorectal cancer and their corresponding metastases. Cancer Med. 2014 Jun;3(3):674-80.
18. Negi RR, Rana SV, Gupta V, Gupta R, Chadha VD, Prasad KK, et al. Over-expression of cyclooxygenase-2 in colorectal cancer patients. Asian Pac J Cancer Prev. 2019;20(6):1675-80.
19. Kiran DK, Preethi NS. COX2 and HER2 expression in colorectal cancer and their histopathological correlation. J Cardiovasc Dis Res. 2023;14(7):1-6.
20. Mohsenifar Z. Evaluation of HER2 in colorectal cancer with aggressiveness of the tumor and follow-up patients. J Gastro Hepato. 2023;10(4):1-8.
21. Nandi S, Das C, Kundu A, Mukhopadhyay M, Basu A. Role of HER2/neu in colorectal carcinoma: a cross-sectional study from a tertiary care centre in West Bengal, India. Natl J Lab Med. 2024;18(1):336-40.
22. Fazeli MS, Adel MG, Lebaschi AH. Colorectal carcinoma: a retrospective, descriptive study of age, gender, subsite, stage, and differentiation in Iran from 1995 to 2001 as observed in Tehran University. Dis Colon Rectum. 2007 Jul;50(7):990-5.
23. Park DI, Kang MS, Oh SJ, Kim HJ, Cho YK, Sohn CI, et al. HER-2/neu overexpression is an independent prognostic factor in colorectal cancer. Int J Colorectal Dis. 2007 May;22(5):491-7.
24. Tavangar A, Shariftabrizi E, Soroush B. HER2/neu over-expression correlates with more advanced disease in Iranian colorectal cancer patients. Med Sci Monit. 2005;11(3):CR126-9.
25. Seo AN, Kwak Y, Kim DW, Kang SB, Choe G, Kim WH, et al. HER2 status in colorectal cancer: its clinical significance and the relationship between HER2 gene amplification and expression. PLoS One. 2014 May 30;9(5):e98528.
26. Joo YE, Kim HS, Min SW, Lee WS, Park CH, Park CS, et al. Expression of cyclooxygenase-2 protein in colorectal carcinomas. Int J Gastrointest Cancer. 2002 May;31(2-3):147-54.
27. Sheehan KM, Sheahan K, O'Donoghue DP, MacSweeney F, Conroy RM, Fitzgerald DJ, et al. The relationship between cyclooxygenase-2 expression and colorectal cancer. JAMA. 1999 Oct 6;282(13):1254-7.
28. Al-Maghrabi J, Buhmeida A, Emam E, Syrjänen K, Sibiany A, Al-Qahtani M, et al. Cyclooxygenase-2 expression as a predictor of outcome in colorectal carcinoma. World J Gastroenterol. 2012 Apr 4;18(15):1793-9.
29. Albasri AM, Elkablawy MA, Hussainy AS, Yousif HM, Alhujaily AS. Impact of cyclooxygenase-2 over-expression on the prognosis of colorectal cancer patients: an experience from Western Saudi Arabia. Saudi Med J. 2018 Aug;39(8):773-9.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Vandana Yadav

This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
