<Originals> COX-2 expression and the prevalence of regulatory T cells in tumor and non-tumor sites of hepatocellular carcinoma

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[Abstract] Aim : The expression of cyclooxygenase-2 (COX-2) plays a role in the differentiation and guidance of regulatory T cells (FOXP3^+ Tregs), and this mechanism has also been studied extensively in hepatocellular carcinoma (HCC). In this study, we investigated the expression of COX-2 and prevalence of FOXP3^+ Tregs in tumor and non-tumor sites to elucidate their association with the clinicopathological features of HCC and disease outcome. Method : This study involved 44 patients with HCC who had undergone hepatectomy without any preoperative treatment. Paraffin-embeddednodules (n=44) were sectioned for immunostaining with COX-2 and FOXP3 monoclonal antibodies, and the degree of COX-2 expression and prevalence of FOXP3^+ Tregs were measured. Results : COX-2 expression in the non-tumor sites showed a positive correlation with the number of FOXP3^+ Tregs (p < 0.001). In addition, in the non-tumor sites, the high FOXP3^+ Tregs prevalence group was significantly associated with TNM stages (p=0.003) and AFP (p=0.027). The expression of COX-2 in the nontumor sites was also significantly associated with disease-free survival (p=0.005). Conclusion : The present findings suggest the association of COX-2 expression in the nontumor sites with disease-free survival and thus the recurrence of HCC. In addition, COX-2 expression and the prevalence of FOXP3^+ Tregs have been positively correlated in the non-tumor sites, indicating that their interaction influences the outcome of HCC. To prevent the recurrence of HCC, it may be necessary to inhibit the expression of COX-2.

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