Cyclooxygenase 2 expression in pancreatic adenocarcinoma and pancreatic intraepithelial neoplasia: An immunohistochemical analysis with automated cellular imaging

Anirban Maitra, Raheela Ashfaq, Carla R. Gunn, Ayman Rahman, Charles J. Yeo, Taylor A. Sohn, John L. Cameron, Ralph H. Hruban, Robb E. Wilentz

Research output: Contribution to journalArticle

143 Scopus citations


We immunohistochemically examined material from 36 pancreata (adenocarcinomas, 30 lesions; pancreatic intraepithelial neoplasia [PanIN], 65; normal pancreatic ducts, 30) for cyclooxygenase 2 (COX-2) with an automated platform. We analyzed 7 to 10 discrete foci and generated an average percentage of positive cells and average staining intensity for each lesion. These 2 values were then multiplied to create an overall "HistoScore" for each lesion. COX-2 demonstrated considerable heterogeneity of expression between and within cases. The overall average percentage of positive cells in adenocarcinomas was 47.3%; in PanINs, 36.3%; and in normal ducts, 19.2%. COX-2 was expressed in more than 20% of cells in 23 adenocarcinomas (77%), 42 PanINs (65%), and 12 normal ducts (40%). The overall average HistoScore for adenocarcinomas was 6.1; for PanINs, 5.4; and for normal ducts, 3.5. Significant differences in COX-2 expression were demonstrable in adenocarcinomas vs normal ducts, PanINs vs normal ducts, and PanIN 2/3 vs PanIN 1a/1b. In general, the patient of COX-2 expression increased from normal to PanIN to adenocarcinoma. The up-regulation of COX-2 in a subset of noninvasive precursor lesions makes it a potential target for chemoprevention with selective COX-2 inhibitors.

Original languageEnglish (US)
Pages (from-to)194-201
Number of pages8
JournalAmerican Journal of Clinical Pathology
Issue number2
StatePublished - Aug 2002
Externally publishedYes



  • Cyclooxygenase 2
  • Image analysis
  • Pancreatic adenocarcinoma
  • Pancreatic intraepithelial neoplasia
  • PanIN

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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