Early reports demonstrated elevated levels of prostaglandins in colorectal cancer compared to normal mucosa15-17 and more recently, a more comprehensive study showed a significant increase in PGE2 in 21 surgically excised colorectal cancers.18 Stemming from this observed increase in prostaglandin synthesis in colorectal cancer, recent studies have analyzed the levels of the COX enzymes in colorectal cancer. Eberhart et al19 measured COX-1 and COX-2 mRNA levels in adenocarcinomas and the paired normal mucosa of 14 surgical patients with cancers classified as Dukes' Stage B to D. Low to undetectable levels of COX-2 mRNA were observed in the normal mucosa. However, COX-2 expression was apparent in 12 of the 14 carcinomas (86%). This increase in COX-2 varied from a 2- to 50-fold elevation compared to normal mucosa and the degree of upregulation did not appear to correlate cyclooxygenase
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