The implications of COX-2 and HER2 protein expression for the prognosis of colorectal cancer patients: An exploratory study from the North African region.

[BACKGROUND] The prognostic value of COX-2 and HER2 protein overexpression in colorectal cancer remains controversial and has not previously been evaluated in North Africa. In this study, we investigated the association between COX-2 and HER2 overexpression, clinicopathological features and patient survival.

[METHODS] Seventy patients with stage I-IV colon adenocarcinoma were prospectively and retrospectively included in this study between 2016 and 2021. The expression of COX-2 and HER2 proteins was evaluated using tissue microarrays (4μm). Overall survival (OS) and recurrence-free survival (RFS) outcomes were compared according to COX-2 and HER2 expression status using the Kaplan-Meier method.

[RESULTS] Positive expression of COX-2 and HER2 proteins was observed in 58 (82.9%) and 2 (2.9%) cases, respectively. COX-2 expression was associated with female sex, vascular invasion, lymph node metastasis, distant metastasis, TNM stage, and poor overall survival. HER2 expression was mainly associated with younger age, presence of positive LN and LN ratios, increased recurrence, and lower recurrence-free survival rate.

[CONCLUSION] This study highlights the prognostic impact of COX-2 and HER2 expression in patients with colorectal cancer. The association of clinicopathological features with COX-2 and HER2 expression suggests the need to incorporate these two biomarkers into the pathomolecular classification of colorectal cancer. Based on survival analysis, COX-2 and HER2 expression were associated with shorter overall survival and recurrence-free survival in patients with colorectal cancer.