Background: This study aimed to evaluate the clinical significance of cysteine-rich 61 (Cyr-61/CCN1) and\ncyclooxygenase-2 (COX-2), and further explored their combined prognostic significance in gastric cancer.\nMethods: This retrospective study examined the expressions of Cyr-61 and COX-2 in 82 surgically removed gastric\ncancer specimens and 43 non-tumor gastric mucosa specimens by immunohistochemical staining to identify the\nabnormal expression of Cyr-61 or COX-2 in gastric cancer. Crude survival curves were constructed by the\nKaplan-Meier method and Cox proportional hazards regression analysis was performed to confirm the prognostic\nroles of Cyr-61/COX-2 as well as sex and histological grade.\nResults: The expressions of Cyr-61 (p < 0.001) and COX-2 (p = 0.001) were both significantly up-regulated in gastric\ncancer samples compared with non-tumor gastric mucosa samples. The high expression of Cyr-61 or COX-2 was\nassociated with invasion, lymph node metastasis, distant metastases, poor histological differentiation, advanced\nTNM stage and lower 5-year survival rate (all p < 0.05). Both Cyr-61 and COX-2 high expressions [hazard ratio (HR) = 31.\n8, 95 % confidence interval (CI) 4.09ââ?¬â??246.8] was associated the higher risk of death during 5 years follow up than single\nCyr-61 high [removed]HR = 4.1, 95 % CI 1.5ââ?¬â??11.6) or COX-2 high [removed]HR = 2.9, 95 % CI 1.06ââ?¬â??7.8).\nConclusions: Cyr-61 and COX-2 expressions are associated with the progression of gastric cancer. Additionally,\ncombined expressions of Cyr-61 and COX-2 has a higher prognostic value than single expression.
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