BACKGROUND Experimental, clinical, and epidemiological studies have implicated mitogenic metabolites of arachidonic acid such as prostaglandin E₂(PGE₂) in colorectal carcinogenesis. Recently, cyclooxygenase 2 (COX-2) which catalyses the conversion of arachidonic acid to PGE₂, has displayed increased levels in human colorectal cancer.

AIMS To evaluate whether there is differential COX-2 expression from different locations (caecum, ascending, transverse, descending, or sigmoid colon, and rectum) in human colorectal cancer.

RESULTS There was a notable overexpression of COX-2 protein in tumours located in the rectum (p<0.001) compared with other locations in the colon. Rectal tumours revealed elevated COX-2 protein levels in 18/20 cases compared with 4/19 colonic cases. No association between enhanced COX-2 protein expression in tumour tissue and Dukes’s stages was found.

CONCLUSIONS Results suggest that the differential COX-2 expression may be due to differences in gene regulatory factors affecting COX-2 expression and/or reflect secondary changes in tumour progression which may have clinical implications.