Barrett's epithelium is a recognized premalignant condition for esophageal
adenocarcinoma. Nonsteroidal antiinflammatory drugs (NSAIDs) decrease the r
elative risk of colon cancer in humans and the esophageal tumor load in car
cinogen-treated mice. Previous studies provided conflicting results for COX
-2 activity in Barrett's mucosa. Pinch mucosal biopsies were collected from
Barrett's and adjacent normal esophageal mucosa from 17 patients with Barr
ett's esophagus. Low-grade dysplasia was found in seven patients. COX-2 pro
tein was undetectable in normal esophageal mucosa. COX-1 protein expression
did not vary between normal and Barrett's epithelium. Increased COX-2 prot
ein was detected in Barrett's epithelium in seven patients (41%) but did no
t differ with or without dysplasia (43% vs 40%). In conclusion, COX-2 prote
in is increased in 41% of patients with Barretts epithelium compared to nor
mal esophageal mucosa but did not differ with or without dysplasia. COX-2 i
nduction may be an early event in the development of Barrett's esophagus.