Expression of cyclooxygenase 2 and vascular endothelial growth factor in gastric carcinoma : relationship with clinicopathological parameters

Abstract EN

Background : Gastric cancer is one of the most common cancers and the second most common cause of cancer-related death worldwide.

Identification of specific prognostic indicators might allow a better prognostic stratification and more effective therapy.

Aim : To assess the expression and relationship between COX-2 and VEGF protein in gastric adenocarcinoma and whether these markers are useful in predicting clinicopathological prognostic parameters.

Materials and methods : The study included 83 formalin-fixed paraffin embedded tissue samples of excised gastric adenocarcinoma and 20 non tumorous tissue controls.

The slides were subjected to COX-2 and VEGF immunohistochemical staining using a streptavidin–biotinperoxidase according to the manufacturer’s protocol.

The results were assessed independently by two pathologists.

The relationships among COX-2 and VEGF expression and clinicopathological parameters were statistically analyzed.

Results: COX-2 and VEGF expressions were obviously higher in carcinoma tissues compared to normal mucosae (p < 0.001).

The expression rate of COX-2 was 54.2 % and of VEGF was 68.7 %.

COX-2 positive tumors were significantly correlated with Lauren classification, tumor depth and Helicobacter pylori infection (p < 0.001, p = 0.008, p = 0.035).

VEGF was significantly associated with lymph node metastasis and tumor depth (p<0.001).

There was a positive association between VEGF and COX-2 expression in gastric adenocarcinoma (Kappa value = 0.55).

Conclusion : In gastric adenocarcinoma, COX-2 expression might serve as a powerful indicator for intestinal type carcinoma, locally advanced disease and H.

pylori infection, while VEGF was related to loco-regional progression.

COX-2 might be involved in the development of angiogenesis in gastric carcinoma through VEGF upregulation.