Expression of Cyclooxygenase 2 (COX-2) and Vascular Endothelial Growth Factor (VEGF) in Gastric Carcinoma and Relationship with Clinicopathological Parameters


The Department of Pathology, Faculty of Medicine, Al-Azhar University


Abstract Background: Gastric cancer remains one of the common and deadly cancers worldwide, especially among older males, identification of specific prognostic indicators might allow a better prognostic stratification and more effective therapy. The cyclooxygenase-2 (COX-2) protein has been detected insome tumors andits over expression is associated with there prognosis. The vascular endothelial growth factor (VEGF), as a cell regulatory factor that affects the blood vessel forma-tion, growth and occurrence of tumors. Aim of Study: To assess cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) immunohistochem-ical (IHC) expression in gastric carcinoma cases, whether these markers are useful in predicting Clinicopathological prognostic parameters and whether there is anassociation between the expression of cyclooxygenase-2 and vascular endothelial growth factor. Material and Methods: A total of 50 archived, formalin fixed, paraffin embedded tissue blocks of 50 cases of gastric adenocarcinoma with different grades. The samples were immunohistochemically analysed for COX-2 & VEGF ex-pressions using a streptavid in biotinperoxidase according to the manufacturers protocol. 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 tonormal mucosae (p < 0.001). Concerning COX-2 the expression rate was 62.%. COX-2 positive tumors were significantly correlated with Lauren classification, tumor grade (p < 0.006, p=0.041). Con-cerning VEGF the expression rate was 66.%. VEGF was significantly associatedwith lymph node metastasis and tumor depth (p < 0.030, p < 0.019). There was significant association-between COX-2 and VEGF expression in gastric adenocarci-noma (p=0.029). Conclusion: In gastric adenocarcinoma, COX-2 expression might serve as a powerful indicator forintestinal type carcinoma and tumor grade, while VEGF was relatedto loco-regional progression. COX-2 might be involved in the development of angiogenesis in gastric carcinoma through VEGF upregu-lation.