Abstract
Neo-angiogenesis may have an important role in the poor prognosis of gallbladder carcinoma. An enhanced expression of COX-2 was found in precancerous lesions and in gallbladder carcinoma, likely to be involved in carcinogenesis as well as in angiogenesis. To study the relationships between the COX-2 expression and degree of vascularization, as well as to evaluate their role in the prognosis of patients with gallbladder carcinoma. 27 cases of gallbladder adenocarcinoma were included, classified grading I-III according the WHO classification. The COX-2 and endothelial antigen CD105 expressions were assessed immunohistochemically. COX-2 expression was evaluated according to the percentage and staining intensity of positive cells into "COX-2 positive" and "COX-2 negative" groups. In order to assess tumor microvessel density (MVD), CD105 positively stained microvessels were counted for each specimen in predominantly vascular areas (hot spots) at 200 x magnification. The MVD ranged from 9 to 46 microvessels/field. 15 tumors belonged to the hypervascular group (MVD > or = 25) and 12 to the hypovascular group. There were 16 (59.2%) COX-2 positive cases. There was difference in the degree of angiogenesis between COX-2 positive vs. COX-2 negative group: 11 (68.8%) out of 16 "COX-2 positive" tumors were hypervascular, in comparison with just 4 (36.4%) of "COX-2 negative" tumors. Our data show that the MVD corresponds to the COX-2 overexpression in gallbladder carcinomas. Augmented tumor neovascularization induced by COX-2 might be responsible for the poor prognosis in gallbladder carcinoma patients.
Highlights
Carcinoma of the gallbladder is an agressive tumor with an overall -year survival rate of less than
It is superior to other panendothelial markers because it distinguishes between newborn tumor vessels and preexsisting parenteral vessels, detecting only tumor neoangiogenesis
The aim of our recent study was to investigate the relationships between the expression of COX- and angiogenesis in gallbladder carcinoma as well as to evaluate their role in the prognosis of patients with gallbladder carcinoma
Summary
Carcinoma of the gallbladder is an agressive tumor with an overall -year survival rate of less than. Activation of the angiogenic pathways in malignant tumors is common and, by inducing new blood vessel formation, may have a decisive role in determining local invasion, metastasis and clinical outcome ( , ). CD (endoglin) is a new endothelial cell marker, to visualize neovasculature and to count the intratumor microvessel density (MVD). ). Expression of the COX- enzyme is responsible for enhanced tumor growth and angiogenesis in various tumours ( - ), having the role both in early carcinogenesis as well as in angiogenesis. Data on gallbladder carcinoma biology are scarce ( , , ). Enhanced expression of cyclooxygenase- (COX- ) was found in precancerous lesions and in gallbladder carcinoma ( ). The aim of our recent study was to investigate the relationships between the expression of COX- and angiogenesis in gallbladder carcinoma as well as to evaluate their role in the prognosis of patients with gallbladder carcinoma
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