COX-2 expression in ampullary carcinoma: correlation with angiogenesis process and clinicopathological variables.
BACKGROUND
There is evidence that the anti-neoplastic effect of non-steroidal anti-inflammatory drugs is attributable to cyclooxygenase-2 (COX-2) inhibition, but the exact mechanisms whereby COX-2 can promote tumour cell growth remain unclear. One hypothesis is the stimulation of tumour angiogenesis by the products of COX-2 activity. To data, there have been few clinicopathological studies on COX-2 expression in human ampullary carcinoma and no data have been reported about its relation with tumour angiogenesis.


OBJECTIVE
To investigate by immunohistochemistry the expression of COX-2 and the angiogenesis process in a series of primary untreated ampullary carcinomas.


METHODS
Tissue samples from 40 archival ampullary carcinomas were analysed for COX-2, vascular endothelial growth factor (VEGF), and an endothelial cell marker von Willebrand factor (vWF) by immunohistochemistry, using specific antibodies.


RESULTS
COX-2 expression was detected in 39 tissue samples (97.5%), of which two (5%) were graded as weak, 26 (65%) as moderate, and 11 (27.5%) as strong. Only one lesion (2.5%) was negative for COX-2 expression. VEGF expression was detected in 36 tissue samples (90%). A significant positive correlation was found between COX-2 and VEGF expression. No statistic correlation was found between COX-2 expression and microvessel density.


CONCLUSIONS
COX-2 is highly expressed in ampullary carcinomas. This suggests an involvement of the COX-2 pathway in ampullary tumour associated angiogenesis, providing a rationale for targeting COX-2 in the treatment of ampullary cancer.
Surgical Pathology, Campus Bio-Medico University, Rome, Italy. g.perrone@unicampus.it
G
G
Perrone
D
D
Santini
A
A
Verzì
B
B
Vincenzi
D
D
Borzomati
F
F
Vecchio
R
R
Coppola
A
A
Antinori
P
P
Magistrelli
G
G
Tonini
C
C
Rabitti
D000328:Adult; D000368:Aged; D014670:Ampulla of Vater; D015415:Biomarkers / Q000032:analysis; D002277:Carcinoma / Q000098:blood supply / Q000201:enzymology*; D003138:Common Bile Duct Neoplasms / Q000098:blood supply / Q000201:enzymology*; D051546:Cyclooxygenase 2 / Q000032:analysis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000209:etiology*; D018709:Statistics, Nonparametric; D042461:Vascular Endothelial Growth Factor A / Q000032:analysis; D014841:von Willebrand Factor / Q000032:analysis
D015415:Biomarkers; D042461:Vascular Endothelial Growth Factor A; D014841:von Willebrand Factor; D051546:Cyclooxygenase 2