title: Immunohistochemical analysis of growth mechanisms in juvenile nasopharyngeal angiofibroma.
abstract: Angiogenic factors are discussed to participate in growth and promotion of juvenile nasopharyngeal angiofibroma (JNA). However, only few data are available and mechanisms remain unclear. In the presented study we analysed the expression and subcellular distribution of several angiogenic growth factors and receptors potentially involved in JNA-growth and -vascularisation. In a retrospective, descriptive, multicenter-study, we analysed 13 formalin-fixed, paraffin-embedded or cryopreserved JNA-tumors (eleven primary tumors and two recurrent ones) after immunohistochemical staining. We used monoclonal antibodies specific for transforming growth factor beta 1 (TGF-beta(1)), basic fibroblast growth factor (bFGF), the VEGF-receptors 1 and -2 (FLT-1 and FLK-1), and the hypoxia inducible factor (Hif-1alpha). Data were compared to the vessel density. Quantitative analysis of staining intensities was performed by a computer assisted quantification technique. Endothelial and stromal compartments of the samples were analysed separately. Data were compared to vessel densities and patients data. The VEGF-Receptor-2 (FLK) was frequently unregulated in the stroma and endothelium of those samples with high vessel densities. Similarly, we observed high bFGF- and TGF-beta(1) levels in the stroma of strong vascularised samples. No correlations of expression levels to patients' data were found. The reported data support the concept of JNA-growth and -vascularisation driven by factors released from stromal fibroblasts. Therefore, inhibition of these factors might be beneficial for the therapy of inoperable JNA.
authors.affiliation: Department of Otorhinolaryngology, University Hospital, School of Medicine, Mainz, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Schuon
authors.forename: Jürgen
authors.initials: J
authors.lastname: Brieger
authors.forename: Ulf R
authors.initials: UR
authors.lastname: Heinrich
authors.forename: Yeduha
authors.initials: Y
authors.lastname: Roth
authors.forename: Witold
authors.initials: W
authors.lastname: Szyfter
authors.forename: Wolf J
authors.initials: WJ
authors.lastname: Mann
mesh_terms: D000293:Adolescent; D000328:Adult; D018322:Angiofibroma / Q000098:blood supply / Q000276:immunology / Q000473:pathology; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000276:immunology*; D006801:Humans; D051795:Hypoxia-Inducible Factor 1, alpha Subunit / Q000276:immunology*; D008233:Lymphotoxin-alpha / Q000276:immunology*; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000098:blood supply / Q000276:immunology / Q000473:pathology; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000473:pathology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000276:immunology*; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000276:immunology*
chemical_list: D051795:Hypoxia-Inducible Factor 1, alpha Subunit; D008233:Lymphotoxin-alpha; D016222:Fibroblast Growth Factor 2; D040281:Vascular Endothelial Growth Factor Receptor-1; D040301:Vascular Endothelial Growth Factor Receptor-2