title: Immunohistochemical expression of cycloxygenase-2 in astrocytoma: correlation with angiogenesis, tumor progression and survival.
abstract: OBJECTIVE
  Cyclooxygenase-2 (Cox-2) appears to play a role in the regulation of progression, invasiveness and angiogenesis of various neoplasms. Experimental studies have indicated that COX-2 regulate angiogenesis by modulating vascular endothelial growth factor (VEGF) production. The aim of this study was to evaluate the immunohistochemical expression of COX-2 in astrocytoma, in relation to VEGF expression, microvessel density (MVD), clinicopathologic factors and patient survival.
  
  
  METHODS
  26 paraffin blocks of astrocytoma, with representative tissues and sufficient follow-up data, were evaluated immunohistochemically for protein marker expression.
  
  
  RESULTS
  COX-2 expression was detected in 21 (80.7%) of 26 astrocytomas with an increased expression in grade IV (100%) as compared to grades II (63.6%) and III (83.3%) (p < 0.001), (r=0.64). A positive correlation was observed between the immunoreactive scores of COX-2, VEGF (p < 0.001), (r=0.61) and MVD (p < 0.001), (r=0.72). Also COX-2 expression was significantly associated with poor survival (p < 0.001), (r=0.58), but did not show significant difference among patient age, sex and tumor location.
  
  
  CONCLUSIONS
  COX-2 is up-regulated in the majority of high-grade astrocytomas and may contribute to astrocytic tumorigenesis by promoting new vessel formation. Moreover, increased COX-2 expression is a significant negative predictor of survival. COX-2 inhibitors may represent an important therapeutic target.
authors.affiliation: Zagazig University, Faculty of Medicine, Department of Pathology, Zagazig, Egypt.
authors.forename: Mona
authors.initials: M
authors.lastname: El-Sayed
authors.forename: Mahmoud M
authors.initials: MM
authors.lastname: Taha
mesh_terms: D000293:Adolescent; D000328:Adult; D001254:Astrocytoma / Q000378:metabolism* / Q000401:mortality / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000378:metabolism*; D001932:Brain Neoplasms / Q000378:metabolism* / Q000401:mortality / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D051546:Cyclooxygenase 2 / Q000378:metabolism*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D055806:Microvessels / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000378:metabolism / Q000401:mortality / Q000473:pathology; D015996:Survival Rate; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D051546:Cyclooxygenase 2