title: Increased expression of VEGF, COX-2, and Ki-67 in Barrett's esophagus: does the length matter?
abstract: BACKGROUND
  Barrett's esophagus (BE) is a major complication of gastroesophageal reflux disease due to its neoplastic potential. The length of the metaplastic epithelium has been associated with cancer risk. Angiogenesis, inflammation, and increased cell proliferation are early events in the malignant sequence. Vascular endothelial growth factor (VEGF), cyclooxygenase-2 (COX-2) and Ki-67 are indirect markers of these complex mechanisms.
  
  
  OBJECTIVE
  To examine the expression of VEGF, COX-2 and Ki-67 in BE and investigate whether there is an association to Barrett's length.
  
  
  METHODS
  Immunohistochemistry for VEGF, COX-2, and Ki-67 was performed in well-characterized Barrett's samples, evaluated using a qualitative scale and compared between long (LSBE) and short (SSBE) segments.
  
  
  RESULTS
  The study population consisted of 98 patients (78 men). LSBE and SSBE was diagnosed in 33 (33.7%) and 65 (66.3%) cases, respectively. VEGF was expressed in vascular endothelium of all Barrett's specimens. COX-2 and Ki-67 expression in metaplastic epithelia was strong in 81.6 and 61.2% of the samples, respectively. Ki-67 expression was significantly stronger in LSBE (p = 0.035), whereas VEGF expression was significantly increased in SSBE (p = 0.031). COX-2 expression was not associated with Barrett's length.
  
  
  CONCLUSIONS
  VEGF, COX-2, and Ki-67 were overexpressed in the majority of Barrett's samples. The length was inversely associated with VEGF expression and directly associated with Ki-67 expression.
authors.affiliation: Gastroenterology Department, Alexandra General Hospital, 80 Vas. Sofias Ave., 11528 Athens, Greece. evazamb@yahoo.com
authors.forename: Evanthia
authors.initials: E
authors.lastname: Zampeli
authors.forename: George
authors.initials: G
authors.lastname: Karamanolis
authors.forename: George
authors.initials: G
authors.lastname: Morfopoulos
authors.forename: Elias
authors.initials: E
authors.lastname: Xirouchakis
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Kalampoki
authors.forename: Spyros
authors.initials: S
authors.lastname: Michopoulos
authors.forename: Sotiria
authors.initials: S
authors.lastname: Savva
authors.forename: Vasilios
authors.initials: V
authors.lastname: Tzias
authors.forename: Irene
authors.initials: I
authors.lastname: Zouboulis-Vafiadis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kamberoglou
authors.forename: Spiros D
authors.initials: SD
authors.lastname: Ladas
mesh_terms: D000328:Adult; D000368:Aged; D001471:Barrett Esophagus / Q000150:complications / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D015415:Biomarkers; D049109:Cell Proliferation; D002471:Cell Transformation, Neoplastic / Q000235:genetics / Q000378:metabolism; D051546:Cyclooxygenase 2 / Q000235:genetics* / Q000378:metabolism; D055088:Early Detection of Cancer; D004938:Esophageal Neoplasms / Q000209:etiology / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D004947:Esophagus / Q000473:pathology*; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D007249:Inflammation / Q000235:genetics / Q000378:metabolism; D019394:Ki-67 Antigen / Q000235:genetics* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000235:genetics / Q000378:metabolism; D012307:Risk Factors; D042461:Vascular Endothelial Growth Factor A / Q000235:genetics* / Q000378:metabolism
chemical_list: D015415:Biomarkers; D019394:Ki-67 Antigen; D042461:Vascular Endothelial Growth Factor A; D051546:Cyclooxygenase 2