Cyclooxygenase-2 and vascular endothelial growth factor in chronic hepatitis, cirrhosis and hepatocellular carcinoma

Abstract

Background/ Aims: Cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) are up-regulated in hepatocellular carcinoma (HCC). To investigate the levels of COX-2 and VEGF expression in chronic hepatitis (CH), cirrhosis, and HCC. Methods: The immunohistochemical expressions of COX-2 and VEGF were evaluated in tissues from patients with CH (n = 95), cirrhosis (n = 38), low-grade HCC (LG-HCC; n = 6), and high-grade HCC (HG-HCC; n = 29). Results: The COX-2 expression scores in CH, cirrhosis, LG-HCC, and HG-HCC were 3.3 +/- 1.9 (mean +/- SD), 4.2 +/- 1.7, 5.5 +/- 1.0, and 3.4 +/- 2.4, respectively (CH vs. cirrhosis, P=0.016; CH vs. LG-HCC, P = 0.008; LG-HCC vs. HG-HCC, P =0.004), and the corresponding VEGF expression scores were 0.9 +/- 0.8, 1.5 +/- 0.7, 1.8 +/- 0.9, and 1.6 +/- 1.1 (CH vs. cirrhosis, P< 0.001; CH vs. LGHCC, P=0.011; LG-HCC vs. HG-HCC, P=0.075). Both factors were correlated with the fibrosis stage in CH and cirrhosis (COX-2: r=0.427, P< 0.001; VEGF: r=0.491, P<0.001). There was a significant correlation between COX-2 and VEGF in all of the tissue samples (r=0.648, P<0.001), and between high COX-2 and VEGF expression scores and survival (COX-2: P= 0.001; VEGF: P<0.001). Conclusions: The expressions of both COX-2 and VEGF are significantly higher in cirrhosis and LG-HCC than in CH. High COX-2 and high VEGF expressions are associated with a high survival rate.