The Expression Of VEGF-C, VEGFR-3 And COX-2 In Pancreatic Carcinoma And Its Relationship To Lymphatic Metastasis

Objective:To investigate the relationship among the expression of vascular endothelial growth factor-c ( VEGF-C ), vascular endothelial growth factor receptor-3 ( VEGFR-3 ) and cyclooxygenase-2 ( COX-2 ) and define the association of them with lymphatic metastasis of pancreatic carcinoma.Methods:Immunohistochemistry methods ( S-P method ) were used to detect the expression of VEGF-C, VEGFR-3 and COX-2 in Paraffin-embedded tumor specimens of pancreatic carcinoma tissue 41 cases and 10 cases of normal pancreatic tissue. The correlations among the expression of VEGF-C, VEGFR-3, COX-2, lymphatic vessel density ( LVD ), clinicopathologic features were statistically analyzed with SPSS 11.0.Results:VEGF-C and COX-2 expressions are observed in the cytoplasm of carcinoma cells. The positive rates of VEGF-C and COX-2 are 66.1% and 86.4% respectively. The positive expression of VEGF-C and COX-2 are significantly higher in tissues of pancreatic carcinoma than in normal pancreatic tissues ( P < 0.05 ). VEGF-C and COX-2 expressions are significantly correlated with lymph node metastasis and tumor clinical stage ( P < 0.05 ). The expression of VEGF-C and COX-2 are not related to patients' gender and age, tumor location and histological grade ( P > 0.05 ). There is significantly statistic correlation between expression of VEGF-C and COX-2 in pancreatic carcinoma. (r = 0.398, P < 0.05 ). VEGFR-3 expression is observed in the cytoplasm of lymphatic endothelial cell around primary tumors. The positive rate of VEGFR-3 are significantly higher in tissues of pancreatic carcinoma ( 58.5%, 24/41 ) than in normal pancreatic tissues ( 10%, 1/10 ) ( P < 0.05 ). VEGFR-3 expressions are significantly correlated with lymph node metastasis and tumor clinical stage ( P < 0.05 ). Statistical analysis showed that there is no significant correlation of patients' age and gender, tumor location, tumor histological grade ( P > 0.05 ). There are significantly statistic correlations between the expression of VEGFR-3, VEGF-C and COX-2 in pancreatic carcinoma (r = 0.597, P = 0.000; r = 0.391, P = 0.034).The positive lymphatic vessel expression is observed in the mesenchyme around primary tumors. The LVD in the tissues of pancreatic carcinomas is 15.47±5.63, which is higher than that of normal pancreatic tissues ( 7.29±3.39 ). LVD in tumors with lymph node metastasis are higher than those of tumors without lymph node metastasis. LVD expressions are significantly correlated with lymph node metastasis, tumor histological grade and tumor clinical stage ( P < 0.05 ). There is no significant correlation between LVD and patients' age and gender, tumor location ( P > 0.05 ). Closely correlations were found between LVD and VEGF-C ( P < 0.05 ), LVD and VEGFR-3 (P < 0.05 ), LVD and COX-2.Conclusions:Positive expression of VEGF-C, VEGFR-3 and COX-2 are increased in pancreatic carcinoma tissues. There is significantly statistic correlation among expressions of VEGF-C, VEGFR-3 and COX- 2 in pancreatic carcinoma.The expression of VEGF-C , VEGFR-3 and COX-2 significantly related to lymph node metastasis and tumor clinical stage.VEGF-C, VEGFR-3 and COX-2 may be significant indexes for lymph node metastasis in pancreatic carcinoma.This implies that selectivity to inhibit VEGF-C, VEGFR-3 or COX-2 could become a new target for therapeutic options of pancreatic carcinoma.