Prognostic Significance of Expression of VEGF and Cox-2 in Nasopharyngeal Carcinoma and Its Association With Expression of C-erbB2 and EGFR

Background and Objectives: This study evaluated several tumor angiogenesis-related markers to examine their expression pattern and relation to clinicopathologic implications of nasopharyngeal carcinoma. Methods: Paraffin sections from 69 nasopharyngeal carcinomas obtained before radiotherapy were prepared. The expression of vascular endothelial growth factor (VEGF), cyclooxygenase-2 (Cox-2), C-erbB2, and epidermal growth factor receptor (EGFR) were investigated by immunohistochemistry and then correlated with various clinicopathologic parameters. Results: VEGF was inversely correlated with C-erbB2 (P = 0.036). In survival analysis, high mitosis (>= 5/10 high power field) was significantly associated with worse relapse-free survival in univariate analysis (P = 0.048) but not in multivariate analysis (P = 0.153). High stage, high mitotic rate, absence of VEGF, and presence of Cox-2 were associated with worse survival in both univariate analysis (P = 0.002, P = 0.038, P = 0.044, and P = 0.028, respectively) and multivariate analysis (P = 0.007, P = 0.036, P = 0.047, and P = 0.004, respectively). Conclusions: Absence of VEGF is a useful indicator of poor prognosis in addition to Cox-2 expression, high stage, and high mitosis. J. Surg. Oncol. 2011; 103: 46-52. (c) 2010 Wiley-Liss, Inc.