Original Article

International Urology and Nephrology

, Volume 40, Issue 4, pp 861-868

VEGF, COX-2, and PCNA expression in renal cell carcinoma subtypes and their prognostic value

  • Ayhan DirimAffiliated withDepartment of Urology, Baskent University School of Medicine Email author 
  • , Asuman Nihan HaberalAffiliated withDepartment of Pathology, Baskent University School of Medicine
  • , Mehmet Resit GorenAffiliated withDepartment of Urology, Baskent University School of Medicine
  • , Mehmet Ilteris TekinAffiliated withDepartment of Urology, Baskent University School of Medicine
  • , Levent PeskirciogluAffiliated withDepartment of Urology, Baskent University School of Medicine
  • , Beyhan DemirhanAffiliated withDepartment of Pathology, Baskent University School of Medicine
  • , Hakan OzkardesAffiliated withDepartment of Urology, Baskent University School of Medicine

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Abstract

Objective

To evaluate the prognostic value of new markers such as VEGF (vascular endothelial growth factor), COX-2 (cyclooxygenase-2), and PCNA (proliferating cell nuclear antigen) and review their differences in expression by histological subtype in patients with renal cell carcinoma (RCC).

Methods

About 99 patients who underwent radical (n = 79) or partial nephrectomy (n = 20) were included in this study. Histopathological specimens from the subjects were retrospectively analyzed immunohistochemically for the presence of VEGF, COX-2, or PCNA.

Results

Mean staining ratios for VEGF, COX-2, and PCNA were 16.5, 16.8, and 31%, respectively. Correlations were evaluated among these three prognostic factors. There was no correlation between PCNA and VEGF (= .068), but there were significant correlations between COX-2 and both PCNA and VEGF (= .005 and = .000, respectively). A significant correlation was found between the expression of VEGF and both pathologic stage and vascular invasion (= .018 and = .025, respectively). In addition, patients with conventional RCC had significantly lower VEGF and COX-2 levels than those with papillary RCC (< .012).

Conclusions

It is obvious that prognostic factors such as VEGF, COX-2, and PCNA may vary depending on histological subtype. The level of expression of these factors together with histological subtype may provide valuable predictive information about the outcome of treatment.

Keywords

COX-2 PCNA Prognostic factors Renal cell carcinoma VEGF