, Volume 40, Issue 4, pp 861-868
Date: 07 Mar 2008

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

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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).


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.


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).


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.