Molecular and Cellular Biochemistry

, Volume 295, Issue 1–2, pp 75–83 | Cite as

Cyclooxygenase-2 expression in astrocytomas. Relationship with microvascular parameters, angiogenic factors expression and survival

  • Marina Perdiki
  • Penelope Korkolopoulou
  • Irene Thymara
  • George Agrogiannis
  • Christina Piperi
  • Efstathios Boviatsis
  • Xenophon Kotsiakis
  • Dimitrios Angelidakis
  • Kalliopi Diamantopoulou
  • Euphemia Thomas-Tsagli
  • Efstratios Patsouris



Cyclooxygenase-2 (COX-2) is the enzyme isoform involved in the synthesis of prostaglandins (PGs) and thromboxane from arachidonic acid. The role of the up-regulation of COX-2 in the formation and progression of gliomas has been dealt with in earlier reports, which describe increased levels of PGs within gliomas. In the present study, we examined the expression of COX-2 in diffuse gliomas of astrocytic origin in relation to microvascular parameters, angiogenic factors and survival.

Materials and methods

A total of 83 cases of diffuse astrocytomas (grade II–IV) were analyzed by immunohistochemistry for the presence of COX-2.


COX-2 expression was detected in 79 cases (95%) with an increased expression in grade IV as compared to grades II/III (p = 0.024). A positive correlation occurred between COX-2 and angiogenic factors such as vascular endothelial growth factor (VEGF) (p < 0.0001) and hypoxia inducible factor (HIF)-1α (p = 0.005), as well as the tumours’ proliferative activity (expressed as the percentage of Ki-67 positive cells) (p = 0.032), and total vascular area (TVA) (p = 0.040). In univariate analysis, COX-2 was associated with shortened survival (p = 0.050). Multivariate survival analysis showed that the interaction model of COX-2 with grade along with age were the only significant prognostic indicators.


These results implicate COX-2 in the angiogenesis and biological aggressiveness of diffuse astrocytomas, and suggest that it would be worthwhile to examine how the inhibition of COX-2 expression may influence astrocytoma patients’ survival.


astrocytoma hypoxia HIF-1α VEGF COX-2 


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Copyright information

© Springer 2006

Authors and Affiliations

  • Marina Perdiki
    • 1
  • Penelope Korkolopoulou
    • 1
  • Irene Thymara
    • 1
  • George Agrogiannis
    • 1
  • Christina Piperi
    • 2
  • Efstathios Boviatsis
    • 3
  • Xenophon Kotsiakis
    • 1
  • Dimitrios Angelidakis
    • 1
  • Kalliopi Diamantopoulou
    • 4
  • Euphemia Thomas-Tsagli
    • 4
  • Efstratios Patsouris
    • 1
  1. 1.Department of PathologyNational and Kapodistrian University of AthensAthensGreece
  2. 2.Department of Biological ChemistryNational and Kapodistrian University of AthensAthensGreece
  3. 3.Department of NeurosurgeryNational and Kapodistrian University of AthensAthensGreece
  4. 4.Department of PathologyAsklepeion HospitalAthensGreece

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