COX-2 expression in ampullary carcinoma: correlation with angiogenesis process and clinicopathological variables
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Updated: Aug 11, 2026
Development of Compendium for Esophageal Squamous Cell Carcinoma
Published on: April 12, 2024
G Perrone1, D Santini, A Verzì
1Surgical Pathology, Campus Bio-Medico University, Rome, Italy. g.perrone@unicampus.it
Background:
There is evidence that the anti-neoplastic effect of non-steroidal anti-inflammatory drugs is attributable to cyclooxygenase-2 (COX-2) inhibition, but the exact mechanisms whereby COX-2 can promote tumour cell growth remain unclear. One hypothesis is the stimulation of tumour angiogenesis by the products of COX-2 activity. To data, there have been few clinicopathological studies on COX-2 expression in human ampullary carcinoma and no data have been reported about its relation with tumour angiogenesis.
Objective:
To investigate by immunohistochemistry the expression of COX-2 and the angiogenesis process in a series of primary untreated ampullary carcinomas.
Methods:
Tissue samples from 40 archival ampullary carcinomas were analysed for COX-2, vascular endothelial growth factor (VEGF), and an endothelial cell marker von Willebrand factor (vWF) by immunohistochemistry, using specific antibodies.
Results:
COX-2 expression was detected in 39 tissue samples (97.5%), of which two (5%) were graded as weak, 26 (65%) as moderate, and 11 (27.5%) as strong. Only one lesion (2.5%) was negative for COX-2 expression. VEGF expression was detected in 36 tissue samples (90%). A significant positive correlation was found between COX-2 and VEGF expression. No statistic correlation was found between COX-2 expression and microvessel density.
Conclusions:
COX-2 is highly expressed in ampullary carcinomas. This suggests an involvement of the COX-2 pathway in ampullary tumour associated angiogenesis, providing a rationale for targeting COX-2 in the treatment of ampullary cancer.
Insights
Cyclooxygenase-2 (COX-2) is highly expressed in ampullary carcinomas, suggesting its role in tumor angiogenesis. Targeting COX-2 may offer a new treatment strategy for ampullary cancer.
Area of Science:
- Oncology
- Molecular Biology
- Pathology
Background:
- Non-steroidal anti-inflammatory drugs' anti-neoplastic effects are linked to cyclooxygenase-2 (COX-2) inhibition.
- Mechanisms of COX-2 in promoting tumor cell growth, particularly tumor angiogenesis, are not fully understood.
- Limited clinicopathological data exists on COX-2 expression and its relation to angiogenesis in human ampullary carcinoma.
Purpose of the Study:
- To investigate cyclooxygenase-2 (COX-2) expression in primary untreated ampullary carcinomas.
- To examine the angiogenesis process in these tumors.
- To correlate COX-2 expression with markers of angiogenesis.
Main Methods:
- Immunohistochemistry was used to analyze 40 archival ampullary carcinoma tissue samples.
- Specific antibodies were employed to detect COX-2, vascular endothelial growth factor (VEGF), and von Willebrand factor (vWF).
- VEGF and vWF served as markers for angiogenesis.
Main Results:
- COX-2 was highly expressed in 97.5% of ampullary carcinomas, with varying intensity.
- Vascular endothelial growth factor (VEGF) expression was detected in 90% of the samples.
- A significant positive correlation was observed between COX-2 and VEGF expression, but not with microvessel density.
Conclusions:
- High COX-2 expression is a common feature of ampullary carcinomas.
- The COX-2 pathway appears to be involved in ampullary tumor-associated angiogenesis.
- Targeting COX-2 presents a potential therapeutic strategy for ampullary cancer treatment.
