To understand the role of cyclooxygenase-2 (COX-2) in gastric cancer, we examined the abundance of COX-2, vascular endothelial growth factor-A (VEGF-A), and CD34 in 45 surgically resected human gastric cancers and paired normal gastric mucosa by immunohistochemical analysis. In addition, the message RNA (mRNA) expression of COX-2 and VEGF-A was evaluated in ten fresh surgically resected human gastric cancers and paired normal gastric mucosas using semi-quantitative reverse transcriptional polymerase chain reaction analysis. Our results confirmed an increased abundance of COX-2 and VEGF-A, and the microvessel density, which was assessed by CD34 abundance, in gastric cancer tissues compared with normal paired mucosa. Abundance of COX-2 and VEGF-A was significantly associated with tumor-node-metastasis (TNM) stage (P<0.05) and lymph node metastasis (P<0.001). In addition, abundance of VEGF-A associates with distance metastasis. A significant correlation was found between COX-2 and VEGF-A abundances (P<0.001). Both abundance of COX-2 and VEGF-A were significantly correlated with microvessel density (P<0.001, respectively). In six of ten cancerous tissues and in one of ten paired normal mucosas, the mRNA expression of COX-2 and VEGF-A was detected in the same specimen. In one other cancerous tissue, only COX-2 mRNA was detected. This study indicates that COX-2 is related to tumor angiogenesis in gastric cancer. VEGF-A might play a main role in the COX-2 angiogenic pathway.
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