Cyclooxygenase-2 expression is associated with vascular endothelial growth factor-c and lymph node metastasis in human oral tongue cancer

Objective. This study aimed to determine the relationship of cyclooxygenase-2 (COX-2) and vascular endothelial growth factor-c (VEGF-C) expression with lymphangiogenesis, lymph node metastasis (LNM), and other clinicopathologic features in human oral tongue cancers. Study Design. Forty tongue cancer specimens were immunohistochemically examined for COX-2 and VEGF-C expression and for lymphatic vessel density (LVD). We analyzed the relationships between COX-2 and VEGF-C expression and the relationships of such expression with clinicopathologic findings and survival of patients. Results. Eighteen tumors out of 40 (45%) showed COX-2 expression, and 18 tumors (45%) expressed VEGF-C. Twelve tumors (30%) coexpressed COX-2/VEGF-C. A significant correlation was found between COX-2 and VEGF-C expression (P < .01). Of note, COX-2/VEGF-C coexpression significantly correlated with lymphangiogenesis, LNM, TNM stage (P < .01), and LVD (P < .05). In Cox regression for survival, COX-2/VEGF-C coexpression was identified as an independent prognostic factor (P < .05). Conclusions. Our results suggest that examination of immunohistochemical expression of COX-2 and VEGF-C predicts LNM and survival in human oral tongue cancers.