Clinical relevance of cyclooxygenase 2 and vascular endothelial growth factor-A expression in classical Hodgkin lymphoma

Abstract

Abstract Background Classical Hodgkin lymphoma (cHL) is a clonal lymphoid neoplasm derived from B cells. Cyclooxygenase 2 (COX2) and vascular endothelial growth factor-A (VEGF-A) play major roles in angiogenesis and impact cHL prognosis. Aim To measure COX2 and VEGF-A expression in cHL patients and assess their potential association with other laboratory and clinical parameters. Patients and methods Seventy-six cHL bone marrow (BM) biopsy specimens were histopathologically examined and immunohistochemically stained for COX2 and VEGF-A expression. Correlations between COX2 and VEGF-A expression and clinicopathologic factors were evaluated. Results COX2 and VEGF-A were expressed in 67/76 (88.2%) and 48/76 (63.2%) of BM specimens, respectively. VEGF-A was associated with advanced cHL stage (P=0.044) and BM infiltration confirmed by CD30 positivity (P=0.023). A significant association was found between VEGF-A positivity and mediastinal lymphadenopathy (P=0.049), inguinal lymphadenopathy (P=0.046), and pulmonary nodules (P=0.048). COX2 positivity was significantly associated with cervical lymphadenopathy (P=0.011). A positive association was found between expression of both markers (COX2 and VEGF-A) (P=0.001). Coexpression of COX2 and VEGF-A was associated with disease staging (P=0.016), mediastinal lymphadenopathy (P=0.019), and inguinal lymphadenopathy (P=0.044). Conclusion COX2 and VEGF-A, as major players in angiogenesis, are associated with tumor progression in cHL. These findings support targeting both markers as the potential therapeutic approach in cHL.