الفهرس 
Clinical Relevance of Cyclo-oxygenase 2(COX2) and Vascular Endothelial Growth Factor (VEGF-A) Expression in Classical Hodgkin Lymphoma Protocol
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Abstract
Classical Hodgkin lymphoma is defined as a monoclonal lymphoid neoplasm composed of mononuclear Hodgkin cells and binucleated Reed-Sternberg cells residing in an infiltrate containing a variable mixture of lymphocytes, eosinophils, neutrophils, plasma cells, histiocytes, fibroblasts, and collagen fibers.
Angiogenesis is important in the proliferation of hematopoietic neoplasms. Vascular endothelial growth factor plays a significant role in the initiation of angiogenesis. Moreover, Lymphoma progression may be enhanced by angiogenesis.
COX-1 and -2 are two key enzymes in the synthesis of prostaglandins from arachidonic acid. COX-2 expression is induced by various inflammatory stimuli. Elevated levels of COX-2 have been detected in many cancers. Several lines of evidence suggest that non-steroidal anti-inflammatory drugs and selective COX-2 inhibitors are promising as anti-cancer drugs.
We aimed in the current study to assess the expression of COX-2 and VEGF-A in CHL patients and to clarify their association with the clinical parameters, to rule out their possible role as prognostic markers for CHL.
VEGF-A expression was detected in 48/76 (63.2%) of the patients, while COX-2 was detected in 67/76 (88.2%) of the patients. Our results could not clarify the relation between VEGF-A and COX-2 expression (p=0.861) among CHL patients, as both markers were positive in 42/76 (55.3%), both were negative in 3/76 (4.0%), VEGF was positive alone in 6/76 (7.9%), and COX-2 was positive alone in 25/76 (32.8%) of the CHL patients.
In our study, there was statistically significant difference between the patients with positive and negative VEGF-A regarding the sex (p= 0.049), there was also a significant difference regarding the correlation between the positivity of VEGF-A and the stage of Patients (p= 0.044). Comparison between CHL patients with positive and with negative VEGF-A expression regarding Bone marrow findings showed significant results in relation to the bone marrow infiltration (p=0.023) and also the positivity of CD 30 (p=0.023).
We also found a significant relation concerning the positivity of VEGF and the mediastinal lymphadenopathy (p=0.049), Inguinal lymphadenopathy (p=0.046), and the presence of Pulmonary nodules (p=0.048). Also, there was statistically significant difference between the patients with positive and negative COX-2 regarding the presence of cervical Lymphadenopathy (p= 0.011).
The comparison between CHL patients with both markers (VEGF-A and COX-2) positive expression and the others showed a significant relation with the presence of mediastinal lymphadenopathy (p=0.019), Inguinal lymphadenopathy (p=0.044), and we found a significant correlation with the staging if the disease (p=0.016).