Correlação entre a expressão de ciclooxigenase-2, VEGF e KI-67 em carcinomas de células escamosas da laringe e hipofaringe com estadiamento TNM

Introducao: Carcinoma de celulas escamosas e a neoplasia mais frequente da laringe e hipofaringe. Para que haja desenvolvimento e evolucao tumoral, a angiogenese e fator essencial, sendo estimulada pelo fator de crescimento vascular endotelial (VEGF) e por fatores proangiogenicos induzidos pela enzima ciclooxigenase-2 (Cox-2). Objetivos: Avaliar a expressao do VEGF, Cox-2 e Ki-67 em carcinomas de celulas escamosas da laringe e hipofaringe e sua correlacao com estadiamento tumoral, dados histopatologicos e relacao entre si. Metodos: Foram estudados 35 casos de tumores de carcinoma de celulas escamosas de laringe e hipofaringe do Departamento de Anatomia Patologica de um hospital terciario atendidos no periodo de 1996 a 2011, divididos em 4 grupos quanto a localizacao e diferenciacao tumoral. A expressao do VEGF, Cox-2 e Ki-67 foi realizada atraves de imunomarcadores. Resultados: A superexpressao do VEGF foi observada em apenas 20% dos casos estudados. A Cox-2 mostrou-se superexpressa em aproximadamente metade dos casos estudados (48,6%). O indice de proliferacao celular (Ki-67) mostrou correlacao positiva com o grau histologico sendo maior nos casos moderadamente/ pouco diferenciados. Houve correlacao positiva entre a expressao do VEGF e da Cox-2. Discussao e conclusao: O VEGF e a Cox-2 estao intrinsicamente ligados, contudo nao parecem ter implicacao quanto a graduacao histologica, extensao e progressao tumoral em carcinomas de celulas escamosas de laringe/hipofaringe. O indice de proliferacao celular medido pelo Ki-67 pode ser util na caracterizacao do grau histologico do carcinoma escamoso, contudo outros fatores devem estar implicados quanto a patogenese e progressao tumoral desta doenca na laringe e hipofaringe. Introduction: Squamous cell carcinoma is the most common cancer of the larynx and hypopharynx. So there is development and tumor development, angiogenesis is an essential factor, being stimulated by vascular endothelial growth factor ( VEGF ) factors induced by the enzyme cyclooxygenase - 2 ( Cox - 2 ) vascular . Objectives: To evaluate the expression of VEGF , Cox - 2 and Ki - 67 in squamous cell carcinomas of the larynx and hypopharynx and its correlation with tumor staging , histopathological data and relationship to each other. Methods: 35 cases of squamous cell carcinoma of the larynx and hypopharynx of Pathology department of a tertiary hospital treated between 1996-2011 were divided into 4 groups according to tumor location and differentiation. Expression of VEGF, COX-2 and Ki-67 was performed by immunomarkers. Results: Overexpression of VEGF was observed in only 20 % of the cases studied. COX-2 overexpression showed up in about half of cases (48.6%). The rate of cell proliferation (Ki -67) showed a positive correlation with histological grade, being higher in cases moderately / poorly differentiated . There was a positive correlation between the expression of VEGF and COX-2. Discussion and Conclusion: VEGF and COX-2 are intrinsically connected, yet not seem to have implications as to the histological grade, extent and progression in squamous cell carcinomas of the larynx / hypopharynx . The cell proliferation index measured by Ki -67 may be useful in characterizing the histological grade of the squamous cell carcinoma, but other factors must be involved as to the pathogenesis and progression of this disease in the larynx and hypopharynx.