AIM:To investigate the role of cyclooxygenase-2(COX-2)and vascular endothelial growth factor (VEGF) in thedevelopment of gastric carcinoma and correlation.betweenexpression of COX-2 and VEGF and clinicopathologic featuresin tissues from patients with gastric carcinoma.METHODS:281 patients with gastric carcinoma whounderwent surgical resection between 1990 and 1999 at theFirst Affiliated Hospital,Anhui Medical University,PRC,werefollowed up.Expression of COX-2 and VEGF was investigatedretrospectively in 232 gastric carcinoma tissues and 60noncancerous specimens by using immunohistochemistry.RESULTS:The 5-year survival rates of early gastric carcinoma(EGC) and advanced gastric carcinoma (AGC) were 93.4%and 59.0%,respectively.Survival time was highly correlatedwith lymph node metastasis,vascular invasion,depth ofinvasion and treatment with chemotherapy.Compared withpaired noncancerous tissues,expression of COX-2 and VEGFand rnicrovessel density (IVlVD) value in carcinoma tissuewere significantly higher.The MVD value was much higherin COX-2-positive group and VEGF-positive group than thatin COX-2-negative group and VEGF-negative group.Expression of COX-2 and VEGF,as well as MVD value werehighly correlated with lymph node metastasis and vascularinvasion.The 5-year survival rate of patients with expressionof COX-2 or VEGF was significantly lower than that of patientswithout COX-2 or VEGF expression.Multivariate analysisrevealed that VEGF overexpression,lymph node metastasis,COX-2 overexpression,depth of invasion and vascular invasionwere all independent prognostic factors of gastric carcinoma.CONCLUSION:Overexpression of COX-2 and VEGF inpatients with gastric carcinoma can enhance the possibilityof invasion and metastasis,implicating a poor prognosis.They may serve as the fairly good prognostic factors toindicate biologic behaviors of gastric carcinoma. AIM: To investigate the role of cyclooxygenase-2 (COX-2) and vascular endothelial growth factor (VEGF) in the development of gastric carcinoma and correlation. Betweenexpression of COX-2 and VEGF and clinicopathologic features in tissues from patients with gastric carcinoma. METHODS: 281 patients with gastric carcinoma whounderwent surgical resection between 1990 and 1999 at the First Affiliated Hospital, Anhui Medical University, PRC, were followed up. Expression of COX-2 and VEGF was investigated retrospectively in 232 gastric carcinoma tissues and 60 noncancerous specimens by using immunohistochemistry .RESULTS: The 5-year survival rates of early gastric carcinoma (EGC) and advanced gastric carcinoma (AGC) were 93.4% and 59.0%, respectively. Survival time was highly correlated with lymph node metastasis, vascular invasion, depth of invasion and treatment with chemotherapy. Compared withpaired noncancerous tissues, expression of COX-2 and VEGF and rnicrovessel density (IVlVD) value in carcinoma tissuewere signif icantly higher. The MVD value was much higher in COX-2-positive group and VEGF-positive group than that in COX-2-negative group and VEGF-negative group. Expression of COX-2 and VEGF, as well as MVD value were highly correlated with lymph node metastasis and vascular invasion.The 5-year survival rate of patients with expression of COX-2 or VEGF was significantly lower than that of patients with COX-2 or VEGF expression. Multivariate analysisrevealed that VEGF overexpression, lymph node metastasis, COX-2 overexpression, depth of invasion and vascular invasionwere all independent prognostic factors of gastric carcinoma. CONCLUSION: Overexpression of COX-2 and VEGF inpatients with gastric carcinoma can enhance the possibility of invasion and metastasis, implicating a poor prognosis. They may serve as the fairly good prognostic factors toindicate biologic behaviors of gastric carcinoma