Microvessel density and expression of vascular endothelial growth factor, basic fibroblast growth factor, and platelet-derived endothelial growth factor in oral squamous cell carcinomas

Angiogenesis, the growth of capillary vessels, plays an important role in the metabolic functions of malignant tissues. Tumor growth and malignant transformation are considered to be dominated by uncontrolled angiogenesis. To understand the mechanism of increased vascularity associated with malignant tissues, we immunohistochemically evaluated microvessel density (MVD) and the expression of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and platelet-derived endothelial growth factor (PDGF) in oral cancers. Microvessel density did not differ significantly between normal oral mucosa and epithelial dysplasia, but was significantly increased in tumor tissues. Expression of angiogenic factors was not found in normal oral mucosa, but increased in association with increasing vascularity in OSCC tissue. In tumor tissue, angiogenic factor expression correlated with MVD. MVD in OSCC was related to T stage, tumor differentiation, and stage of invasion. VEGF expression also correlated with tumor differentiation and the stage of invasion. These findings suggest that VEGF might play an important role in tumor angiogenesis of OSCC.     

涎腺腺样囊性癌中NOS和VEGF的表达与血管生成及临床病理因素的关系

目的：研究血管内皮生长因子（vascular endothelial growth factor,VEGF）、诱导型一氧化氮合酶（induciblenitric oxide synthase,iNOS）和内皮型一氧化氮合酶（endothelial nitric oxide synthase,eNOS）在涎腺腺样囊性癌（salivaryadenoid cystic carcinoma,SACC）中表达的相关性;探讨三者与SACC血管生成和临床病理特征的关系;研究一氧化氮（nitric oxide,NO）和VEGF的相互作用及NO在VEGF促肿瘤生长中的作用机制。方法：应用免疫组织化学方法检测32例SACC手术切除标本VEGF、iNOS和eNOS的表达,CD34血管内皮细胞特异性染色计数肿瘤微血管密度（microvesseldensity,MVD）。结果：①20例SACC组织表达VEGF,22例表达iNOS,25例表达eNOS;②VEGF与iNOS的表达正相关,与eNOS的表达无相关;③VEGF、iNOS的表达与涎腺腺样囊性癌MVD呈正相关,eNOS的表达与涎腺腺样囊性癌MVD的差异无显著性意义;④VEGF的表达与SACC病理类型、淋巴结转移、肿瘤部位及临床分期密切相关;iNOS的表达与病理类型、肿瘤部位及临床分期密切相关;与淋巴结转移未见相关。eNOS表达与以上因素均无关。结论：①iNOS对VEGF的生成和发挥作用的过程有重要影响;②MVD随着VEGF和iNOS表达的增强而增加,说明两者对SACC血管生成具有促进作用.     

NOS和VEGF在唇鳞癌组织中的表达

目的:研究血管内皮生长因子(VEGF)、诱导型一氧化氮合酶(iNOS)和内皮型一氧化氮合酶(eNOS)在唇鳞癌组织中表达的相关性,及该三者与唇鳞癌血管生成和临床病理特征的关系,探讨一氧化氮(NO)和VEGF对唇癌生长的作用机制。方法: 应用免疫组织化学方法检测42例唇鳞癌手术切除标本VEGF、iNOS和eNOS的表达,第Ⅷ因子相关抗原(FⅧRAg)血管内皮细胞特异性染色计数肿瘤微血管密度(MVD)。结果:(1)26例唇鳞癌组织表达VEGF,28例表达iNOS,31例表达eNOS;VEGF与iNOS的表达正相关,与eNOS的表达无相关;(2)VEGF、iNOS的表达与唇鳞癌MVD呈正相关,eNOS的表达与唇鳞癌MVD的差异无显著性意义;(3)VEGF的表达与唇鳞癌淋巴结转移和肿瘤分化程度及肿瘤浸润深度正相关;与临床分期无关。iNOS表达与唇鳞癌的分化程度、临床分期和有无淋巴结转移及肿瘤浸润深度正相关;eNOS表达与唇鳞癌临床分期、分化程度和有无淋巴结转移及肿瘤浸润深度均无关。结论: (1)iNOS对VEGF的生成和发挥作用的过程可能有重要影响;(2)MVD随着VEGF和iNOS表达的增强而增加,说明两者对唇鳞癌血管生成具有促进作用。     

VEGF和NOS在口腔鳞癌组织中的表达

目的:研究口腔鳞癌组织血管内皮生长因子(VEGF)、诱导型一氧化氮合酶(iNOS)、内皮型一氧化氮合酶(eNOS)的表达与癌细胞增殖的相关性。方法：应用免疫组化方法检测64例口腔鳞癌手术切除标本VEGF、iNOS、eNOS和增殖细胞核抗原(PCNA)的分布及表达。结果：①39例(60.94％)口腔鳞癌组织表达VEGF，42例(65.63％)表达iNOS；45例(70.31％)表达eNOS；②VEGF与iNOS的表达具有明显相关性，VEGF与eNOS的表达无明显相关性；③表达VEGF的口腔鳞癌PCNA标记指数(PLI)明显高于不表达VEGF的口腔鳞癌；表达iNOS的口腔鳞癌PLI明显高于不表达iNOS的口腔鳞癌。表达eNOS的口腔鳞癌PLI与不表达eNOS的口腔鳞癌无显著性差异(P＞0.05)。结论：①VEGF与iNOS的表达具有明显相关性，说明iNOS在VEGF的生成和发挥作用过程中起重要作用；②PLI随着VEGF和iNOS表达的增加而增加；提示二者对口腔鳞癌细胞增殖具有促进作用。     

Association between vascular endothelial growth factor (VEGF) expression and tumor angiogenesis in ameloblastomas.

BACKGROUND: Expression of vascular endothelial growth factor (VEGF), a major angiogenic factor, and microvessel density (MVD), assessed by the use of anti-CD34 antibody, were immunohistochemically examined in benign and malignant ameloblastomas, as well as tooth germs, to clarify the possible role of angiogenesis in epithelial odontogenic tumors. METHODS: Specimens of 5 tooth germs, 35 benign ameloblastomas and 5 malignant ameloblastomas were examined by immunohistochemistry using anti-VEGF and CD34 monoclonal antibodies. RESULTS: Immunoreactivity for VEGF was detected in both normal and neoplastic odontogenic epithelial cells, and weakly in microvessels near odontogenic epithelial cells, suggesting that this angiogenic factor acts on endothelial cells via a paracrine mechanism in odontogenic tissues. Both benign and malignant ameloblastomas showed elevated VEGF expression as compared to tooth germs. VEGF expression was low in keratinizing cells in acanthomatous ameloblastomas and granular cells in granular cell ameloblastomas, and acanthomatous ameloblastomas showed the lowest VEGF reactivity among the subtypes of ameloblastomas. MVD in both benign and malignant ameloblastomas was higher than that in tooth germs, indicating increased demands for blood in the neoplastic tissues. CD34-positive microvessels in follicular ameloblastomas were numerous and small, whereas those in plexiform ameloblastomas were scattered and dilated. MVD tended to depend on VEGF expression levels in both benign and malignant ameloblastomas. CONCLUSIONS: VEGF was considered to be an important mediator of angiogenesis in these epithelial odontogenic tumors, and up-regulation of VEGF might be associated with neoplastic or malignant changes of odontogenic epithelial cells.     

Association of clinicopathologic parameters with the expression of inducible nitric oxide synthase and vascular endothelial growth factor in mucoepidermoid carcinoma

Oral Diseases (2011) 17 , 590–596 Background: The roles that inducible nitric oxide synthase (iNOS) and vascular endothelial growth factor (VEGF) play in tumorigenesis have been given special attention. In many tumors, their expression is upregulated. In addition, iNOS can stimulate the expression of VEGF. This study was carried out to investigate the expression of iNOS and VEGF as well as their relationship with angiogenesis and the clinicopathological characteristics of mucoepidermoid carcinoma (MEC). Method: The expression of iNOS and VEGF was detected by Streptavidin–peroxidase immunohistochemistry, and microvessel density (MVD) was determined by anti‐CD34 antibody staining in 70 MEC cases and 40 normal salivary gland tissues (NSG). Follow‐up was performed on the 70 patients with MEC. Non‐parametric tests were performed for the comparison of iNOS and VEGF expression. Results: The positive expression rates of iNOS and VEGF were successively enhanced in NSG, well‐differentiated and poorly differentiated MEC (P < 0.05). MVD counts were positively correlated with the expression levels of iNOS and VEGF in MEC (P < 0.05). The expression of iNOS was positively correlated with the expression of VEGF (P < 0.05). iNOS and VEGF expression were significantly associated with tumor differentiation, size metastasis, and relapse (P < 0.05) but were not correlated lymph node metastasis and metastasis. Conclusion: Inducible nitric oxide synthase can stimulate the expression of VEGF, and their expression status may help assess tumor malignancy and patient prognosis.     

整合素连接激酶和一氧化氮合酶在口腔鳞状细胞癌中的表达及意义

目的:探讨整合素连接激酶(ILK)和一氧化氮合酶(NOS)在口腔鳞状细胞癌(OSCC)中的表达及意义。方法:收集71例择期行手术切除治疗的OSCC患者肿瘤组织及癌旁组织,利用免疫组化SP法对ILK、eNOS和iNOS在肿瘤组织及癌旁组织中表达进行检测。结果:ILK、eNOS和iNOS在癌旁组织中阳性表达率分别为39.4%、45.1%和29.6%,且主要以弱阳性为主,而在OSCC组织中阳性表达率分别为98.6%、93.0%和95.8%,且以强阳性表达为主,ILK、eNOS和iNOS在OSCC组织中阳性表达显著高于癌旁组织,差异均有统计学意义(P<0.05);ILK和iNOS在OSCC组织中表达均与分化程度和淋巴结转移有关(P<0.05);Spearman相关分析显示,ILK在OSCC组织中强表达与iNOS强表达呈正相关(r=0.529,P=0.000)。结论:ILK、eNOS和iNOS在OSCC组织中出现高表达,可能通过促进肿瘤中血管生成而参与OSCC细胞浸润和转移过程。     

诱导型一氧化氮合酶和血管内皮生长因子在成釉细胞瘤中的表达

目的：研究诱导型一氧化氮合酶（iNOS）和血管内皮生长因子（VEGF）在成釉细胞瘤（AB）中表达的相关性，探讨两者与成釉细胞瘤血管生成和临床生物学行为的关系。方法：应用免疫组化SP法。检测35例良性成釉细胞瘤（原发24例、复发11例）及5例恶性成釉细胞瘤和10例牙源性角化囊性瘤（KCOT）中VEGF、iNOS的表达和微血管密度（MVD）（CD34标记）。并对上述指标用SPSS11．0统计软件包进行统计学分析。结果：KCOT、原发AB、复发AB、恶性AB中的iNOS、VEGF的阳性表达率和MVD计数依次增加，组间差异均具有统计学意义（P〈0．05）；MVD在成釉细胞瘤中计数均随着iNOS和VEGF表达的增强而升高（P〈0．05）；iNOS和VEGF两者在成釉细胞瘤之间也具有相关性（rs=0．66，P〈0．05）。结论：iNOS和VEGF的表达与成釉细胞瘤的血管生成及其侵袭性生物学行为密切相关。     

颜面皮肤癌中VEGF表达和微血管密度的临床意义

目的 研究微血管密度(microvessel density，MVD)和血管内皮生长因子(vascular endothelial growth factor，VEGF)在颜面皮肤癌中的表达，探讨其临床意义。方法 采用SABC免疫组织化学染色方法检测42例颜面皮肤癌中MVD和VEGF的表达，采用SPSS软件行统计分析。结果 69．05％颜面皮肤癌组织呈VEGF阳性表达。VEGF表达阳性的颜面皮肤癌组织MVD显著高于VEGF表达阴性音。VEGF表达与肿瘤的分化程度、淋巴结转移及浸润深度密切相关，而与肿瘤的临床分期无关。MVD记数与肿瘤的分化程度、淋巴结转移、浸润深度及临床分期密切相关。结论 颜面皮肤癌组织VEGF表达与微血管密度有明显的相关性，是颜面皮肤癌主要的新生血管诱导因子之一，VEGF、MVD可做为反映颜面皮肤癌生物学行为的一个有效指标。     

Microvascular density and vascular endothelial growth factor immunoreactivity as predictors of regional lymph node metastasis from betel-associated oral squamous cell carcinoma.

PURPOSE: Neovascularization has profound effects on tumor growth and metastasis. Vascular endothelial growth factor (VEGF) is a mitogen that acts exclusively on endothelial cells. The roles of miscrovascularity density (MVD) and VEGF expression in the progression of oral squamous cell carcinoma (OSCC) have been controversial. The purpose of the present study was to measure the MVD and VEGF expression in a cohort of patients with betel-associated OSCC and to evaluate for possible clinicopathologic correlations.PATIENTS AND METHODS: The paraffin sections from 49 subjects with OSCC were subjected to immunohistochemical studies to measure the highest MVD (h-MVD) and cytoplasmic immunoreactivity of VEGF. The findings in the tissue samples were analyzed with regard to the patients' risk factors and clinical course. RESULTS: The OSCC samples had an average h-MVD score of 27.7/mm(2). VEGF immunoreactivity was positive in 75.5% of samples. Both h-MVD and VEGF immunoreactivity were statistically associated with lymph node metastasis (P =.012 and.037, respectively). A marginally significant association was also noted between the h-MVD and patient survival (P =.056). The age and oral habits of patients, as well as the tumor site and size, did not appear to be correlated with h-MVD or VEGF immunoreactivity. CONCLUSION: The data suggest that both h-MVD and VEGF immunoreactivity may be useful predictors for the progression of a subset of OSCC associated mostly with betel use. Antiangiogenesis therapy might have a role in reducing regional metastasis.     

口腔恶性黑色素瘤中血管内皮生长因子和一氧化氮合酶的表达与癌细胞增殖的关系

目的研究口腔恶性黑色素瘤组织血管内皮生长因子(VEGF)、诱导型一氧化氮合酶(iNOS)、内皮型一氧化氮合酶(eNOS)的表达与癌细胞增殖的相关性。方法应用免疫组化方法检测11例口腔恶性黑色素瘤手术切除标本VEGF、iNOS、eNOS和增殖细胞核抗原(PCNA)的分布及表达。结果11例中7例(63.64%)瘤组织表达VEGF,6例(54.55%)表达iNOS,9例(81.82%)表达eNOS,VEGF与iNOS的表达具有相关性,而与eNOS的表达无相关性;表达VEGF的口腔恶性黑色素瘤PCNA标记指数(PLI)高于不表达VEGF者;表达iNOS的口腔恶性黑色素瘤PLI高于不表达iNOS者。表达与不表达eNOS的口腔恶性黑色素瘤PLI差异无显著性(P>0.05)。结论iNOS、PLI对口腔恶性黑色素瘤细胞增殖具有促进作用。     

口腔黏膜癌变过程中Slit蛋白的表达及其与血管生成的关系

目的:研究Slit蛋白在口腔黏膜癌变过程中的表达及其与肿瘤血管形成的关系。方法:采用免疫组织化学Envision法检测40例人口腔鳞状细胞癌、18例上皮单纯增生、20例上皮异常增生、20例原位癌及19例正常口腔黏膜标本Slit、VEGF的表达和MVD。结果:口腔鳞癌组中有34例Slit表达阳性,与正常黏膜组及癌前病变组相比有显著性差异(P<0.01),而19例正常口腔黏膜仅有1例表达为弱阳性,与原位癌组及上皮异常增生组之间有显著性差异(P<0.01,P<0.05)。VEGF的表达趋势与Slit蛋白一致,Slit蛋白和VEGF表达均与MVD呈显著正相关(P<0.01)结论:口腔鳞癌癌变过程中Slit蛋白阳性表达与其恶性程度呈正相关,Slit在口腔鳞癌中有促血管形成的作用,并可能对口腔鳞癌的发展过程起重要作用。     

iNOS 、VEGF和CD34在人涎腺腺样囊性癌中的表达及意义

目的：研究诱导型一氧化氮合酶（inducible nitric oxidesynthase，iNOS）、血管内皮生长因子（vascular endo-thelial growth factOr，VEGF）及微血管密度（Microvessel density，MVD）在人涎腺腺样囊性癌（adenoid cystic carcinoma，ACC）中的表达及相关性，探讨它们与ACC血管生成和临床生物学行为的关系。方法：应用免疫组化SABC法，检测15例ACC、10例腮腺多形性腺瘤（plemorphic adenoma，PA）及10例正常腮腺组织（normal salivary gland，SG）中iNOS和VEGF的表达和微血管密度MVD（CD34标记）计数，并对上述指标应用SPSSl3．0统计软件进行统计学分析。结果：PA、SG、ACC中的iNOS和VEGF的阳性表达率及MVD计数依次增加，各组之间有显著性差异（P〈0．05）；MVD在ACC中的计数均随着iNOS和VEGF表达的增强而升高；iNOS和VEGF两者在腺样囊性癌之间也具有相关性。结论：iNOS、VEGF和CD34的表达与ACC的血管生成及发生发展密切相关。     

乙酰肝素酶在口腔鳞癌发生发展中的表达和功能

目的:研究乙酰肝素酶(heparanase,Hpa)在口腔鳞癌(oral squamous-cellcarcinoma,OSCC)中的表达及其与微血管密度(microvessel density,MVD)的关系,从而了解Hpa在OSCC血管生成、浸润和转移中的作用。方法:选用人正常口腔黏膜组织10例,口腔白斑15例,OSCC标本48例,采用免疫组化方法和原位杂交技术检测Hpa的表达,用CD31抗体进行血管内皮的免疫组化染色,计数MVD。结果:在口腔白斑组织中Hpa蛋白、Hpa mRNA的阳性表达率均显著高于它们在正常口腔黏膜组织中的表达(P均<0.05),并显著低于它们在OSCC中的表达(P均<0.05)。有淋巴结转移组和肌层浸润组的OSCC组织Hpa蛋白和mRNA的阳性表达显著高于无淋巴结转移组和黏膜及黏膜下层浸润组(P均<0.05)。Hpa蛋白、Hpa mRNA阳性表达的OSCC组织中MVD显著高于阴性表达组(P均<0.05)。结论:Hpa在OSCC中呈高表达,与血管生成密切相关,对OSCC的生长、浸润和转移有促进作用。     

口腔鳞状细胞癌淋巴结转移危险因素的Logistic回归分析

目的选择常用的临床及病理指标,通过多因素分析,筛选出与口腔鳞癌淋巴结转移密切相关的指标,建立预测方程,为临床预测口腔鳞癌淋巴结转移提供参考。方法选择100例口腔鳞癌患者,记录性别、年龄、发病部位、T分期、N分期、病程等6个临床指标;选择肿瘤细胞浸润深度、浸润方式、淋巴细胞浸润程度、肿瘤的粘附力、基底膜的连续性、血管生成、肿瘤增殖等病理指标,进行Logistic逐步回归分析。结果浸润深度、平均血管密度、VEGF和E—CD染色阳性细胞率具有统计学意义。得出预测方程：P=exp（-6．5689＋1．5309XDEPTH＋3．8116XMVD＋2．8066XVEGF＋5．5917XE—CD）／1＋exp（-6．5689＋1．5309XDEPTH＋3．8116XMVD＋2．8066XVEGF＋5．5917XE—CD）。经回代分析,预测方程的准确性为95％。结论口腔鳞癌细胞的浸润深度、E-CD和VEGF的表达程度、肿瘤血管平均密度是与口腔鳞癌淋巴结转移密切相关的危险因素,通过预测方程得出的概率值可为手术方案的制定提供参考。     

口腔鳞癌中环氧合酶-2的表达与微血管密度的关系

目的　检测口腔鳞癌中环氧合酶-2(COX-2)和微血管密度(MVD)的表达,以探讨COX-2的表达与口腔鳞癌 血管生成的关系及其临床意义。方法　应用PV-9000两步免疫组织化学染色法检测76例口腔鳞癌组织、12例正常 口腔黏膜组织中的COX-2的表达,并通过CD34单抗标记检测肿瘤MVD。结果　COX-2在口腔鳞癌中的阳性表达 率为81·6%,明显高于对照组(P<0·001)。COX-2表达阳性组的MVD值为37·51±13·48,显著高于阴性组的MVD 值19·71±12·87 (t=4·547,P<0·01),亦明显高于正常组织的MVD值12·92±5·37 (t=5·308,P<0·01)。COX-2 的表达与口腔鳞癌颈淋巴结转移、瘤体大小、TNM分期及分化程度相关(P<0·05)。结论　口腔鳞癌组织COX-2高 表达与MVD及口腔鳞癌颈淋巴结转移、瘤体大小、TNM分期及分化程度有密切关系,COX-2可能是口腔鳞癌的重要 促血管生成因子之一。     

血管内皮细胞生长因子在口腔鳞状细胞癌进展和预后中的作用研究进展

血管内皮细胞生长因子fvascular endothelial growth factor。VEGF）是目前被鉴定出的最强的血管生长因子,其家族由7个配体、3种受体以及2种共受体组成。通过多条信号通路．VEGF表现出促进血管内皮细胞增殖和新生血管形成、淋巴内皮细胞生长和淋巴道转移、抗凋亡等多种细胞学效应。肿瘤的生长、转移及预后与VEGF密切相关,新生血管既为肿瘤生长提供营养．也为肿瘤的转移提供通道。本文针对VEGF及其受体的分子结构、信号机制、细胞学效应,以及其与口腔鳞状细胞癌（oral squamous cell carcinoma,oscc）进展和预后的关系等进行综述。     

VEGF和NOS在涎腺腺样囊性癌中的表达及与细胞增殖的关系

目的研究涎腺腺样囊性癌(salivary adenoid eystic carcinoma,SACC)组织血管内皮生长因子(vascular endothelial growth factor,VEGF)、诱导型一氧化氮合酶(inducible nitric oxide synthase,iNOS)和内皮型一氧化氮合酶(endothelial nitric oxide synthase,eNOS)的表达与癌细胞增殖的相关性。方法应用免疫组化方法检测32例SACC手术切除标本VEGF、iNOS、eNOS和增殖细胞核抗原(proliferating cell unclear angigen,PCNA)的分布及表达。结果①20例(62.5%)SACC组织表达VEGF,22例(68.75%)表达iNOS;25例(78.13%)表达eNOS;②VEGF与iNOS的表达具有明显相关性,VEGF与eNOS的表达无明显相关性;③表达VEGF的涎腺腺样囊性癌PCNA标记指数(PLI)明显高于不表达VEGF的SACC;表达iNOS的涎腺腺样囊性癌PLI明显高于不表达iNOS的SACC。表达eNOS的涎腺腺样囊性癌PLI与不表达eNOS的SACC无显著性差异(P>O.05)。结论①VEGF与iNOS的表达具有明显相关性,说明iNOS在VEGF的生成和发挥作用过程中起重要作用;②PLI随着VEGF和iNOS表达的增加而增加;说明二者对SACC细胞增殖具有促进作用。     

口腔鳞状细胞癌中血管内皮生长因子-C的表达及其与血管、淋巴管生成、淋巴结转移的关系

目的探讨血管内皮生长因子-C（VEGF-C）在口腔鳞状细胞癌（OSCC）组织中的表达情况及其与血管、淋巴管生成、淋巴结转移之间的关系。方法调查拥有完整临床病理资料的67例口腔鳞癌患者的手术切除标本,采用SP免疫组化技术检测VEGF-C的表达情况并分析其与微血管密度（MVD）、淋巴管密度（LVD）及其他临床病理指标的关系。结果晚期病例、淋巴结转移阳性病例的VEGF-C表达明显升高（P值分别为0.015和<0.001）,而VEGF-C表达与患者性别、肿瘤部位、肿瘤分化程度无关（P>0.05）。VEGF-C高表达组的LVD明显高于VEGF-C低表达组（P=0.001）,但两组间MVD无统计学差异（P=0.125）。此外,淋巴结转移阳性组的LVD明显高于淋巴结转移阴性组（P=0.026）。结论VEGF-C可能主要通过参与诱导口腔鳞癌淋巴管生成促进淋巴结转移。     

涎腺腺样囊性癌COX-2表达与肿瘤血管生成的研究

目的：探讨环氧化酶-2（Cycloxygenase-2,COX-2）表达与涎腺腺样囊性癌（salivary adenoid cystic carcino-ma,SACC）血管生成的关系。方法：免疫组化法检测SACC中COX-2、诱导型一氧化氮合酶（inducible nitric oxide synthase,iNOS）、血管内皮生长因子（vascular endothelial growth factor,VEGF）表达,并测定肿瘤微血管密度（microvessel density,MVD）。结果：SACC中COX-2表达与VEGF、iNOS表达密切相关（P〈0.05,P〈0.01）。SACC中COX-2表达阳性组和阴性组MVD有显著差异（P〈0.01）.结论：SACC中COX-2表达和肿瘤血管生成有关,iNOS和VEGF可能参与COX-2对肿瘤血管生成的促进作用。