The combination of nuclear factor kappa B, cyclo-oxygenase-2 and vascular endothelial growth factor expression predicts poor prognosis in stage II and III colorectal cancer

Background/Aim: To evaluate immunohistochemical expression of nuclear factor-kappa B (NFκB), cyclo-oxygenase (COX)-2, and vascular endothelial growth factor (VEGF) and the impacts thereof on clinicopathological tumor features and survival in patients with colorectal cancer. Materials and Methods: Sixty-six patients with colorectal cancer (stage II or III) were enrolled. Results: The positive expression rates of NFκB, COX2, and VEGF were 62.1%, 51.5%, and 63.6%, respectively. Sixteen tumor samples (24.2%) coexpressed all three markers. Coexpression of all three markers correlated with pTNM III, poor histological grade, larger tumor diameter, and elevated carcinoembryonic antigen level. pTNM III and coexpression of all three markers were independent prognostic factors for cancer-specific and disease-free survival. Conclusion: The combination of NFκB, COX2, and VEGF expression correlated with advanced pathological features and had a prognostic impact on cancer-specific and disease-free survival. These findings suggest that coexpression of three markers may have a synergistic effect on aggressive tumor biology.