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Overexpression of vascular endothelial growth factor receptor 2 in pterygia may have a predictive value for a higher postoperative recurrence rate
  1. Koray Gumus1,
  2. Sarper Karakucuk1,
  3. G Ertugrul Mirza1,
  4. Hulya Akgun2,
  5. Hatice Arda1,
  6. Ayse O Oner1
  1. 1Department of Ophthalmology, Erciyes University School of Medicine, Kayseri, Turkey
  2. 2Department of Pathology, Erciyes University School of Medicine, Kayseri, Turkey
  1. Correspondence to Koray Gumus, Department of Ophthalmology, Erciyes University School of Medicine, Kayseri 38039, Turkey; drkorayg{at}hotmail.com

Abstract

Background To investigate the expression levels of vascular endothelial growth factor (VEGF), vascular endothelial growth factor receptor 1 (VEGFR-1) and VEGFR-2 in pterygium and to clarify the prognostic significance of these expressions in pterygia.

Methods A total of 40 surgically excised pterygia and 9 normal conjunctivae were immunohistochemically studied applying the streptavidin–biotin method in paraffin-embedded tissue sections. Monoclonal antibodies were targeted against VEGF, VEGFR-1 and VEGFR-2 proteins. At the sixth postoperative month, the recurrence rate was graded on a scale of 1–4.

Results The mean percentage of VEGF-positive epithelial cells was comparable in pterygium and normal conjunctivae. However, the pterygium group presented higher expression levels of VEGF in pterygia endothelial cells (p=0.05). In terms of VEGFR-1 expression in epithelial cells, no statistically significant difference was found between two groups (p=0.658). However, normal conjunctivae exhibited higher expression levels of VEGFR-1 in endothelial cells (p=0.002). Epithelial cells in pterygium presented higher combined scores of VEGFR-2 (87.5% and 22.2%, respectively) (p=0.013). While higher expression levels of VEGFR-2 were documented in pterygia endothelial cells, no VEGFR-2 immunoreactivity was observed in the endothelial cells of normal conjunctivae (p<0.001). Expression levels of VEGFR-2 in epithelial cells and endothelial cells were positively correlated with the postoperative recurrence grading system (p<0.001 and τ=0.627, p=0.001 and τ=0.508, respectively).

Conclusions The results suggest that VEGF may play a key role through VEGFR-2 in the pathogenesis of pterygium. Moreover, overexpression of VEGFR-2 in pterygia may have a predictive value for a higher postoperative recurrence rate.

  • Conjunctiva

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