The incidence of the adenocarcinoma of the distal oesophagus is increasing - majorly among white males in the western world. Its prognosis is bad. Chronic gastroduodenal reflux (GERD) causes metaplasia of oesophagus tissue to Barrett esophagus - and cancer development in later progress. Prostaglangin E2 (PGE2) has several functions. Some involvement in carcinogenesis has been discussed recently. PGE2 is a mediator, especially for neovascularisation in tumour development. PGE2 is synthesised by Prostaglandin-E-Synthasis (PGES). The main aspect of this study was an expression analysis of PGES. We did semiquantitative genetic analysis of 123 paraffin-blocks of adenocarcinoma on mRNA-level (TaqMan). The mean mRNA-Quantity (PGES/GAPDH ratio) was 10.72 [range 0.35-68.41]. Significant correlations of PGES with COX-1 and -2, VEGF-A and -C, and TGFbeta (p<0.001) were found. The correlation with the microvessel density (MCD) was shown, too. The amount of PGES did not correlate significantly with any clinical-pathological parameter: UICC classification (T: p=0.191; N: p=0.905), WHO classification (p=0.651), R classification (p=0.655), grading G (p=0.464), lymphatic invadion L (p=0.541). The amount of PGES (PGES level above or below the median, Kaplan-Meier) is significantly correlated with survival. Low PGES is associated with prolonged survival. According to this study, PGES of the distal oesophagus is associated with factors of angiogenesis and cellular regulation.