Korean J Urol.  2007 Apr;48(4):376-382. 10.4111/kju.2007.48.4.376.

Correlation of Cyclooxygenase-2 Expression and Microvessel Density with Prognosis in Transitional Cell Carcinoma of the Upper Urinary Tract

• Cha MH
• Cho DS
• Yim H
• Cho KS
• Hong SJ
• Cho NH
• Kim SI
• Ahn HS
• Kim SJ

• KMID: 1997103
• DOI: http://doi.org/10.4111/kju.2007.48.4.376

Abstract

PURPOSE
The aim of this study was to investigate the relationship of cyclooxygenase (COX)-2 expression and microvessel density (MVD), a reflection of angiogenesis, with prognosis in patients with transitional cell carcinoma of the upper urinary tract (TCC-UUT).
MATERIALS AND METHODS
Formalin-fixed, paraffin-embedded tissue sections of TCC-UUT from 91 patients, who had undergone radical nephroureterectomy, were examined immunohistochemically using antibodies against COX-2 and CD34. MVD was determined with CD34-stained slides. The expression patterns of COX-2 and MVD were compared with the clinicopathological variables.
RESULTS
The COX-2 expression was significantly correlated with T stage (p=0.002), N stage (p=0.010), and grade (p=0.027). MVD was also significantly correlated with T stage (p<0.001), N stage (p=0.002), and grade (p=0.001). The COX-2 expression was significantly correlated with MVD (p=0.001). The survival rate of patients with COX-2 positive tumors or high MVD was significantly lower than that of patients with COX-2 negative tumors or low MVD, respectively (p=0.0013, p=0.0312). Univariate analyses identified T stage, N stage, grade, COX-2 expression, and MVD as significant prognostic factors for cancer-specific survival; multivariate analyses indicated that T stage was the only independent prognostic factor.
CONCLUSIONS
The increased expression of COX-2 and MVD is associated with a worse prognosis in TCC-UUT. The COX-2 expression is correlated with MVD. These results suggest that COX-2 may play an important role in the progression of TCC-UUT and angiogenesis may be affected by COX-2 during the progression of TCC-UUT.

Keyword

Cyclooxygenase 2; Prognosis; Transitional cell carcinoma; Urinary tract

MeSH Terms

Antibodies
Carcinoma, Transitional Cell*
Cyclooxygenase 2*
Humans
Microvessels*
Multivariate Analysis
Prognosis*
Prostaglandin-Endoperoxide Synthases
Survival Rate
Urinary Tract*
Antibodies
Cyclooxygenase 2
Prostaglandin-Endoperoxide Synthases

Figure

• 

  Fig. 1. Immunohistochemical staining for cyclooxygenase-2 (COX-2) in transitional cell carcinoma of the upper urinary tract tissues (x400). (A) Cancer cells are not stained (COX-2 intensity 0). (B) Smooth muscle cells are stained as an internal control. Cancer cells are stained weakly compared to an internal control (intensity 1). (C) Cancer cells are stained in same intensity as internal control (intensity 2). (D) Cancer cells are strongly stained for COX-2 (intensity 3).

• 

  Fig. 2. Kaplan-Meier cancer-specific survival curves according to cyclooxygenase-2 (COX-2) expression (A) or microvessel density (MVD) (B). The survival rate of patients with COX-2 positive tumors or high MVD was significantly lower than that of patients with COX-2 negative tumors or low MVD, respectively (p=0.0013, p=0.0312).

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