Yonsei Med J.  2005 Feb;46(1):133-140. 10.3349/ymj.2005.46.1.133.

Cyclooxygenase-2 and p53 Expression as Prognostic Indicators in Conventional Renal Cell Carcinoma

• Cho DS
• Joo HJ
• Oh DK
• Kang JH
• Kim YS
• Lee KB
• Kim SJ

• KMID: 2158123
• DOI: http://doi.org/10.3349/ymj.2005.46.1.133

Abstract

The aim of this study was to investigate the relationship of cyclooxygenase (COX) -2 and p53 expression with prognosis in patients with conventional renal cell carcinoma (RCC). Formalin-fixed, paraffin-embedded tissue sections of conventional RCC from 92 patients, who had undergone radical nephrectomy, were examined for COX-2 and p53 expression by immunohistochemistry and compared with clinicopathological variables. The COX-2 expression significantly correlated only with tumor size (p=0.049), whereas the p53 expression profoundly correlated with the TNM stage (p=0.024), M stage (p=0.001), and metastasis (synchronous or metachronous; p= 0.004). The COX-2 overexpression did not significantly associate with p53 positivity (p=0.821). The survival rate of patients correlated with the p53 expression (p < 0.0001) but not with the COX-2 expression (p=0.7506). Multivariate analyses indicated that tumor size, M stage, and p53 expression were independent prognostic factors for cancer-specific survival. The COX-2 expression was not an independent factor. These results show that the increased expression of p53 was associated with metastasis and a worse prognosis in conventional RCC, which suggests that p53 might have played an important role in the progression of conventional RCC. The increased expression of COX-2 was associated only with tumor size, but may not be an important prognostic factor in conventional RCC. No association was observed between COX-2 overexpression and p53 positivity in conventional RCC.

Keyword

Cyclooxygenase-2; p53; prognosis; renal cell carcinoma

MeSH Terms

Carcinoma, Renal Cell/*metabolism/mortality/pathology
Humans
Kidney Neoplasms/*metabolism/mortality/pathology
Prognosis
Prostaglandin-Endoperoxide Synthase/*metabolism
Protein p53/*metabolism
Tumor Markers, Biological/*metabolism

Figure

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  Fig. 1 Immunohistochemical staining for COX-2. (A) COX-2 immunostaining was not seen (COX-2 intensity, 0). (B) Almost all cancer cell cytoplasms strongly stained for COX-2 (COX-2 intensity, 3). Original magnification, ×400.

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  Fig. 2 Immunohistochemical staining for p53. (A) Tumor cells showed no nuclear staining for p53 (p53 negative). (B) A strong nuclear expression of p53 was seen (p53 positive). Original magnification, ×400.

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  Fig. 3 Kaplan-Meier cancer-specific survival curves according to the p53 expression. The survival rate of patients with p53-positive tumors was significantly lower than that of patients with p53-negative tumors (p<0.0001).

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  Fig. 4 Kaplan-Meier cancer-specific survival curves according to the COX-2 expression. There was no difference in survival rates according to the level of the COX-2 expression (p=0.7506). Weak, scores 0 - 4; moderate, scores 5-8; strong, scores 9-12.

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