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Cyclooxygenase-2 expression increases with the stage and grade in transitional cell carcinoma of the urinary bladder
Pankaj Wadhwa1, Anil K Goswami, Kusum Joshi
1Department of Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Objectives:
Experimental models of carcinogenesis show that non-steroidal anti-inflammatory drugs (NSAIDs) increase apoptosis, inhibit angiogenesis and reduce metastases. A linkage between the activity of prostaglandin synthase enzyme cyclooxygenase-2 (COX-2), a known mediator of inflammation, and cancer angiogenesis is implicated. We investigated the expression of COX-2 in bladder cancer tissue specimens using immunohistochemistry.
Methods:
The immunohistochemical expression of COX-2 in bladder cancer was evaluated by scoring the intensity of immunoreactivity from 0 to 3. Further, the degree of COX-2 expression was correlated with the tumor grade and depth of invasion (T stage).
Result:
Fifty eight percent patients (n=22) had superficial bladder tumors, while 42% (n=16) were invasive bladder cancers. Overall, COX-2 immuno-positivity was seen in 84.2% (32/38) patients. COX-2 expression was positive in 76.4% (13/17) cases with pTa tumors, 100% (5/5) of pT1 tumors, 86.6% (13/15) of pT2 tumors and in 100% (1/1) of pT3 tumor. The higher stage tumors stained more intensely; this correlation was significant(p=0.01987; chi2=19.6977). With reference to the grade of tumors, a positive expression was seen in 81.25% (13/16) of the low-grade tumors and 89% (17/19) of the high-grade tumors. The differential COX-2 expression relative to the grade of tumor was found to be statistically significant (p=0.05; chi2=15.8612).
Conclusion:
The degree of COX-2 expression is significantly increased with advancing grade and T stage of disease (p < 0.05).
Insights
Cyclooxygenase-2 (COX-2) is highly expressed in bladder cancer, with increased expression correlating significantly with higher tumor grade and stage. This suggests COX-2 may play a role in bladder cancer progression.
Area of Science:
- Oncology
- Molecular Biology
- Cancer Research
Background:
- Non-steroidal anti-inflammatory drugs (NSAIDs) show anti-cancer effects in experimental models by increasing apoptosis, inhibiting angiogenesis, and reducing metastasis.
- Cyclooxygenase-2 (COX-2), a mediator of inflammation, is implicated in cancer angiogenesis.
Purpose of the Study:
- To investigate the expression of cyclooxygenase-2 (COX-2) in bladder cancer tissue specimens.
- To correlate COX-2 expression levels with tumor grade and depth of invasion (T stage).
Main Methods:
- Immunohistochemistry was used to evaluate COX-2 expression in bladder cancer tissues.
- Immunoreactivity for COX-2 was scored from 0 to 3.
- Statistical analysis was performed to correlate COX-2 expression with tumor grade and T stage.
Main Results:
- COX-2 immuno-positivity was observed in 84.2% of the 38 bladder cancer patients studied.
- COX-2 expression intensity significantly correlated with advancing tumor T stage (p=0.01987).
- A statistically significant correlation was found between COX-2 expression and tumor grade (p=0.05).
Conclusions:
- The degree of COX-2 expression is significantly elevated in bladder cancer.
- Increased COX-2 expression is associated with higher tumor grade and advanced T stage.
- These findings suggest a role for COX-2 in bladder cancer progression.
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