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

PURPOSE: Cyclooxygenase (COX)-2 plays an important role in cancer progression by affecting tumor cell proliferation, resistance to apoptosis, angiogenesis, and tumor invasion in several types of cancers. However, studies about COX-2 expression in transitional cell carcinoma of the upper urinary tract have been limited. In this study, the relationship of COX-2 expression and microvessel density (MVD), a reflection of angiogenesis, with prognosis in patients with transitional cell carcinoma of the upper urinary tract was investigated. MATERIALS AND METHODS: Formalin-fixed, paraffin-embedded tissue sections of transitional cell carcinoma of the upper urinary tract from 91 patients who had undergone radical nephroureterectomy were stained immunohistochemically with specific antibodies against COX-2 and CD34. COX-2 immunostaining was semi-quantitatively estimated based on proportion and intensity and then immunoreactive scores for each case were generated by multiplying the values for the two parameters. COX-2 immunostaining was considered to be positive if immunoreactive scores were over 5. MVD was determined with CD34-stained slides. The expression pattern of COX-2 and MVD was compared with the clinicopathological variables. RESULTS: 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). 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 only independent prognostic factor. CONCLUSIONS: Increased expression of COX-2 and MVD is associated with a worse prognosis in transitional cell carcinoma of the upper urinary tract. COX-2 expression is correlated with MVD. These results suggest that COX-2 may be important in the progression of upper urinary tract transitional cell carcinoma and angiogenesis may be affected by COX-2 during the progression of upper urinary tract transitional cell carcinoma.

Author dc:creator

• 차, 민호

Contributors dc:contributor

• 김, 세중
• 대학원 의학과
• 200424409

• Cyclooxygenase-2
• 미세혈관밀도
• 예후
• 상부요로
• 이행세포암

Language dc:language

ko

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000001916
000000001916

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/1626