Hammam Olfat Ali, Aziz Ahmed A, Roshdy Mamdouh S, Abdel Hadi Ahmed M
Theodor Bilharz Research Institute, Giza, Egypt.
Medscape J Med. 2008 Mar 11;10(3):60.
Cyclooxygenase (COX) is an angiogenic factor that is strongly related to inflammatory diseases and the development of cancer and metastasis in several cancers. It is overexpressed in a variety of premalignant and malignant conditions, including urinary bladder cancer. Our aim was to investigate and compare the expression of COX-2 enzyme in patients with bladder cancer, chronic cystitis, and normal bladder tissue. The results were correlated to the classic prognostic factors, mainly tumor stage and grade, in a trial to determine the prognostic significance of COX-2 marker.
Seventy-five bladder samples were taken, including 50 cases with bladder cancer (31 were schistosomal-associated and 19 non-schistosomal-associated), 20 samples from cases with chronic cystitis (7 were nonschistosomal and 13 were schistosomal cystitis), and 5 samples from normal bladder tissue taken as control. The specimens were stained by streptavidin-biotin immunohistochemistry protocol, with COX-2 monoclonal antibody.
Although no notable expression of COX-2 was observed in the normal bladder, it was slightly expressed in chronic cystitis especially in areas of dysplasia and squamous metaplasia, whereas there was a significant increase in COX-2 (P < .001) with moderate-to-strong granular cytoplasmic expression in all malignant histologic types. The COX-2 reactivity was higher in transitional cell carcinoma (TCC) than in squamous cell carcinoma (SqCC) (P < .01). COX-2 expression was significantly higher in schistosomal-associated TCC than in non-schistosomal-associated TCC (P < .01). There was a statistically significant positive correlation between COX-2 expression and tumor grade (P = .0052). COX-2 expression was significantly higher in grade 3 bladder TCC than in grades 1 and 2 bladder TCC (P < .05, P < .01). A correlation between COX-2 expression and progression of bladder TCC also was observed (P = .001). There was a significant difference in COX-2 expression level between the bladder TCCs at different clinical stages (P < .01).
COX-2 is overexpressed in schistosomal-associated bladder cancer. COX-2 may be of significance to the development and proliferation of bladder TCC, consistent with a potential role for COX-2 inhibitors in the prevention and management of this disease.
环氧化酶（COX）是一种血管生成因子，与炎症性疾病以及多种癌症的发生、发展和转移密切相关。它在多种癌前和恶性病变中过度表达，包括膀胱癌。我们的目的是研究并比较COX-2酶在膀胱癌患者、慢性膀胱炎患者及正常膀胱组织中的表达情况。在一项旨在确定COX-2标志物预后意义的试验中，将结果与主要的经典预后因素（主要是肿瘤分期和分级）进行了关联分析。
采集了75份膀胱样本，包括50例膀胱癌患者（31例与血吸虫病相关，19例与血吸虫病无关），20份慢性膀胱炎患者的样本（7例非血吸虫性，13例血吸虫性膀胱炎），以及5份正常膀胱组织样本作为对照。标本采用链霉亲和素-生物素免疫组织化学方法，用COX-2单克隆抗体进行染色。
正常膀胱组织中未观察到COX-2的显著表达，慢性膀胱炎中COX-2有轻度表达，特别是在发育异常和鳞状化生区域，而在所有恶性组织学类型中，COX-2均有显著增加（P <.001），呈中度至强颗粒状细胞质表达。移行细胞癌（TCC）中的COX-2反应性高于鳞状细胞癌（SqCC）（P <.01）。血吸虫病相关的TCC中COX-2表达显著高于非血吸虫病相关的TCC（P <.01）。COX-2表达与肿瘤分级之间存在统计学上的显著正相关（P =.0052）。3级膀胱TCC中的COX-2表达显著高于1级和2级膀胱TCC（P <.05，P <.01）。还观察到COX-2表达与膀胱TCC进展之间的相关性（P =.001）。不同临床分期的膀胱TCC之间COX-2表达水平存在显著差异（P <.01）。
COX-2在血吸虫病相关的膀胱癌中过度表达。COX-2可能对膀胱TCC的发生和增殖具有重要意义，这与COX-2抑制剂在该疾病预防和治疗中的潜在作用一致。
