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    Korean J Urol. 2007 Apr;48(4):376-382. Korean.
    Published online Apr 30, 2007.
    https://doi.org/10.4111/kju.2007.48.4.376
    Copyright © 2007 The Korean Urological Association
    Original Article

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

    Min Ho Cha, Dae Sung Cho, Hyunee Yim,1 Kang Su Cho,2 Sung Joon Hong,2 Nam Hoon Cho,3 Sun Il Kim, Hyun Soo Ahn and Se Joong Kim
      • Department of Urology, Ajou University School of Medicine, Suwon, Korea.
      • 1Department of Pathology, Ajou University School of Medicine, Suwon, Korea.
      • 2Department of Urology, Yonsei University College of Medicine, Seoul, Korea.
      • 3Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
    • Corresponding author (Email: sejoong@ajou.ac.kr )
    Received January 15, 2007; Accepted March 02, 2007.

    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.

    Keywords
    Cyclooxygenase 2; Prognosis; Transitional cell carcinoma; Urinary tract

    Figures

    Fig. 1
    Immunohistochemical staining for cyclooxygenase-2 (COX-2) in transitional cell carcinoma of the upper urinary tract tissues (×400). (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).

    Tables

    Table 1
    Clinicopathological data

    Table 2
    Relationship between COX-2 expression or microvessel density and clinicopathological variables

    Table 3
    Univariate and multivariate survival analyses

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