title: Association of cyclooxygenase-2 expression with prognosis of stage T1 grade 3 bladder cancer.
abstract: OBJECTIVE
  To determine whether the expression of cyclooxygenase-2 (COX-2) has prognostic significance in Stage T1G3 transitional cell carcinoma of the bladder, the most unfavorable subgroup in terms of recurrence and disease progression.
  
  
  METHODS
  Thirty-seven consecutive patients with initial T1G3 transitional cell carcinoma, who had undergone complete transurethral resection, followed by 6 weeks of intravesical instillation of bacille Calmette-Guérin (BCG), and with at least 1 year of follow-up, were enrolled in the study. Paraffin-embedded cancer tissue samples were immunohistochemically stained for COX-2, and possible correlations with clinicopathologic features, such as age, shape and multiplicity of tumor, recurrence, and progression were examined.
  
  
  RESULTS
  The median follow-up was 27 months (range 12 to 67). Sixteen patients (43.2%) experienced recurrence and 6 (16.2%) had progression defined as muscle invasion. Of 37 specimens, 16 (43.2%) stained positive for COX-2, defined as 5% or greater of positively stained cancer cells. COX-2 expression was statistically significant in predicting both recurrence (P = 0.0493) and disease progression (P = 0.0272). Patient age and the shape and multiplicity of tumors were not significantly predictive of recurrence or progression.
  
  
  CONCLUSIONS
  In a pathologically homogeneous group of T1G3 transitional cell carcinoma of the bladder, the expression of COX-2 correlated with recurrence and progression. Thus, patients with COX-2 positive superficial bladder cancer may need to be followed up more vigorously. Additional studies on the mechanistic implications of COX-2 with respect to recurrence and progression and the possible application of a COX-2 inhibitor to prevent recurrence and progression of superficial bladder cancer are warranted.
authors.affiliation: Department of Urology and Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Sun I l
authors.initials: SI
authors.lastname: Kim
authors.forename: Soo Mee
authors.initials: SM
authors.lastname: Kwon
authors.forename: Young Sig
authors.initials: YS
authors.lastname: Kim
authors.forename: Sung Joon
authors.initials: SJ
authors.lastname: Hong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000201:enzymology* / Q000473:pathology*; D051546:Cyclooxygenase 2; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007527:Isoenzymes / Q000032:analysis*; D008297:Male; D008565:Membrane Proteins; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009363:Neoplasm Proteins / Q000032:analysis*; D009364:Neoplasm Recurrence, Local / Q000201:enzymology; D009367:Neoplasm Staging; D011379:Prognosis; D011451:Prostaglandin-Endoperoxide Synthases / Q000032:analysis*; D001749:Urinary Bladder Neoplasms / Q000201:enzymology* / Q000473:pathology*
chemical_list: D007527:Isoenzymes; D008565:Membrane Proteins; D009363:Neoplasm Proteins; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases