title: Cyclooxygenase-2 expression increases with the stage and grade in transitional cell carcinoma of the urinary bladder.
abstract: OBJECTIVE
  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).
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  The degree of COX-2 expression is significantly increased with advancing grade and T stage of disease (p < 0.05).
authors.affiliation: Department of Urology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Wadhwa
authors.forename: Anil K
authors.initials: AK
authors.lastname: Goswami
authors.forename: Kusum
authors.initials: K
authors.lastname: Joshi
authors.forename: Surinder K
authors.initials: SK
authors.lastname: Sharma
mesh_terms: D000328:Adult; D000368:Aged; D002295:Carcinoma, Transitional Cell / Q000378:metabolism* / Q000473:pathology*; D051546:Cyclooxygenase 2 / Q000096:biosynthesis* / Q000378:metabolism; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D001749:Urinary Bladder Neoplasms / Q000378:metabolism* / Q000473:pathology*
chemical_list: D051546:Cyclooxygenase 2