title: Cyclooxygenase-2 protein expression in relation to apoptotic potential and its prognostic significance in bladder urothelial carcinoma.
abstract: BACKGROUND
  Cyclooxygenase-2 (COX-2), a critical enzyme in the conversion of arachidonic acid to prostaglandin E2, influences the biological behavior of human tumors, being involved in carcinogenesis, tumor progression, reduced apoptosis and differentiation. The aim of the present study was to investigate the role of COX-2 protein expression in urothelial carcinoma (UC) of the urinary bladder in relation to clinicopathological data and indices of apoptotic potential.
  
  
  METHODS
  Immunohistochemistry was applied to 134 paraffin-embedded specimens of UC for the detection of COX-2, p53, bcl-2, caspase-3, bax protein, MLH1 and hTERT.
  
  
  RESULTS
  Ninety-four UCs (70.1%) had an enhanced expression of COX-2. The COX-2 semi-quantitative expression was unrelated to tumor grade and local invasion, but it was positively linked with caspase-3 (CPP32) and bax protein semi-quantitative immunoreactivity (p = 0.007 and p = 0.026), as well as with the quantitative expression of MLH1 (p = 0.019). COX-2 was also found to be inversely correlated with the nuclear localization of the catalyst component of the telomerase complex, hTERT (p = 0.009). Multivariate statistical analysis showed that COX-2 immunopositivity was independently associated with worse prognosis of patients with non muscle-invasive UCs (p = 0.002).
  
  
  CONCLUSIONS
  COX-2 overexpression, being possibly a subsequence of apoptosis activation, is associated with an unfavorable overall survival of patients with pTa-T1 UCs.
authors.affiliation: Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, 75 Mikras Asias St., Goudi, GR-11527 Athens, Greece.
authors.forename: K
authors.initials: K
authors.lastname: Diamantopoulou
authors.forename: A
authors.initials: A
authors.lastname: Lazaris
authors.forename: E
authors.initials: E
authors.lastname: Mylona
authors.forename: A
authors.initials: A
authors.lastname: Zervas
authors.forename: K
authors.initials: K
authors.lastname: Stravodimos
authors.forename: I
authors.initials: I
authors.lastname: Nikolaou
authors.forename: S
authors.initials: S
authors.lastname: Athanassiadou
authors.forename: L
authors.initials: L
authors.lastname: Nakopoulou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017209:Apoptosis / Q000502:physiology*; D051546:Cyclooxygenase 2 / Q000096:biosynthesis*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D016612:Paraffin Embedding; D016016:Proportional Hazards Models; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000201:enzymology* / Q000473:pathology*; D019459:Urothelium / Q000473:pathology
chemical_list: D051546:Cyclooxygenase 2