title: Cyclooxygenase-2 (COX-2) up-regulation is a prognostic marker for poor clinical outcome of upper tract urothelial cancer.
abstract: BACKGROUND
  There are no reliable biomarkers for diagnosis, prediction of outcome or treatment effect monitoring for upper tract urothelial carcinoma (UTUC), which is a uniquely prevalent cancer in Taiwan. In the present study, 128 primary UTUC specimens of various grades and primary tumor status were examined for the expression of cyclooxygenase-2 (COX-2) in tumor and stroma tissues aiming to clarify the association of COX-2 expression with clinical outcomes in Taiwanese patients with UTUC.
  
  
  METHODS
  Immunohistochemistry was implemented to investigate COX-2 expression levels in 128 paired tumor and stroma specimens. The association of COX-2 expression with tumor progression and prognosis was analyzed.
  
  
  RESULTS
  Our data demonstrated that positive COX-2 expression was more frequent in stromal cells (57.0%), than in tumor sites (53.1%), and the up-regulation of COX-2 was strongly associated with higher cancer-specific death and cancer recurrence rates. In COX-2-negative cases, no similar correlation was found.
  
  
  CONCLUSIONS
  COX-2 expression was up-regulated in both stromal and tumor cells of more than half of the studied UTUC patients and the positive expression of COX-2 in stromal cells may be a potential predictive and prognostic biomarker for UTUC, especially for cancer-specific death and recurrence.
authors.affiliation: Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan, ROC.
authors.forename: Hung-Lung
authors.initials: HL
authors.lastname: Ke
authors.forename: Hung-Pin
authors.initials: HP
authors.lastname: Tu
authors.forename: Hui-Hui
authors.initials: HH
authors.lastname: Lin
authors.forename: Chee-Yin
authors.initials: CY
authors.lastname: Chai
authors.forename: Lin-Li
authors.initials: LL
authors.lastname: Chang
authors.forename: Wei-Ming
authors.initials: WM
authors.lastname: Li
authors.forename: Ching-Chia
authors.initials: CC
authors.lastname: Li
authors.forename: Yi-Chen
authors.initials: YC
authors.lastname: Lee
authors.forename: Hsin-Chih
authors.initials: HC
authors.lastname: Yeh
authors.forename: Wen-Jeng
authors.initials: WJ
authors.lastname: Wu
authors.forename: Da-Tian
authors.initials: DT
authors.lastname: Bau
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000096:biosynthesis* / Q000235:genetics; D051546:Cyclooxygenase 2 / Q000096:biosynthesis* / Q000235:genetics; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007680:Kidney Neoplasms / Q000201:enzymology / Q000235:genetics; D007682:Kidney Pelvis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015854:Up-Regulation; D014516:Ureteral Neoplasms / Q000201:enzymology / Q000235:genetics; D001749:Urinary Bladder Neoplasms / Q000201:enzymology / Q000235:genetics; D014571:Urologic Neoplasms / Q000201:enzymology* / Q000235:genetics
chemical_list: D014408:Biomarkers, Tumor; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human