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Cyclooxygenase‐2 promotes angiogenesis in pTa/T1 urothelial bladder carcinoma but does not predict recurrence
Author(s) -
Friedrich M.G.,
Toma M.I.,
Petri S.,
Huland H.
Publication year - 2003
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1046/j.1464-410x.2003.04345.x
Subject(s) - immunostaining , endoglin , cd34 , medicine , immunohistochemistry , pathology , angiogenesis , neovascularization , proportional hazards model , carcinoma , urothelium , urinary bladder , urology , biology , stem cell , genetics
OBJECTIVE To investigate the effect of cyclooxygenase‐2 (COX‐2) on microvessel density (MVD) and on the clinical prognosis in patients with non‐muscle invasive urothelial carcinoma of the bladder, as COX‐2 expression is significantly greater in epithelial tumours and there is increasing evidence that COX‐2 might contribute to tumour neovascularization. PATIENTS AND METHODS We assessed tumour samples from 110 patients undergoing transurethral resection for primary pTa/pT1 bladder carcinoma (pTa, 84; pT1, 26; grade 1, 22; grade 2, 81; grade 3, seven). Paraffin sections were assessed immunohistochemically using antibodies against COX‐2, CD34 (endothelial cells) and CD105 (proliferating vessels). COX‐2 expression was quantified by the number of stained cells (negative, +, ++) and the MVD calculated as vessels per field. RESULTS Of the 110 tumours, 45 (41%) had no immunostaining for COX‐2, 40 had faint staining with at least isolated positive cells (+) and 25 stained ++. COX‐2 positive tumours had significantly greater vascularization for proliferating vessels. In COX‐2 negative tumours the MVD was 22.1, identified by CD34 immunostaining, and 3.4 for proliferating vessels (CD105), whereas COX‐2 positive tumours had a MVD of 18.3 (CD34), and of 5.8, respectively (CD105). Complete follow‐up data were available in 91 patients; after a mean follow‐up of 25 months, 18 (20%) had tumour recurrences. There was no significant difference in the recurrence rates or disease‐free survival between COX‐2‐positive (19%, 25.6 months) or ‐negative patients (21%, 25.2 months). CONCLUSION These results confirm the involvement of COX‐2 in angiogenesis in bladder cancer, as COX‐2 promoted blood vessel proliferation in the tumour zone, and indicate the usefulness of COX‐2‐inhibiting drugs in preventing and treating superficial bladder cancer.