环氧化酶-2在膀胱癌组织及尿脱落细胞中的表达和意义

Expression of Cyclooxygenase-2 in Human Transitional Cell Carcinoma of the Urinary Bladder and Exfoliated Urothelial Cells of Bladder Cancer

目的探讨COX2在膀胱癌组织中的表达,了解尿脱落细胞COX2表达在膀胱癌早期诊断中的价值。方法应用免疫组化技术检测48例膀胱移行细胞癌组织、免疫细胞化学技术检测40例膀胱移行细胞癌患者和30例非肿瘤患者尿脱落细胞COX2的表达。结果膀胱移行细胞癌组织COX2阳性表达率为72.9%,对照组正常膀胱黏膜无表达。COX2的表达与膀胱癌临床分期显著相关(P<0.05),不同病理分级膀胱癌的表达差别无显著性意义。非肿瘤患者尿脱落细胞无COX2表达,膀胱癌尿脱落细胞COX2免疫细胞化学检测阳性率为67.5%,明显高于常规尿细胞学的37.5%(P<0.05),尤其对于G1级和Ta～T1期的低级、早期肿瘤,尿脱落细胞COX2免疫细胞化学检测与常规尿细胞学检查相比,具有显著性意义(P<0.05)。结论COX2在膀胱移行细胞癌的发生发展中起重要作用,与肿瘤的浸润、转移相关。尿脱落细胞COX2表达检测特异性高,可作为早期诊断膀胱癌的一种标志物。

Objective To investigate the significance of expression of cyclooxygenase-2(COX-2) in human transitional cell carcinomas(TCCs) of the urinary bladder and to evaluate the value of COX-2 expression in exfoliated urothelial cells in early diagnosis. Methods The expression of COX-2 in human TCCs of the urinary bladder was observed with immunohistochemical methods and COX-2 immunocytology were performed on exfoliated urothelial cells in the patients with TCC and 30 subjects with normal urothelium.Results COX-2 specific proteins were found in 35 of 48 TCC specimens but not in control urinary bladder tissues. There are statistical significances between the T a-1 and T 2-4 stage cases(P< 0.05), but no correlation was found between COX-2 and tumor grading. The expression of COX-2 was negative in all controls. The positive staining of COX-2 in exfoliated urothelial cells of patients with TCC was 67.5%, which was significantly higher than the positive rate of cytopathology ( 37.5%) (P< 0.05), especially in low grade (G1 )and low stage (Ta～T1) cancer. Conclusions The results suggested that COX-2 overexpression plays a role in development and invasion of TCCs. COX-2 immunocytology had a higher specificity in detection of bladder tumors and therefore would be a good marker in early diagnosis.