병기 T1, 분화도 3 방광암에 있어서 Cyclooxygenase-2와 p53의 예후 판정의 가치 = Prognostic Value of Cyclooxygenase-2 and p53 Expression in Stage T1 Grade III Bladder Cancer

다국어 초록 (Multilingual Abstract)

Purpose: The prognostic value of p53 remains controversial in stage T1, grade III(T1GIII) transitional cell carcinomas(TCC) of the bladder. Recent studies have reported increased expression of cyclooxygenase-2(COX-2) in bladder cancer. The prognostic values of p53 and COX-2 were compared in T1GIII TCC of the bladder.
Materials and Methods: Among 57 consecutive patients, diagnosed with T1GIII TCC of the bladder by transurethral resection(TURB), 37 were eligible for this study. Exclusion criteria included; the first TURB performed elsewhere, no or inadequate(less than 6 weeks) bacillus Calmette- Guerin treatment and postoperative follow-up of less than 1 year. The expressions of p53 and COX-2 were evaluated by immunohistochemical staining of TURB tissues. Possible correlations of the p53 and COX-2 expressions with the clinicopathological features, such as age, shape and multiplicity of tumor, recurrence and progression, were examined.
Results: During a mean follow-up of 27 months, the disease recurred in 43.2% and progressed in 16.2%. Of the 37 specimens, 31(83.8%) and 16(43.2%) stained positive for COX-2 and p53 expressions, respectively. There were no significant differences in age, shape and multiplicity of the tumors, recurrence-free survival and progression-free survival between the p53 positive and negative groups. However, the recurrence-free and progression-free survivals were significantly lower in the COX-2 positive than in the COX-2 negative group(p=0.049 and p=0.027, respectively). When combined, p53 and COX-2 more accurately predicted recurrence than COX-2 alone(p=0.036), but not the progression(p=0.776).
Conclusions: In the pathologically homogeneous group of T1GIII TCC of the bladder, COX-2 was superior to p53 in predicting the prognosis.

참고문헌 (Reference)

1 "p53-mediated induction of Cox-2 counteracts p53- or genotoxic stress induced apoptosis" 21 : 5635-5644, 2002

2 "p53 status does not predict initial clinical response to bacillus Calmette-Guerin intravesical therapy in T1 bladder tumors" 159 : 1079-1084, 1998

3 "p53 immunoreactivity in biopsy specimens of T1G3 transitional cell carcinoma of the bladder - a helpful parameter in guiding the decision for or against cystectomy?" 36 : 610-614, 2000

4 "Relation between cyclooxygenase-2 expression and tumor invasiveness and patient survival in transitional cell carcinoma of the urinary bladder" 92 : 188-193, 2001

5 "Prostaglandin E2-mediated suppression of cellular immunity in colon cancer patients" 71-7, surgery1984

6 "Prognostic value of p53 overexpression in T1G3 bladder tumors treated with bacillus Calmette-Guerin therapy" 59 : 409-413, 2002

7 "Predictive value of cell cycle markers p53 and Ki-67 in superficial bladder tumor recurrence" 5 : 4079-4084, 1999

8 "Overexpression of p53 protein in a high-risk population of patients with superficial bladder cancer before and after bacillus Calmette-Guerin therapy correlation to clinical outcome" 14 : 2646-2652, 1996

9 "Non-invasive papillary carcinoma of the bladder associated with carcinoma in situ" 575-80, jurol1976

10 "Immunohistological expression of p53 in primary pT1 transitional cell bladder cancer in relation to tumour progression" 526-32, brjurol1994

11 "Immunohistochemical analysis of proliferating cell nuclear antigen, p53 protein and nm23 protein, and nuclear DNA content in transitional cell carcinoma of the bladder" 78 : 1762-1774, 1996

12 "Host cyclooxygenase-2 modulates carcinoma growth." 105 : 1589-1594, 2000

13 "Expression of cyclooxygenase-2(COX-2) in human invasive transitional cell carcinoma(TCC) of the urinary bladder" 59 : 5647-5650, 1999

14 "Expression of cyclooxygenase-2 in patients with bladder carcinoma" 165 : 1468-1472, 2001

15 "Expression of cyclooxygenase-2 in human transitional cell carcinoma of the urinary bladder" 158 : 849-853, 2001

16 "Enhanced expression of cyclooxygenase-2 in high grade human transitional cell bladder carcinomas" 157 : 29-35, 2000

17 "Cyclooxygenase regulates angiogenesis induced by colon cancer cells" 93 : 705-716, 1998

18 "Correlation between p53 over expression and response to bacillus Calmette-Guerin therapy in a high risk select population of patients with T1G3 bladder cancer" 159 : 788-791, 1998

19 "Correlation and prognostic significance of p53 p21WAF1/CIP1 and Ki-67 expression in patients with super-ficial bladder tumors treated with bacillus Calmette-Guerin intravesical therapy" 161 : 792-798, 1999

20 "Can p53 nuclear over-expression, Bcl-2 accumulation and PCNA status be of prognostic significance in high-risk superficial and invasive bladder tumours?" 25 : 61-65, 1999

21 "Can biological markers predict recurrence and progression of superficial bladder cancer" 10 : 441-445, 2000

22 "Association of p53 nuclear overexpression and tumor progression in carcinoma in situ of the bladder" 388-92, jurol1994

23 "Association of cyclooxygenase-2 expression with prognosis of stage T1 grade 3 bladder cancer" 60 : 816-821, 2002

24 "Alterations in cellular adhesion and apoptosis in epithelial cells overexpressing prostaglandin endoperoxide synthase-2" 83 : 493-501, 1995