Background. Urothelial carcinoma of the urinary bladder (UCB) is the commonest bladder tumor. Cyclooxygenase-2 (COX-2) mediates angiogenesis, cell survival/proliferation, and apoptosis. This study investigates the relation of COX-2 immunostaining in UCB to clinicopathological parameters in Saudi Arabia. Methods. The study population includes 123 UCB and 25 urothelial mucosae adjacent to UCB. UCB samples were collected before any local or systemic therapy. Tissue microarrays were designed and constructed, and TMA blocks were sliced for further immunohistochemical staining. Immunohistochemical staining was done using a mouse anti-human COX-2 monoclonal antibody. A cutoff point of 10% was chosen as the threshold to determine low and high COX-2 immunostaining. Results. COX-2 immunostaining is higher in UCB than in the adjacent urothelium (). High COX-2 immunostaining is associated with high-grade UCB (), distant metastasis (), lymphovascular invasion (), positive muscle invasion (), pT2 and above (), and high anatomical stages (stage II and above). High COX-2 immunostaining is an independent predictor of higher tumor grade (), muscle invasion (), advanced pathological T (), lymphovascular invasion (), and distant metastasis (). High COX-2 immunostaining is associated with lower overall survival rate (). Conclusion. COX-2 immunostaining is associated with the invasiveness of UCB which may be used as an independent prognostic marker. COX-2 may be a significant molecule in the initiation and progression of UCB. Molecular and clinical investigations are required to explore the molecular downstream of COX-2 in UCB and effectiveness of COX-2 inhibitors as adjuvant therapy along with traditional chemotherapy.

中文翻译：

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膀胱尿路上皮癌中 COX-2 免疫染色增加与侵袭性和预后不良有关。

背景。膀胱尿路上皮癌（UCB）是最常见的膀胱肿瘤。环氧合酶 2 (COX-2) 介导血管生成、细胞存活/增殖和细胞凋亡。本研究调查了 UCB 中 COX-2 免疫染色与沙特阿拉伯临床病理参数的关系。方法。研究人群包括 123 个 UCB 和 25 个与 UCB 相邻的尿路上皮粘膜。在任何局部或全身治疗之前收集 UCB 样本。设计和构建组织微阵列，并将TMA块切片用于进一步的免疫组织化学染色。使用小鼠抗人 COX-2 单克隆抗体进行免疫组织化学染色。选择 10% 的截止点作为确定低和高 COX-2 免疫染色的阈值。结果. UCB 中的 COX-2 免疫染色高于邻近的尿路上皮（）。高 COX-2 免疫染色与高级别 UCB 相关（),远处转移 (),淋巴血管侵犯 (），阳性肌肉浸润（), pT2 及以上 ()和高解剖阶段（阶段 II 及以上）。高 COX-2 免疫染色是较高肿瘤分级的独立预测因子（),肌肉入侵 (),晚期病理 T (),淋巴血管侵犯 ()和远处转移 (）。高 COX-2 免疫染色与较低的总生存率相关（）。 结论。COX-2 免疫染色与 UCB 的侵袭性相关，可用作独立的预后标志物。COX-2 可能是 UCB 起始和进展的重要分子。需要分子和临床研究来探索 UCB 中 COX-2 的分子下游以及 COX-2 抑制剂作为传统化疗辅助治疗的有效性。