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Cyclooxygenase-2 expression on urothelial and inflammatory cells of cystoscopic biopsies and urine cytology as a possible
predictive marker for bladder carcinoma. (COX-2) is a key enzyme involved in the production of prostaglandins. The aim
of the current study was to elucidate the involvement of COX-2 in bladder carcinoma by examining its expression on both
urothelial and inflammatory cells in tissue biopsies and urine cytology samples.A total of 65 patients were included in the study.
They represented seven control cases ; pure chronic cystitis premalignant lesions (18) in the form of squamous metaplasia or
urothelial dysplasia as well as transitional cell carcinoma (TCC) and squamous cell carcinoma (SqCC). Immunohistochemistry
of formalin-fixed, paraffin-embedded tissue sections and urine cytology samples was performed for all cases using COX-2 : The
study revealed positive COX-2 expression on the urothelial and inflammatory cells from all cases of chronic cystitis, squamous
metaplasia and SqCC compared with 42.8% and 71.4% of normal controls, respectively. The score of urothelial COX-2 expression
was sequentially upregulated from normal to chronic cystitis,,However,the inflammatory cellular expression was down regulated
with malignant transformation compared with chronic cystitis.In TCC, COX-2 was over-expressed on both urothelial and
inflammatory cells in advanced tumors. Urine cytology samples were positive for COX-2 in a comparable manner to cystoscopic
biopsies.The results have provided,.First, using the differential COX-2 expression on both inflammatory and urothelial cells as
markers for premalignant or malignant transformation; second, urine cytology was found to have a high sensitivity for COX-2
expression ,so proved to be valuable in malignancy as a non-invasive substitute for cystoscopy.
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