Cyclooxygenase-2 and B-cell lymphoma-2 expression in cystitis glandularis and primary vesicle adenocarcinoma

Abstract

BackgroundAlthough cystitis glandularis (CG) is a common benign urinary bladder epithelial abnormality, it remains unclear whether CG is a premalignant lesion. Cyclooxygenase-2 (COX-2) and B-cell lymphoma-2 (Bcl-2) overexpression has recently been reported as a potential tumor initiator or promoter. We evaluated and compared COX-2 and Bcl-2 expression in CG, chronic cystitis (CC), and primary vesicle adenocarcinoma (ADC) tissues.MethodsWe conducted a retrospective study to investigate COX-2 and Bcl-2 levels in CG and ADC. We obtained tissue samples from 75 patients (including 11 cases of CC, 30 typical cases of CG (CGTP), 30 cases of intestinal CG (CGIT), and 4 cases of ADC) between 1989 and 2009 from the Surgical Pathology Archives of the No. 2 People’s Hospital of Zhenjiang, affiliated with Jiangsu University. COX-2 and Bcl-2 immunohistochemical staining was performed on all tissues. Nine normal bladder epithelial specimens were evaluated as control samples. Correlations between COX-2 and Bcl-2 expression in CG were also analyzed.ResultsCOX-2 and Bcl-2 expression was higher in the ADC group compared to other groups (p < 0.05). COX-2 and Bcl-2 levels were higher in the CGIT group compared to the CGTP group (p = 0.000 for both). The CGIT and CGTP groups both showed higher COX-2 expression compared to the CC group (p = 0.000 for both). There was no difference in Bcl-2 expression between the CGTP and CC groups (p = 0.452). Additionally, the difference in COX-2 and Bcl-2 expression between the control and CC groups was also insignificant (p = 0.668 and p = 0.097, respectively). Finally, we found that COX-2 and Bcl-2 levels were positively related (r = 0.648, p = 0.000).ConclusionCOX-2 and Bcl-2 overexpression in the CG group suggests that CG, particularly the intestinal type, may be a premalignant lesion that converts into a tumor in the presence of carcinogens.

Novel strategy for cystitis glandularis: Oral treatment with cyclooxygenase‐2 inhibitor

“…Li et al . have speculated that CG is converted into a premalignant lesion in the presence of carcinogens . In contrast, Corica et al .…”

“…Intestinal metaplasia has several similarities to colonic mucosa, including morphology and gene expression pattern of some markers, and celecoxib, a non‐steroidal anti ‐ inflammatory COX‐2 selective inhibitor, is effective in preventing colorectal adenoma . The inflammatory factor COX‐2 is overexpressed in CG . Therefore, we used celecoxib for treatment of our patient with refractory CG.…”

“…11 The inflammatory factor COX-2 is overexpressed in CG. 5 Therefore, we used celecoxib for treatment of our patient with refractory CG. In the present case, TUR-BT, antibiotics, other NSAIDs, steroid pulse therapy, steroid maintenance therapy and anti-allergy drugs were ineffective.…”

“…In contrast, chronic inflammation is suggested to play a pathophysiological role in CG . Recent studies have shown that COX‐2 is overexpressed in CG . COX‐2 is an inducible enzyme that is especially present in inflammatory tissues and various tumors .…”

“…4 Recent studies have shown that COX-2 is overexpressed in CG. 5 COX-2 is an inducible enzyme that is especially present in inflammatory tissues and various tumors. 6-8 COX-2 functions as an inflammatory mediator to catalyze the conversion of free essential fatty acids to prostanoids, which are known to be vasodilators.…”