The relationship between the systemic inflammatory response, tumour proliferative activity, T-lymphocytic infiltration and COX-2 expression and survival in patients with transitional cell carcinoma of the urinary bladder

Abstract

The relationship between the systemic inflammatory response, tumour proliferative activity, T-lymphocytic infiltration, and COX-2 expression and survival was examined in patients with transitional cell carcinoma of the urinary bladder (n ¼ 103). Sixty-one patients had superficial disease and 42 patients had invasive disease. Cancer-specific survival was shorter in those patients with invasive compared with superficial bladder cancer (Po0.001). On univariate analysis, stratified by stage, increased Ki-67 labelling index (Po0.05), increased COX-2 expression (Po0.05), C-reactive protein (Po0.05) and adjuvant therapy (Po0.01) were associated with poorer cancer-specific survival. On multivariate analysis of these significant factors, stratified by stage, only C-reactive protein (HR 2.89, 95% CI 1.42 -5.91, P ¼ 0.004) and adjuvant therapy (HR 0.29, 95% CI 0.14 -0.62, P ¼ 0.001) were independently associated with poorer cancer-specific survival. These results would suggest that tumour-based factors such as grade, COX-2 expression or T-lymphocytic infiltration are subordinate to systemic factors such as C-reactive protein in determining survival in patients with transitional cell carcinoma of the urinary bladder.

Intratumoral forkhead box P3‐positive regulatory T cells predict poor survival in cyclooxygenase‐2–positive uveal melanoma

“…27,33 It is noteworthy that the extent of COX-2 expression also was correlated with the prevalence of CD4-positive T cells, as described previously in bladder cancer. 34 However, when considering the primary localization of infiltrating cells, high COX-2 expression was associated significantly with the presence of intratumoral FOXP3-positive Tregs but not with the intratumoral presence of CD4-positive T cells, suggesting mechanisms within the tumor microenvironment of UM that favor the recruitment and/or preferential enrichment of Tregs over conventional, CD4-positive T cells. 10 The role of T-cell infiltration for the clinical course of malignant diseases is controversial, and various studies have linked it to a better 5 or worse 6 prognosis, depending on the type of cancer.…”

Classification using hierarchical clustering of tumor-infiltrating immune cells identifies poor prognostic ovarian cancers with high levels of COX expression

“…40,[45][46][47] Several groups, including ours, have shown a negative correlation between COX-2 expression and the number of tumor-infiltrating CD8 þ cells in cervical cancer, 46,47 endometrial cancer, 48 hepatocellular carcinoma, 49 and transitional-cell carcinoma of the urinary bladder. 50 Furthermore, in experimental data using mice, COX-2 inhibitors increased the number of tumor-infiltrating CD8 þ cells. 17,[51][52][53] In human head and neck cancer, a COX-2 inhibitor administered before operation increased the number of tumor-infiltrating CD8 þ cells.…”

A Novel Molecular Grading Model: Combination of Ki67 and VEGF in Predicting Tumor Recurrence and Progression in Non-invasive Urothelial Bladder Cancer

“…However, none of these markers have been applied to clinical practice alone and proved by multi-center and large scale study (Habuchi et al, 2005). Interestingly, more and more evidence has shown that the combination of biomarkers from the same or different categories has obvious advantages compared to the single markers (Hilmy et al, 2006;Yurakh et al, 2006;Gonul et al, 2008).…”