Cyclooxygenase‐2 expression on urothelial and inflammatory cells of cystoscopic biopsies and urine cytology as a possible predictive marker for bladder carcinoma

Cyclooxygenase‐2 (COX‐2) is a key inducible enzyme involved in the production of prostaglandins. It contributes to human carcinogenesis by various mechanisms. The aim of the current study was to elucidate the possible involvement of COX‐2 in human bladder carcinoma by examining its expression on both urothelial and inflammatory cells in tissue biopsies and urine cytology samples of different urinary bladder lesions. A total of 65 patients were included in the study and were selected from cases admitted to Urology Department, Theodor Bilharz Research Institute (TBRI), Giza, Egypt. They represented seven control cases with almost normal‐looking bladder tissue; pure chronic cystitis (n=12); premalignant lesions (18) in the form of squamous metaplasia (n=8) or urothelial dysplasia (n=10) as well as transitional cell carcinoma (TCC) (n=18), and squamous cell carcinoma (SqCC) (n=10). Immunohistochemistry of formalin‐fixed, paraffin‐embedded tissue sections and urine cytology samples was performed for all cases using COX‐2 (H‐62): sc‐7951, a rabbit polyclonal antibody. The study revealed positive COX‐2 expression on the urothelial and inflammatory cells of cystoscopic biopsies from all cases of pure 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 up‐regulated from normal to chronic cystitis (either pure or associated with premalignant changes) (p<0.05) to malignant changes (p<0.05). However, the inflammatory cellular expression was down‐regulated with malignant transformation compared with chronic cystitis (p<0.05). 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 that observed in cystoscopic biopsies. Accordingly, the results of the current study have provided new information in two aspects: First, is the possibility of using the differential COX‐2 expression on both inflammatory and urothelial cells as markers for premalignant or malignant transformation; second, besides cystoscopy, urine cytology was found to have a high sensitivity for COX‐2 expression and hence proved to be valuable in malignancy as a non‐invasive substitute for cystoscopy.     

Simultaneous Occurrence of two Squamous Cell Carcinomas within a Nevus Sebaceous of Jadassohn in an 11-Year-Old Girl

Abstract:   The development of a squamous cell carcinoma within a nevus sebaceous of Jadassohn is very rare. We report here for the first time, the simultaneous occurrence of two squamous cell carcinomas within a single nevus sebaceous of Jadassohn.     

Preoperative Ultrasonic Assessment of Thin Melanocytic Skin Lesions Using a 100-MHz Ultrasound Transducer: A Comparative Study

BACKGROUND It has been shown that tumor thickness (TT) of melanocytic skin lesions (MSL) of less than 1 mm vertical thickness assessed by 20 MHz are often incorrectly evaluated.
OBJECTIVE We aimed to evaluate the accuracy of 100-MHz ultrasound for the determination of TT of thin MSL, compared with conventional 20-MHz ultrasound and histologic findings.
METHODS Thirty-seven patients with 50 suspicious MSL, including tumor diameter up to 1 cm and maximum vertical TT of less than 1 mm, were recruited. The agreement between the histologically and ultrasographically measured TT was analyzed using Bland and Altman plots.
RESULTS Compared to histology, 20-MHz ultrasound (33.9 μm) as well as 100-MHz (16 μm) resulted in overestimation of TT that was twofold higher for 20-MHz ultrasound. The latter also revealed wider 95% limits of agreement (4.9 to 63 μm) than 100-MHz ultrasound (3.5 to 28.7 μm).
CONCLUSION Analysis of agreement clearly demonstrated that the performance of 100-MHz ultrasound is superior to conventional 20-MHz ultrasound, even though a relatively small positive bias was observed in 100-MHz ultrasound, indicating a systematic error. We consider 100-MHz ultrasound a useful tool for the noninvasive determination of TT of thin MSL in vivo.