環氧酵素在台灣人泌尿上皮癌化學抗藥機制之角色
許富順、杜元博、蒲永孝1
新北市立聯合醫院 外科部 泌尿科、台大醫院 泌尿部1
原發性腎盂淋巴上皮癌
陳浩瑋1,2、闕光瞬1、吳文正1、李經家1、葉信志1、李香瑩1、蔡嘉駿1、黃俊農2
1高雄市立大同醫院 泌尿科；2高雄醫學大學附設中和紀念醫院 泌尿部
Primary lymphoepithelioma-like carcinoma of the renal pelvis
Hao-Wei Chen1,2, Kuang-Shun Chueh1, Wen-Jeng Wu1, Ching-Chia Li1, Hsin-Chih Yeh1, Hsiang-Ying Lee1, Chia-Chun Tsai1, Chun-Nung Huang2
Divisions of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan1;
Department of Urology, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan2
Lymphoepithelioma-like carcinoma (LELC) is best known to occur in the nasopharynx. When LELC occurs in the urinary tract, this extremely rare neoplasm most commonly affects the bladder but has also been reported in the renal pelvis, ureter, prostate, and urethra.
We present a case of LELC arising in the right renal pelvis of a 73-year-old woman with hematuria and hydronephrosis. Computed tomography demonstrated right renal pelvis tumor. Ureteroscopy biopsy showed papillary urothelial neoplasm of low malignant potential. An operation with hand-assisted laparoscopic right nephroureterectomy and extravesical bladder cuff exision was carried out. The pathologic examination showed pure type of LELC, pT2N0.
Unlike lymphoepithelioma in the nasopharynx, immunohistochemical analysis of this urinary LELC was negative for the Epsteine-Barr virus. No disease recurrence was noted at 1-year follow-up. Only ten previous cases of LELC involving the renal pelvis have been reported. This is the first report of a renal pelvis LELC case in Taiwan.
Fu-Shun Hsu, Yuan-Po Tu , Yeong-Shiau Pu1
Department of Urology, New Taipei City Hospital, Taiwan;
Department of Urology, National Taiwan University Hospital, Taiwan1
Purpose: To investigate associations between cyclooxygenase-2 (COX-2) expression and chemoresistance, and invasiveness of human urothelial carcinoma (UC) cell lines and tissue specimens in Taiwanese patients with UC.
Materials and Methods: Expression levels of COX-2 mRNA and protein in two human UC cell lines (T24 and NTUB1) and four chemoresistant urothelial carcinoma cell lines (T24/A, NTUB1/P, NTUB1/As, and NTUB1/T) were evaluated and compared by reverse transcription polymerase chain reaction and Western blot analysis. Expression levels of COX-2 were investigated by immunohistochemical analysis of paraffin-embedded cancer tissue specimens from 102 patients with UC and five healthy control patients. The chemosensitivity for COX-2 inhibitor combining with other chemotherapeutic agents were tested by MTT array and Chou-Talalay method. Kaplan-Meier and log-rank were applied to calculate the differences of recurrence-free survival between invasive and non-invasive UC patients.
Results: Forty of the 102 UC patients (39.2%) were diagnosed as COX-2 positive expression cases. T24 cells but not NTUB1 cells expressed COX-2. All four chemoresistant UC cell lines expressed COX-2. COX-2 expression was significantly associated with local tumor invasion (p < 0.043) in human UC tissue specimens but not associated with other clinical and pathological characteristics, such as source of specimen, sex, and tumor grade. Rofecoxib at 1 μM concentration enhanced the chemosensitivity of all 6 UC cell lines. There was no difference in recurrence-free survival between COX-2 positive and negative expression within invasive UC or non-invasive UC cohorts.
Conclusion: High COX-2 expression was detected in T24 UC cells but not in NTUB1 UC cells. COX-2 was expressed in chemoresistant UC cells. COX-2 overexpression was associated with tumor invasiveness in Taiwanese patients with UC.