Immunhistochemical analysis of CD133, CD44, COX-2 in urothelial carcinomas and surrounding non tumoral mucocals and determination of malignant potential of non tumoral mucosa

Bladder cancer is the 10th most common cancer in the world and is the 13th among cancerrelated deaths. Due to the high risk of recurrence and the need for lifelong follow-up, treatment costs increase compared to other tumors. Recent studies with cancer stem cells have shown that stem cells have a strong relationship with prognosis, recurrence and response to treatment. Transformation into cancer stem cells in the organism may begin or accelerate during tissue regeneration in response to toxins, infections, radiation or metabolic effects that cause mutations. CD133 and CD44 are important markers identified in the subpopulation of cancer stem cells. COX-2 can activate PGE- 2 mediated stem cells with inflammation. In our study, cases diagnosed with UC and CS in the Pathology Department of Meram Faculty of Medicine were evaluated. Immunohistochemical CD133, CD44, COX2 stains were applied to the cases and the data were statistically compared with clinicopathological parameters. Statistically significant positive expression was found in the adjacent mucosa without tumor in CD133 and PUC cases compared to the tumor (p=0.020). CD133 negative expression rate in tumoral areas of patients aged 60 years and older was found to be statistically significantly higher than those under 60 years of age (p=0.021). The strength of CD133 staining in high-grade tumors was found to be statistically significantly higher (p=0.028). Statistically significant positive expression was found in the adjacent mucosa without tumor in CD44 and PUC and CUC cases (p<0.001, p=0.037). In high-grade tumors and in cases with lymph node metastasis, the intensity of CD44 staining was found to be statistically significantly higher (p=0.035, p=0.015). In cases with chronic cystitis, the intensity and final expression of COX-2 staining were found to be statistically significantly higher than the normal adjacent mucosa of urothelial carcinomas (p=0.003). The rate of COX-2 expression in the normal mucosa of patients with PUC was found to be statistically significantly lower than the mucosa of patients with CUC without tumor and those with chronic cystitis (p<0.001). The strong expression of COX-2 was found to be statistically significantly higher in the tumoral area of the patients with CUC compared to the tumoral area of the PUC patients (p=0.028). We found that the intensity of COX-2 staining was strong in high-grade tumors and statistically significantly higher (p= 0.027). We think that CD133, CD44, COX-2 molecules may be associated with poor prognosis.