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Cyclooxygenase-2 expression in cervical intraepithelial neoplasia III and squamous cell cervical carcinoma, and its correlation with clinicopathologic variables
  1. P. Dursun*,
  2. K. Yuce*,
  3. A. Usubutun and
  4. A. Ayhan*
  1. * Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
  2. Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
  1. Address correspondence and reprint requests to: Polat Dursun, MD, Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey. Email: pdursun{at}ttnet.net.tr or pdursun{at}yahoo.com

Abstract

The objective of the study was to compare cyclooxygenase-2 (COX-2) expression in cervical intraepithelial neoplasia III (CIN III) and squamous cell carcinoma (SCC) of the cervix, and its correlation with clinicopathologic factors of SCC with a review of the available literature. This study included 25 patients with CIN III and 67 patients with stage I–IIa SCC. All patients in the SCC group were treated with radical hysterectomy plus pelvic and para-aortic lymphadenectomy and postoperative chemoradiotherapy based on their histopathologic risk factors. Immunohistochemical analysis was performed on paraffin-embedded sections with COX-2 antibody. COX-2 expression in the SCC group was significantly higher than in the CIN III group (55.2% [37/67] vs 24% [6/25]; P= 0.008). Significantly higher expression of COX-2 was observed in patients with lymphovascular space invasion (LVSI) compared to patients without LVSI (61.9% [34/55] vs 33.3% [3/9]; P= 0.02). Additionally, patients with tumor sizes >4 cm had significantly higher COX-2 expression than patients with tumor sizes <4 cm (65.9% [27/41] vs 39% [10/26] P= 0.028). There was no significant relationship with respect to COX-2 expression and parametrial involvement, lymph node metastasis, recurrences, and survival. In multivariate analysis, LVSI was the only statistically significant determinant for COX-2 expression (P= 0.024; OR = 2.35; 95% CI = 1.1–4.9). Our results and a review of the literature both suggest that COX-2 expression may have a role in the development and progression of CIN III and it is related to some clinicopathologic variables of cervical carcinoma. Further studies are needed to clarify the role of COX-2 inhibitors in the management of CIN and SCC.

  • CIN III
  • COX-2 inhibitors
  • cyclooxygenase-2
  • HSIL
  • lymph node metastasis
  • lymphovascular invasion
  • preinvasive cervical neoplasia
  • prognosis
  • squamous cell cervical carcinoma
  • tumor size

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