Does uterine prolapse alter endometrial cyclooxygenase 2 expression and promote the development of premalignant lesions?

Abstract

OBJECTIVE:

The aim of this study was to evaluate the expression of cyclooxygenase 2 (COX-2) and its association with the development of premalignant lesions in gland structures of the endometrium in patients with uterine prolapse, a condition which exposes the uterus to mechanical and infectious stress.

METHODS:

The study included 102 patients who underwent hysterectomy to correct grade 3-4 uterine prolapse and 105 patients who underwent hysterectomy for other causes. Endometrial gland structures underwent immunohistochemical staining and COX-2 expression was graded. Grades 0 and 1 represent low expression; grades 2 and 3 correspond to high levels of COX-2 expression.

RESULTS:

The prevalence of grade 2-3 COX-2 expression was significantly higher in the endometrial gland structures of patients with prolapse and hyperplasia compared to the remaining patients (p = 0.014). Grade 0-1 COX-2 expression was significantly more common in the endometrial gland structures of patients without uterine prolapse or hyperplasia (p = 0.004). Among the patients without endometrial hyperplasia, COX-2 expression was elevated in the endometrial gland structures of those with uterine prolapse compared to those without prolapse.

CONCLUSION:

Elevated COX-2 expression may explain the presence of unexpected premalignant lesions of the endometrium in patients with uterine prolapse.

• Authors: Mine Genc, Oya Nermin Sivrikoz, Nur Sahin, Esin Celik, Guluzar Arzu Turan, Serkan Guclu
• Journal: Gynecologic and obstetric investigation (Gynecol Obstet Invest) Vol. 80 Issue 2 Pg. 119-23 ( 2015) ISSN: 1423-002X [Electronic] Switzerland
• PMID: 25662613 (Publication Type: Journal Article)
• Copyright: © 2015 S. Karger AG, Basel.

Chemical References

• Cyclooxygenase 2

Topics

• Adult
• Aged
• Aged, 80 and over
• Cyclooxygenase 2 (metabolism)
• Endometrial Hyperplasia (pathology)
• Endometrial Neoplasms (etiology, pathology)
• Endometrium (metabolism, pathology)
• Female
• Humans
• Hysterectomy
• Inflammation (complications, metabolism)
• Middle Aged
• Uterine Prolapse (pathology)