The expression of cyclooxygenase-2 in carcinoma of uterine cervix

Background: Cancer of the cervix is the second leading cause of cancer deaths in women worldwide and remains a leading cause of mortality among women of reproductive age in developing countries. In India, 27% deaths is attributed to cervical cancer among females between 15 and 44 years of age. Studying the expression of COX-2 in cancer tissues and its role in the growth of malignant tumours is important because NSAIDs might help to prevent cancer. Furthermore, selective COX-2 inhibitors are available that block the effects of COX-2 expression but spare the expression of COX-1. Aim and Objectives: The aim of our study is to classify carcinoma of uterine cervix using WHO criteria and to determine the differential expression pattern of cyclooxygenase-2 (COX-2) in carcinoma cervix and to compare this expression with clinicopathological parameters. Materials and Methods: A total of hundred (100) cases of cervical carcinoma were included in the study material submitted as cervical biopsies or hysterectomy specimens in the Department of Pathology, The tissue block was sectioned at 4-5 μm and the sections were stained for Haematoxylin and Eosin stains (H and E). The tumours were classified and graded using the WHO criteria. Immunohistochemistry was performed on the representative sections with COX-2 antibodies using standard protocols. Cases of colon cancer were taken as positive control and negative control were obtained by omitting the primary antibody in the staining protocol. Positive cases showed cytoplasmic positivity. The raw data was converted to immunohistochemical score (IHC Score) by multiplying the quantity and staining intensity scores. The scores theoretically ranged from 0-12. Score of 0-3 was considered Negative, 4-8- Moderate and 9-12 as Strong. Using the Chi-square test the distribution of COX-2 positive cases was analysed according to clinicopathological features. P-value < 0.05 was regarded as statistically significant. Results: In our study there was a significant correlation observed between expression of COX-2 and inflammation. No significant correlation was found between other parameters. Conclusion: The data suggests that COX-2 induction may play a role in high cervical inflammation and carcinogenesis. The patients with a high COX-2 expression could possibly be benefitted with more individualized treatments such as COX-2 inhibitors