The role of COX2 immunohistochemical expression in endometrial endometrioid carcinoma and endometrial hyperplasia and it's correlation with clinicopathological parameters

Hamza, Marwa Mohammed; Ejam, Sura

doi:10.52573/ipmj.2025.150080

	The role of COX2 immunohistochemical expression in endometrial endometrioid carcinoma and endometrial hyperplasia and it's correlation with clinicopathological parameters
Iraqi Postgraduate Medical Journal
Article 8, Volume 24, Issue 3, July 2025, Pages 370-377 PDF (2 M)
Document Type: Research Paper
DOI: 10.52573/ipmj.2025.150080
Authors
Marwa Mohammed Hamza^* ¹; Sura Ejam²
¹Al-Hilla Teaching Hospital
²Babylon University/college of midicin
Abstract
Background: Uterine corpus tumor is one of the most prevalent gynecological malignancies. 75% of women are postmenopausal at time of diagnosis .Thus, Postmenopausal bleeding is the most common symptom, COX2, also known as prostaglandin H synthase, catalyzes the formation of prostaglandin from arachidonic acid, identified as a potential indicator of the neoplastic transformation of normal cells into tumors cell. Aim of Study: To evaluate the Cyclooxygenase-2(COX2) immunohistochemical expression in endometrial carcinoma and endometrial hyperplasia with and without atypia and itś correlation with clinicopathological parameters . Method: Cross sectional study carried out in the Department of Pathology, Babylon Center during the period from December 2022 through December 2023 including (70) cases: (36) endometrial biopsy (34) hysterectomy specimens ; patients age range from 31 to77 years.(20) cases as endometrial hyperplasia without atypia;(20) cases as atypical endometrial hyperplasia; (30) cases of endometrial carcinoma. Two sections of 5μm thickness were taken from each block, the first was stained with (H&E) stain for histopathological revision, the other section was stained for COX2 (IHC) antigen expression . Results: Higher COX2 expression with strong cytoplasmic and membranous staining was found in endometrial carcinoma than endometrial hyperplasia which mostly show weak to negative staining, this expression increase with advanced stage and grade of endometrial carcinoma which mean that COX2 have a role in tumor progression from hyperplasia to carcinoma . Conclusion: ● COX2 immunohistochemical expression increased in endometrial carcinoma ,associated closely with parameters of tumor aggressiveness such as advanced tumor stage and grade, this makes the possibility of the use of COX2 inhibitors as adjunct endometrial carcinoma treatment and to decrease recurrence after treatment, also the possibility for it use in prevention of endometrial carcinoma in high risk groups. ● Endometrial carcinoma with strong positivity for COX-2 expression have a poor prognostic significance.
Keywords
Cox2 enzyme; endometrial carcinoma; endometrial hyperplasia

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