COX-2 overexpression in peritoneal lesions is correlated with nonmenstrual chronic pelvic pain.
OBJECTIVE
To investigate cyclooxygenase (COX-2) expression within different endometriotic lesions and to assess whether these expression patterns correlate with clinical characteristics.


METHODS
Retrospective cross-sectional study.


METHODS
University Hospital.


METHODS
Seventy patients with histologically confirmed exclusively peritoneal (n=20), ovarian (n=19) or deep-infiltrating (n=31) endometriosis and a detailed medical history.


METHODS
Immunohistochemical analysis for COX-2 was performed on 108 endometriotic lesions.


RESULTS
COX-2 intensity, percentage of stained glandular endometriotic cells, and correlation of COX-2 expression with clinicopathological parameters. Semiquantitative COX-2 expression did not differ between distinct morphological types of endometriosis and showed no association with the menstrual cycle. Patients with peritoneal-only endometriosis suffering from moderate or severe chronic pelvic pain showed significantly more frequent COX-2 overexpression than asymptomatic patients or patients with minimal symptoms. In patients with exclusively ovarian or deep-infiltrating endometriosis no association between COX-2 expression and clinical parameters, such as chronic pelvic pain, dysmenorrhoea, dyspareunia, sterility, lower urinary tract symptoms or gastrointestinal symptoms was observed.


CONCLUSIONS
Peritoneal endometriotic lesions with increased COX-2 expression have a special relevance for the development of chronic, nonmenstruation-associated, pelvic pain in endometriotic patients. These patients may benefit from therapy with COX-2 inhibitors.
Buchweitz
Olaf
O
Department of Obstetrics and Gynecology, University of Münster, Albert Schweitzer Str. 33, D-48149 Münster, Germany. buchweo@mednet.uni-muenster.de
Staebler
Annette
A
Wülfing
Pia
P
Hauzman
Erik
E
Greb
Robert
R
Kiesel
Ludwig
L
D002908:Chronic Disease; D003430:Cross-Sectional Studies; D051546:Cyclooxygenase 2 / Q000032:analysis / Q000096:biosynthesis*; D004715:Endometriosis / Q000150:complications / Q000201:enzymology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017699:Pelvic Pain / Q000209:etiology*; D010529:Peritoneal Cavity / Q000473:pathology*; D010532:Peritoneal Diseases / Q000150:complications / Q000201:enzymology*; D012189:Retrospective Studies
D051546:Cyclooxygenase 2