title: Cyclooxygenase-2 (COX-2) immunostaining does not correlate with the degree of vulvar neoplasia.
abstract: OBJECTIVE
  The cyclooxygenase-2 (COX-2) enzyme is up-regulated in inflammatory and neoplastic conditions. In the last decade, its biological role has been investigated in various pre-invasive and invasive cancers with the hope that it can serve as a target for cancer prevention and treatment.
  
  
  METHODS
  We evaluated the expression of COX-2 in vulvar biopsies to determine its relationship to the degree of dysplasia. COX-2 expression was studied by immunohistochemistry in 62 consecutive vulvar biopsies divided into four diagnostic groups. Group 1 included inflamed vulva (n = 14); group 2, vulvar intraepithelial neoplasia (VIN) I and VIN II (n = 20); group 3, VIN III and carcinoma in situ (n = 18); and group 4, invasive squamous cell carcinoma (n = 10). Representative sections were immunostained using polyclonal anti-COX-2 antibodies at concentration 1:25 without pretreatment. Immunostaining was scored according to the proportion of positive epithelial cells in the vulvar mucosa as 0 (no positive cells), 1(< 5% positive), 2 (6-50% positive), or 3 (> 50% positive).
  
  
  RESULTS
  Mean immunostaining scores were 1.6, 1.4, 0.7, and 1.2 for groups 1, 2, 3, and 4, respectively. Scores were different between the groups (chi(2) = 9.908, P = 0.019) as shown by Cochran-Mantel-Haenszel statistical analysis (modified ridit scores), but did not correlate with age or the degree of dysplasia. The strongest staining for COX-2 was in the inflammatory group.
  
  
  CONCLUSIONS
  COX-2 staining in inflamed, dysplastic, and malignant vulvar epithelium is variable but, as shown in this study, does not correlate with the degree of vulvar dysplasia or malignancy.
authors.affiliation: Department of Pathology, Sunnybrook and Women's College Health Sciences Centre, Toronto ON.
authors.forename: Sharon
authors.initials: S
authors.lastname: Nofech-Mozes
authors.affiliation: Division of Gynaecologic Oncology, Toronto Sunnybrook Regional Cancer Centre, Toronto ON.
authors.forename: Rachel
authors.initials: R
authors.lastname: Kupets
authors.affiliation: Department of Pathology, Sunnybrook and Women's College Health Sciences Centre, Toronto ON.
authors.forename: Golnar
authors.initials: G
authors.lastname: Rasty
authors.affiliation: Department of Pathology, Sunnybrook and Women's College Health Sciences Centre, Toronto ON.
authors.forename: Nadia
authors.initials: N
authors.lastname: Ismiil
authors.affiliation: Division of Gynaecologic Oncology, Toronto Sunnybrook Regional Cancer Centre, Toronto ON.
authors.forename: Allan
authors.initials: A
authors.lastname: Covens
authors.affiliation: Department of Pathology, Sunnybrook and Women's College Health Sciences Centre, Toronto ON.
authors.forename: Mahmoud A
authors.initials: MA
authors.lastname: Khalifa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000201:enzymology / Q000473:pathology; D051546:Cyclooxygenase 2 / Q000378:metabolism*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009367:Neoplasm Staging; D011230:Precancerous Conditions / Q000175:diagnosis / Q000201:enzymology / Q000473:pathology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014846:Vulvar Neoplasms / Q000175:diagnosis* / Q000201:enzymology* / Q000473:pathology
chemical_list: D051546:Cyclooxygenase 2