title: Is the immunohistochemical expression of proliferation (Ki-67) and apoptosis (Bcl-2) markers and cyclooxigenase-2 (COX-2) related to carcinogenesis in postmenopausal endometrial polyps?
abstract: OBJECTIVE
  To evaluate the pattern of Ki-67, Bcl-2 and COX-2 expression in the glandular epithelium and stroma of malignant and benign endometrial polyps in postmenopause.
  
  
  METHODS
  A total of 390 postmenopausal women underwent surgical hysteroscopy; women with endometrial polyps were included. Polypoid lesions were histologically classified as benign, premalignant or malignant lesions. Ki-67, Bcl-2 and COX-2 expression were evaluated by immunohistochemistry according to percentage of stained cells, staining intensity, and final score.
  
  
  RESULTS
  The prevalence of malignancy in endometrial polyps was 7.1% and was associated with postmenopausal bleeding. The final score showed that only mean COX-2 expression was higher in malignant polyps both in the glandular epithelium (6.1 +/- 2.5) (p < 0.001) and stroma (2.4 +/- 3.0) (p < 0.01). There was a higher Bcl-2 expression, especially in the glandular epithelium, with no differences between benign polyps and premalignant/malignant polyps. Ki-67 expression was low in both benign polyps and premalignant/malignant polyps.
  
  
  CONCLUSIONS
  Polyps in postmenopause have a high COX-2 expression that is higher in malignant polyps than in benign polyps. There was no difference in Ki-67 and Bcl-2 expression between malignant polyps and premalignant/malignant polyps.
authors.affiliation: Department of Obstetrics and Gynecology, State University of Campinas-UNICAMP School of Medicine, 13083-970 Campinas, SP, Brazil.
authors.forename: Armando
authors.initials: A
authors.lastname: Antunes
authors.forename: Liliana A L A
authors.initials: LA
authors.lastname: Andrade
authors.forename: Glauce A
authors.initials: GA
authors.lastname: Pinto
authors.forename: Rogerio
authors.initials: R
authors.lastname: Leão
authors.forename: Aarão M
authors.initials: AM
authors.lastname: Pinto-Neto
authors.forename: Lúcia
authors.initials: L
authors.lastname: Costa-Paiva
mesh_terms: D000368:Aged; D017209:Apoptosis; D014408:Biomarkers, Tumor / Q000378:metabolism; D049109:Cell Proliferation; D051546:Cyclooxygenase 2 / Q000378:metabolism*; D016889:Endometrial Neoplasms / Q000453:epidemiology / Q000378:metabolism* / Q000473:pathology; D004717:Endometrium / Q000378:metabolism / Q000473:pathology; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology; D007150:Immunohistochemistry / Q000379:methods; D019394:Ki-67 Antigen / Q000378:metabolism*; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology; D011127:Polyps / Q000453:epidemiology / Q000378:metabolism* / Q000473:pathology; D017698:Postmenopause; D011230:Precancerous Conditions / Q000453:epidemiology / Q000378:metabolism / Q000473:pathology; D015995:Prevalence; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D019253:Proto-Oncogene Proteins c-bcl-2; D051546:Cyclooxygenase 2