title: Does uterine prolapse alter endometrial cyclooxygenase 2 expression and promote the development of premalignant lesions?
abstract: OBJECTIVE
  The aim of this study was to evaluate the expression of cyclooxygenase 2 (COX-2) and its association with the development of premalignant lesions in gland structures of the endometrium in patients with uterine prolapse, a condition which exposes the uterus to mechanical and infectious stress.
  
  
  METHODS
  The study included 102 patients who underwent hysterectomy to correct grade 3-4 uterine prolapse and 105 patients who underwent hysterectomy for other causes. Endometrial gland structures underwent immunohistochemical staining and COX-2 expression was graded. Grades 0 and 1 represent low expression; grades 2 and 3 correspond to high levels of COX-2 expression.
  
  
  RESULTS
  The prevalence of grade 2-3 COX-2 expression was significantly higher in the endometrial gland structures of patients with prolapse and hyperplasia compared to the remaining patients (p = 0.014). Grade 0-1 COX-2 expression was significantly more common in the endometrial gland structures of patients without uterine prolapse or hyperplasia (p = 0.004). Among the patients without endometrial hyperplasia, COX-2 expression was elevated in the endometrial gland structures of those with uterine prolapse compared to those without prolapse.
  
  
  CONCLUSIONS
  Elevated COX-2 expression may explain the presence of unexpected premalignant lesions of the endometrium in patients with uterine prolapse.
authors: Department of Obstetrics and Gynecology, Sifa University School of Medicine, Izmir, Turkey.
authors: Mine
authors: M
authors: Genc
authors: Oya Nermin
authors: ON
authors: Sivrikoz
authors: Nur
authors: N
authors: Sahin
authors: Esin
authors: E
authors: Celik
authors: Guluzar Arzu
authors: GA
authors: Turan
authors: Serkan
authors: S
authors: Guclu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D051546:Cyclooxygenase 2 / Q000378:metabolism*; D004714:Endometrial Hyperplasia / Q000473:pathology*; D016889:Endometrial Neoplasms / Q000209:etiology / Q000473:pathology*; D004717:Endometrium / Q000378:metabolism* / Q000473:pathology*; D005260:Female; D006801:Humans; D007044:Hysterectomy; D007249:Inflammation / Q000150:complications / Q000378:metabolism*; D008875:Middle Aged; D014596:Uterine Prolapse / Q000473:pathology*
chemical_list: D051546:Cyclooxygenase 2