COX–2 is overesxpressed in ovarian endometriosis and might represent a therapeutic target

Aims: Recent studies have suggested that cyclooxygenase–2 (COX–2) is involved in the pathogenesis of endometriosis. The aim of this study was to investigate the expression of COX–2 in different anatomical sites of endometriosis

Methods: COX–2 expression was analysed immunohistochemically in 60 samples of endometriotic tissue from different anatomical sites (25 ovarian, 14 uterine, 21 peritoneal/Fallopian tube/omental endometriosis) using a monoclonal antibody against COX–2. Staining results were analysed semiqiantitatively for staining intensity and percent of positive cells.

Results: COX–2 immunoreaction was observed in glandular epithelial cells in 96,5% of all cases; stromal cells were completely negative. COX–2 overexpression (defined as >75% positive stained cells) was seen in 72% of the ovarian and in about 40% of uterine and peritoneal lesions (p<0.05). There was also a sognoficant correlation for staining intensity, favoring ovarian lesions (p<0.0002).

Conclusions: Increased COX–2 expression in the ovarian endometriotic lesions was observed with respect to other extraovarian localizations. Cox–2 inhibitors may be an option in the treatment of symptomatic patients with ovarian endometriosis and might play a role in prevention of ovarian carcinoma in patients who are under risk for ovarian cancer and affected by endometriosis.