Cyclooxygenase-2 (COX-2) Immunostaining Does Not Correlate With the Degree of Vulvar Neoplasia

Sharon Nofech-Mozes, Rachel Kupets, Golnar Rasty, Nadia Ismiil, Allan Covens, Mahmoud A. Khalifa

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


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 (χ2=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. Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)290-294
Number of pages5
JournalJournal of Obstetrics and Gynaecology Canada
Issue number4
StatePublished - 2006
Externally publishedYes

Bibliographical note

Funding Information:
This work was funded in part by the Canadian Foundation for Women’s Health.


  • Cyclooxygenase-2
  • Vulvar intraepithelial neoplasia
  • Vulvar invasive squamous cell carcinoma

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