COX-2 overexpression as a biomarker of early cervical carcinogenesis: A pilot study

J. Salvador Saldivar, David Lopez, Rebecca A. Feldman, Reena Tharappel-Jacob, Antonio de la Rosa, Daniel Terreros, William S. Baldwin

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Background.: Recent studies have demonstrated that cyclooxygenase-2 (COX-2) expression is up-regulated in a number of cancers. Selective inhibition of COX-2 offers a potential pharmacological strategy for cancer prevention. The COX-2 isoform is induced in response to inflammatory factors and is expressed in premalignant lesions, including cervical tissues. Few studies have investigated COX-2 expression as a biomarker for early cervical carcinogenesis. In this preliminary study, we assessed the variability of COX-2 overexpression in cervical premalignant lesions. Methods.: Fifty-two patients were recruited and consented. Paired abnormal and control (normal) cervical biopsies were obtained and evaluated for high-risk human papillomavirus (HPV), inflammation, histopathological diagnosis, and COX-2 protein concentration by ELISA. Paired Student's t-test and general linear regression models were used to compare mean COX-2 protein concentrations among biopsy samples and selected risk variables. Results.: Forty-seven of fifty-two paired biopsies were evaluated. COX-2 protein concentrations were 4.9-fold greater in abnormal biopsies (CIN 1 and CIN 2) than normal biopsies. COX-2 was also significantly increased in inflammation-positive biopsies. No significant association was found between COX-2 levels and HPV high-risk positivity, age, parity, STI history, or hormonal contraceptive use, but the sample size was small. Conclusions.: These results suggest that COX-2 induction begins in the premalignant phase of cervical carcinogenesis and is correlated with inflammation. A trial using a much larger number of specimens will allow further development of our understanding of COX-2 as a biomarker for use in chemoprevention trials.

Original languageEnglish (US)
Pages (from-to)S155-S162
JournalGynecologic Oncology
Issue number1 SUPPL.
StatePublished - Oct 2007
Externally publishedYes


  • COX-2
  • Cervical cancer
  • Cervical intraepithelial neoplasia
  • Inflammation

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology


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