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Wang X, Chen J, Zheng J. The roles of COX-2 in protozoan infection. Front Immunol 2023; 14:955616. [PMID: 36875123 PMCID: PMC9978824 DOI: 10.3389/fimmu.2023.955616] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 02/06/2023] [Indexed: 02/18/2023] Open
Abstract
Protozoan diseases cause great harm in animal husbandry and require human-provided medical treatment. Protozoan infection can induce changes in cyclooxygenase-2 (COX-2) expression. The role played by COX-2 in the response to protozoan infection is complex. COX-2 induces and regulates inflammation by promoting the synthesis of different prostaglandins (PGs), which exhibit a variety of biological activities and participate in pathophysiological processes in the body in a variety of ways. This review explains the roles played by COX-2 in protozoan infection and analyzes the effects of COX-2-related drugs in protozoan diseases.
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Affiliation(s)
- Xinlei Wang
- Department of Clinical Laboratory, The Second Hospital of Jilin University, Jilin University, Changchun, China
| | - Jie Chen
- Institute of Theoretical Chemistry, Jilin University, Changchun, China
| | - Jingtong Zheng
- Department of Pathogenobiology, College of Basic Medical Sciences, Jilin University, Changchun, China
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A review of the pathophysiology of recurrent implantation failure. Fertil Steril 2021; 116:1436-1448. [PMID: 34674825 DOI: 10.1016/j.fertnstert.2021.09.014] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/06/2021] [Accepted: 09/14/2021] [Indexed: 11/20/2022]
Abstract
Implantation is a critical step in human reproduction. The success of this step is dependent on a competent blastocyst, receptive endometrium, and successful cross talk between the embryonic and maternal interfaces. Recurrent implantation failure is the lack of implantation after the transfer of several embryo transfers. As the success of in vitro fertilization has increased and failures have become more unacceptable for patients and providers, the literature on recurrent implantation failure has increased. While this clinical phenomenon is often encountered, there is not a universally agreed-on definition-something addressed in an earlier portion of this Views and Reviews. Implantation failure can result from several different factors. In this review, we discuss factors including the maternal immune system, genetics of the embryo and parents, anatomic factors, hematologic factors, reproductive tract microbiome, and endocrine milieu, which factors into embryo and endometrial synchrony. These potential causes are at various stages of research and not all have clear implications or immediately apparent treatment.
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Peculiarities of intrauterine pathological processes in women of the postmenopauseal period. EUREKA: HEALTH SCIENCES 2021. [DOI: 10.21303/2504-5679.2021.001853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Aim of the research is studying the pecularities of the endometrium pathological processes in postmenopausal women on the basis of the hysteroscopy data evaluation, as well as conduction of histopathological and immunochemical studies.
Materials and methods. To study the pecularities of intrauterine pathological processes, 100 postmenopausal women were selected and studied. All women underwent hysteroscopy with separate diagnostic scraping of the uterine cavity. Also, 10 samples of glandular-fibrous endometrial polyps (GFEP) in women of reproductive age and 9 samples of such pathology in the postmenopausal period were studied by immunohistochemical method, using 6 primary specific monoclonal antibodies.
Results. The results showed that in 64 (64 %) postmenopausal women pathological changes of the endometrium were presented with GFEP, and in 2 patients (2 %) endometrial adenocarcinoma was found. It was also determined that the nuclei of epithelial and stromal cells of GFEP in postmenopausal women are characterized by lower expression of estrogen and progesterone receptors, compared with women with such formations in the reproductive age. In addition, it was found that in postmenopausal women the expression of the apoptosis inhibitor bcl-2 and aromatase P450 in the epithelial and stromal cells of GFEP was more expressed, and the expression of the Bах antigen, on the contrary, was significantly lower than in women of reproductive age.
Conclusions. Fundamental molecular-biological differences of GFEP in postmenopausal women compared with women of reproductive age were revealed. It was found that in postmenopausal women there is a significantly lower dependence of such polyps on the effects of estrogen and progesterone. In addition, the data indicate an increased risk of neoplastic transformation in such women.
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Giordano MV, Alvarenga TF, Bastos Júnior CDS, Giordano MG, Baracat EC, Soares Júnior JM. Does obesity modify the expression of cyclin D1 and pten in endometrial polyps in postmenopausal women? Gynecol Endocrinol 2021; 37:467-470. [PMID: 33345649 DOI: 10.1080/09513590.2020.1862787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
To assess cyclin D1 and PTEN immunoexpression in benign endometrial polyps (EPs) in asymptomatic postmenopausal women and its correlation with obesity. Methods: This was a cross-sectional study based on data from a sample of 52 patients diagnosed with EP between February 2018 and January 2019. The women included in this study were amenorrheal for at least 1 year and were asymptomatic (no postmenopausal bleeding). Obesity defined by body mass index (BMI) was investigated for correlation with Cyclin-D1 and PTEN gene expression (immunohistochemistry) in glandular and stromal compartments of polyps. Results: No significant differences among groups were identified in any clinical and epidemiological parameter (age, age of menopause, time since menopause, number of gestations, polyp size, leucocyte count, fasting blood glucose and basic pathologies), except for BMI. Body mass index did not alter PTEN or Cyclin D1 immunoexpression. Conclusion: Our study shows that obesity does not appear to be a relevant factor in the immunoexpression of PTEN and Cyclin D1 in benign EP, in either the stromal or glandular compartments.
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Affiliation(s)
| | | | | | | | - Edmund Chada Baracat
- Department of Obstetrics and Gynecology, Laboratory of Structural and Molecular Gynecology (LIM 58), Universidade de São Paulo Hospital das Clínicas, Sao Paulo, Brazil
| | - José Maria Soares Júnior
- Department of Obstetrics and Gynecology, Laboratory of Structural and Molecular Gynecology (LIM 58), Universidade de São Paulo Hospital das Clínicas, Sao Paulo, Brazil
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Giordano MV, Lucas HDS, Fiorelli RKA, Giordano LA, Giordano MG, Baracat EC, Júnior JMS. Expression levels of BCL2 and MKI67 in endometrial polyps in postmenopausal women and their correlation with obesity. Mol Clin Oncol 2020; 13:69. [PMID: 33014368 DOI: 10.3892/mco.2020.2139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 09/01/2020] [Indexed: 11/06/2022] Open
Abstract
Obesity is associated with numerous diseases, including endometrial disorders in postmenopausal women, such as adenocarcinoma, hyperplasias and endometrial polyps, and the risk of malignant transformation of these structures. The present study evaluated the influence of body mass index (BMI) on cell proliferation (BCL2 and MKI67) in endometrial polyps in postmenopausal women. A prospective cross-sectional study using immunohistochemical analysis of the expression of a cell proliferation marker (MKI67) and an anti-apoptotic gene (BCL2) in endometrial polyps in postmenopausal women was performed. The patients were divided into three groups depending on BMI: i) <24.9 kg/m2 (normal); ii) >25 and <29.9 kg/m2 (overweight); and iii) >30 kg/m2 (obese). The present study analyzed the expression of these markers in relation to polyp size, histological type and time since menopause in 38 patients. The interpretation of MKI67 and BCL2 expression accounted for the percentage of positive cells (scores): 1 (weak), <5% of cells showed expression; 2 (moderate), between 5 and 50%; and 3 (intense), >50%. Statistical analysis was performed using GraphPad InStat version 3.00 software. ANOVA was used to analyze BCL2 and MKI67 expression. A significance level of P<0.05 was adopted for rejecting the null hypothesis. There was greater glandular expression of MKI67 in obese women than in normal weight women (P=0.02) and greater expression of BCL2 in the stroma of polyps >2 cm (P=0.03). Hyperplastic polyps exhibited hyperexpression of MKI67 (P=0.04) compared with atrophic polyps. No difference in MKI67 and BCL2 expression was identified in the glands and stroma of polyps when comparing overweight and obese postmenopausal patients. The present findings suggest that BMI has an influence on proliferation markers (MKI67) in the polyps of postmenopausal women and that polyps >2 cm exhibit hyperexpression of BCL2 in the stroma.
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Affiliation(s)
- Mario Vicente Giordano
- Department of General and Specialized Surgery, Gaffrée e Guinle University Hospital (HUGG), Rio de Janeiro 20270-004, Brazil.,Department of Gynecology and Obstetrics, University of São Paulo (USP), São Paulo 05403-000, Brazil
| | - Hiram Da Silveira Lucas
- Department of General and Specialized Surgery, Gaffrée e Guinle University Hospital (HUGG), Rio de Janeiro 20270-004, Brazil
| | - Rossano Kepler Alvim Fiorelli
- Department of General and Specialized Surgery, Gaffrée e Guinle University Hospital (HUGG), Rio de Janeiro 20270-004, Brazil
| | - Luiz Augusto Giordano
- Department of General and Specialized Surgery, Gaffrée e Guinle University Hospital (HUGG), Rio de Janeiro 20270-004, Brazil
| | - Mario Gáspare Giordano
- Department of General and Specialized Surgery, Gaffrée e Guinle University Hospital (HUGG), Rio de Janeiro 20270-004, Brazil
| | - Edmund Chada Baracat
- Department of Gynecology and Obstetrics, University of São Paulo (USP), São Paulo 05403-000, Brazil
| | - José Maria Soares Júnior
- Department of Gynecology and Obstetrics, University of São Paulo (USP), São Paulo 05403-000, Brazil
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Adomaitienė L, Nadišauskienė R, Nickkho-Amiry M, Čižauskas A, Palubinskienė J, Holland C, Seif MW. Proliferation in Postmenopausal Endometrial Polyps-A Potential for Malignant Transformation. ACTA ACUST UNITED AC 2019; 55:medicina55090543. [PMID: 31466367 PMCID: PMC6780687 DOI: 10.3390/medicina55090543] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 07/31/2019] [Accepted: 08/22/2019] [Indexed: 12/26/2022]
Abstract
Background and objectives: Endometrial polyps in asymptomatic postmenopausal women are often incidentally found, yet only 1.51% of them are malignant. Their potential for malignant transformation has not been adequately addressed. The aim of this study was to investigate the proliferation within endometrial polyps as one of the indicators of their malignization potential in asymptomatic postmenopausal women. Materials and Methods: Immunohistochemical studies of Ki-67 were performed. Cases included 52 benign postmenopausal polyps, 19 endometrioid carcinoma with coexisting benign polyps, 12 polyps with foci of carcinoma and 4 cases of polyps, which later developed carcinoma. The control group included 31 atrophic endometria and 32 benign premenopausal polyps. Ki-67 was scored in either 10 or 20 “hot spot” fields, as percentage of positively stained cells. Results: The median epithelial Ki-67 score in postmenopausal benign polyps (4.7%) was significantly higher than in atrophic endometria (2.41%, p < 0.0001) and significantly lower than in premenopausal benign polyps (11.4%, p = 0.003) and endometrial cancer (8.3%, p < 0.0001). Where endometrial polyps were found in association with endometrial carcinoma, Ki-67 was significantly higher in cancer (p < 0.0001). No significant difference was found between Ki-67 scores of cancer focus and of the polyps tissue itself, respectively 2.8% and 4.55%, p = 0.37. Ki-67 expression, where polyps were resected and women later developed cancer, was not significantly different (p = 0.199). Conclusion: Polyps from asymptomatic postmenopausal women showed significantly more proliferation in both epithelial and stromal components than inactive atrophic endometria but less than premenopausal benign polyps and/or endometrial cancer. Benign postmenopausal endometrial polyps exhibit low proliferative activity, suggesting low malignant potential and may not require resection in asymptomatic women.
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Affiliation(s)
- Lina Adomaitienė
- Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania.
| | - Rūta Nadišauskienė
- Department of Obstetrics and Gynaecology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania
| | - Mahshid Nickkho-Amiry
- Department of Obstetrics and Gynaecology, University of Manchester and St. Mary's Hospital, Manchester M13 9WL, UK
| | - Arvydas Čižauskas
- Department of Patological Anatomy, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania
| | - Jolita Palubinskienė
- Department of Histology and Embryology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania
| | - Cathrine Holland
- Department of Obstetrics and Gynaecology, University of Manchester and St. Mary's Hospital, Manchester M13 9WL, UK
| | - Mourad W Seif
- Department of Obstetrics and Gynaecology, University of Manchester and St. Mary's Hospital, Manchester M13 9WL, UK
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Impact of serum adipokines on tumor mitotic and apoptotic activity in endometrial cancer. JOURNAL OF SURGERY AND MEDICINE 2019. [DOI: 10.28982/josam.581498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Recurrent endometrial polyps – influencing factors and treatment. GINECOLOGIA.RO 2019. [DOI: 10.26416/gine.23.1.2019.2219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
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Banas T, Pitynski K, Okon K, Mikos M, Czerw AI, Deptała A, Ludwin A. Immunoexpression of DNA fragmentation factor 40, DNA fragmentation factor 45, and B-cell lymphoma 2 protein in normal human endometrium and uterine myometrium depends on menstrual cycle phase and menopausal status. Arch Med Sci 2018; 14:1254-1262. [PMID: 30393479 PMCID: PMC6209718 DOI: 10.5114/aoms.2017.69383] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 07/07/2017] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION DNA fragmentation factors 40 and 45 (DFF40 and DFF45) are final executors of apoptosis, and B-cell lymphoma 2 (Bcl-2) is a well-recognized apoptosis inhibitor. We aimed to evaluate DFF40, DFF45 and Bcl-2 immunoexpression in the normal human endometrium with respect to the glandular and stromal layer and in uterine myometrium. MATERIAL AND METHODS DFF40, DFF45, and Bcl-2 expression was assessed via immunohistochemistry in the endometrium and myometrium collected postmenopausally and premenopausally during the proliferative and secretory phases of the menstrual cycle. RESULTS Compared to the myometrium and stroma, endometrial glands showed the highest DFF40 and DFF45 expression in pre- and postmenopausal specimens. DFF45, but not DFF40, glandular expression dependent on menstrual cycle phase and DFF40 and DFF45 scoring was significantly lower in postmenopausal specimens. Significantly higher Bcl-2 expression was observed in proliferative glandular endometrium compared to secretory and postmenopausal specimens. No cycle- or menopause-dependent changes were reported for stromal or myometrial DFF40, DFF45 or Bcl-2 expression. DFF40, DFF45 and Bcl-2 expression was independent of age, age at menarche and menopause, BMI, menstrual cycle and menses lengths, parity and gravidity. CONCLUSIONS The study provides important evidence regarding menstrual cycle-dependent changes in the expression of DFF40, DFF45 and Bcl-2 in the normal human endometrium, especially in the glandular layer, and shows that their levels are stable in the normal uterine myometrium.
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Affiliation(s)
- Tomasz Banas
- Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland
| | - Kazimierz Pitynski
- Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland
| | - Krzysztof Okon
- Department of Pathomorphology, Jagiellonian University Medical College, Krakow, Poland
| | | | - Aleksandra I Czerw
- Department of Public Health, Medical University of Warsaw, Warsaw, Poland
| | - Andrzej Deptała
- Department of Cancer Prevention, Medical University of Warsaw, Warsaw, Poland
| | - Artur Ludwin
- Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland
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Endometrial Polyps and Benign Endometrial Hyperplasia Have Increased Prevalence of DNA Fragmentation Factors 40 and 45 (DFF40 and DFF45) Together With the Antiapoptotic B-Cell Lymphoma (Bcl-2) Protein Compared With Normal Human Endometria. Int J Gynecol Pathol 2018; 37:431-440. [DOI: 10.1097/pgp.0000000000000442] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Abstract
OBJECTIVE The aim of the study was to evaluate clinical predictive factors for endometrial polyps in postmenopausal women compared with postmenopausal women without polyps. METHODS In this cross-sectional study, 132 Brazilian women with a histopathological diagnosis of endometrial polyps were compared with 264 women without endometrial alterations (control). The study group included women aged at least 45 years with amenorrhea for at least 12 months, who underwent hysteroscopic polypectomy. The control group consisted of women aged at least 45 years with amenorrhea for at least 12 months, without postmenopausal bleeding and endometrial thickness less than 5 mm by transvaginal ultrasonography. Clinical, anthropometric (body mass index and waist circumference), laboratory, and ultrasonographic data were collected to evaluate predictive factors for endometrial polyps. The Student's t test, χ test, and logistic regression (odds ratio [OR]) were used for statistical analysis. RESULTS A higher percentage of women with polyps were obese (72%) when compared with control (39%) (P < 0.0001). Waist circumference was greater among women with polyps (P = 0.0001). The incidence of diabetes, hypertension, and dyslipidemia was higher among women with endometrial polyps (P < 0.0001). According to the diagnostic criteria of the US National Cholesterol Education Program/Adult Treatment Panel III (NCEP/ATP III), 48.5% of the women with polyps and 33.3% of the controls were classified as having metabolic syndrome (MetS) (P = 0.004). The risk of endometrial polyps was higher in women with body mass index at least 25 kg/m (OR = 4.66; 95% CI 2.16-10.05); glucose at least 100 mg/dL (OR = 2.83; 95% CI 1.36-5.90); dyslipidemia (OR = 7.02; 95% CI 3.70-13.32); diabetes (OR = 2.58; 95% CI 1.05-6.32); and MetS (OR = 2.76; 95% CI 1.18-6.46) when compared with control, adjusted for age, and time since menopause. CONCLUSIONS In postmenopausal women, obesity, dyslipidemia, hyperglycemia, and the presence of MetS were predictive factors for endometrial polyps.
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Kasap E, Karaarslan S, Gur EB, Genc M, Sahin N, Güclü S. Investigation of the Roles of Cyclooxygenase-2 and Galectin-3 Expression in the Pathogenesis of Premenopausal Endometrial Polyps. J Pathol Transl Med 2016; 50:225-30. [PMID: 27086598 PMCID: PMC4876085 DOI: 10.4132/jptm.2016.03.08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 03/06/2016] [Accepted: 03/08/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The pathogenesis and etiology of endometrial polyps has not been elucidated. In this study, we aimed to examine the pathogenic mechanisms of endometrial polyp development using immunohistochemistry. We evaluated the expression of galectin-3 and cyclooxgenase-2 (COX-2) during the menstrual cycle in premenopausal women with endometrial polyps or normal endometrium. METHODS Thirty-one patients with endometrial polyps and 50 healthy control patients were included in this study. The levels of expression of COX-2 and galectin-3 were studied by immunohistochemistry. RESULTS The percentage of COX-2-positive cells and the intensity of COX-2 staining in the endometrium did not vary during the menstrual cycle either in the control group or in patients with endometrial polyps. However, expression of galectin-3 was significantly lower in endometrial polyps and during the proliferative phase of the endometrium compared with the secretory phase. CONCLUSIONS Our data suggests that the pathogenesis of endometrial polyps does not involve expression of COX-2 or galectin-3.
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Affiliation(s)
- Esin Kasap
- Department of Obstetrics and Gynecology, Sifa University School of Medicine, Izmir, Turkey
| | - Serap Karaarslan
- Department of Patology, Sifa University School of Medicine, Izmir, Turkey
| | - Esra Bahar Gur
- Department of Obstetrics and Gynecology, Sifa University School of Medicine, Izmir, Turkey
| | - Mine Genc
- Department of Obstetrics and Gynecology, Sifa University School of Medicine, Izmir, Turkey
| | - Nur Sahin
- Department of Obstetrics and Gynecology, Sifa University School of Medicine, Izmir, Turkey
| | - Serkan Güclü
- Department of Obstetrics and Gynecology, Sifa University School of Medicine, Izmir, Turkey
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Surgical Management of Endometrial Polyps in Infertile Women: A Comprehensive Review. Surg Res Pract 2015; 2015:914390. [PMID: 26301260 PMCID: PMC4537769 DOI: 10.1155/2015/914390] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 07/26/2015] [Indexed: 11/18/2022] Open
Abstract
Endometrial polyps are benign localized lesions of the endometrium, which are commonly seen in women of reproductive age. Observational studies have suggested a detrimental effect of endometrial polyps on fertility. The natural course of endometrial polyps remains unclear. Expectant management of small and asymptomatic polyps is reasonable in many cases. However, surgical resection of endometrial polyps is recommended in infertile patients prior to treatment in order to increase natural conception or assisted reproductive pregnancy rates. There is mixed evidence regarding the resection of newly diagnosed endometrial polyps during ovarian stimulation to improve the outcomes of fresh in vitro fertilization cycles. Hysteroscopy polypectomy remains the gold standard for surgical treatment. Evidence regarding the cost and efficacy of different methods for hysteroscopic resection of endometrial polyps in the office and outpatient surgical settings has begun to emerge.
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Pereira AKC, Garcia MT, Pinheiro W, Ejzenberg D, Soares JM, Baracat EC. What is the influence of cyclooxygenase-2 on postmenopausal endometrial polyps? Climacteric 2014; 18:498-502. [PMID: 25242379 DOI: 10.3109/13697137.2014.966240] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND The genesis of the endometrial polyp is as yet unclear. There is evidence that the polyp is related to the inflammatory process and that it interacts with the cyclooxygenase-2 (COX-2) enzyme. OBJECTIVE To review the influence of COX-2 on the postmenopausal endometrial polyp. METHODS A systematic review was made of the Medline, Embase, and Cochrane databases, covering the years of 2001-2014. The inclusion criteria were: experimental studies with immunohistological analysis of COX-2 in endometrial polyps; women; hysteroscopic and surgical evaluation; and studies with comparisons between the endometrial polyp and other tissues (normal endometrium, adjacent endometrium, and other uterine diseases). The exclusion criteria were: polyps in other organs; genetic polymorphisms; endometrial cancer exclusively; abnormal uterine bleeding unrelated to polyps. The search key words (taken from the Medical Subject Headings - MeSH) were endometrial polyp and cyclooxygenase-2. RESULTS Seven of ten articles were selected. Results showed positive COX-2 expression in the glandular epithelium of the polyps, and expression was more intense when the polyp was malignant. However, there was a study which did not find any difference between polyps and the normal endometrium, and there was another which compared polyps in menacme with postmenopausal polyps. CONCLUSION There is no consensus in the literature as to the participation of COX-2 in the development of benign and/or malignant endometrial polyps. In all of the studies, COX-2 was present in the postmenopausal polyps and with greater intensity in the malignant ones.
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Affiliation(s)
- A K C Pereira
- Disciplina de Ginecologia do Departamento de Obstetrícia e Ginecologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , Brazil
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