Correlation of cyclooxygenase-2 (COX-2) and aromatase expression in human endometrial cancer: Tissue microarray analysis

Jeffrey M. Fowler, Nilsa Ramirez, David E. Cohn, Nicole Kelbick, James Pavelka, Inbar Ben-Shachar, Carl Morrison

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59 Scopus citations


Objective: The objective of this study was to compare the prevalence of cyclooxygenase-2 (COX-2), aromatase, and hormone receptor immunohistochemical (IHC) expression to well defined clinical-pathologic prognostic factors in a large group of surgically staged endometrial cancer patients. Study design: A tissue microarray (TMA) was constructed from 336 separate specimens of endometrial cancer. IHC was perfomed for estrogen (ER) and progesterone (PR) receptor, COX-2, COX-1, and aromatase. Results: The majority of tumors expressed COX-2 (59%) and aromatase (65%). COX-2 staining significantly correlated with aromatase expression (P < .014) but did not correlate with ER and PR. COX-2 expression was correlated with worsening histologic grade (P < .026) and approached statistical significance for deep myometrial invasion (P < .055). After applying multivariate analysis, no single IHC or combination of IHCs correlated with intrauterine poor prognostic factors or advanced stage. Only myometrial invasion >50% (OR 6.98, P < .001) and nonendometrioid histology (OR 4.933, P < .001) were predictive of advanced stage after multivariate analysis. Conclusion: COX-2 and aromatase are expressed in the majority of endometrial cancer patients. COX-2 expression was not associated with the great majority of surgical-pathologic prognostic factors. COX-2 expression did significantly correlate with aromatase expression, suggesting that intratumoral production of estrogen in endometrial cancer may be an important mechanism in tumorigenesis.

Original languageEnglish
Pages (from-to)1262-1271
Number of pages10
JournalAmerican Journal of Obstetrics and Gynecology
Issue number4
StatePublished - Apr 2005
Externally publishedYes


  • Aromatase
  • Cyclooxygenase-2
  • Endometrial carcinoma
  • Tissue microarray


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