Background: Cyclo-Oxygenase-2 (COX-2) derived prostaglandins are known to participate in carcinogenesis, tumor cell invasion and metastasis. COX-2 is expressed in all stages of cancer and it’s over expression is associated with poor prognosis. The purpose of the present study was to correlate COX-2 expression with tumor differentiation and lymphovascular invasion in cervical cancer. Materials and Methods: Fifty one surgically resected hysterectomy specimens and cervical biopsy specimens sent for histopathology department in a tertiary care hospital were included in the study. Formalin-xed parafn-embedded tissue sections were stained by Hematoxylin and Eosin. Immunohisto-chemistry for COX-2 was also performed on these blocks. Statistical analysis used: Chi square test and Fisher Exact test were applied to test the significant associations, where p< 0.05 was considered as statistically significant. Results: Of the 51 specimens, 6 (11.8%) were found to be Cervical intra epithelial neoplasia (CIN), 40 (78.4%) were Squamous cell carcinoma (SCC), 4 (7.9%) were Adenocarcinoma and 1 (1.9%) was of poorly differentiated carcinoma variant. Though majority of the specimens were of invasive carcinomas (45), microscopic evidence of Lymphovascular invasion was seen only in 27 (60%) cases. All adenocarcinoma and poorly differentiated carcinoma cases and some (22) SCC cases showed lymphovascular invasion. Intensity of COX-2 expression was lower in in-situ carcinomas compared to invasive carcinomas. It was found that higher intensity of COX-2 expression was significantly associated with higher tumour grade and lymphovascular invasion. (p < 0.05) Conclusion: In the present study, intensity of COX-2 expression was found to be varying with the tumour grade and lymphovascular invasion in carcinoma cervix. This demonstrates the role of COX-2 as a prognostic marker in cervical carcinomas.

Keywords: Cyclo-Oxygenase-2; Carcinoma of cervix; Lymphovascular invasion; Tumour differentiation.