Cox-2 expression in ovarian malignancies: a review of the clinical aspects.

COX-2 is an inducible enzyme expressed only in response to stimuli such as mitogens, cytokines, growth factors or hormones, and is pro-inflammatory. It plays an important role in tumorigenesis. The purpose of the present report is to review the clinical aspects of COX-2 expression in ovarian malignancies. A PubMed (http://www.pubmed.gov/) search of investigations published from July 2001 until August 2008 and containing the term COX-2 in combination with ovarian malignancies was conducted. The clinical aspects of the relevant investigations were reviewed. COX-2 is expressed in ovarian tumors of low malignant potential (LMP), in epithelial ovarian carcinoma (EOC) and primary peritoneal carcinoma (PPC) and apparently plays a role in their carcinogenesis. Its expression seems to be correlated with VEGF that serves as a predictor of poor prognosis in some non-gynecologic malignancies. COX-2 expression is higher in EOC than in LMPs. The results with regard to the association between COX-2 expression and prognostic factors, response to treatment and outcome in ovarian malignancies are inconsistent. Clinical studies dealing with the effect of COX-2 inhibitors on outcome are scarce. The use of COX-2 expression in gynecological malignancies in clinical practice remains to be elucidated.