Background: Oral Squamous Cell Carcinoma (OSCC) arises through progressive genetic alterations influenced by both genetic predisposition and environmental factors. Inflammatory mediators like Cyclooxygenase-2 (COX-2) elevate cytokines and Prostaglandins (PGs), notably PGE2, which attract immune cells and generate Reactive Oxygen Species (ROS). These promote DNA damage and mutations, increasing the risk of tumorigenesis.

Aim and Objectives: To evaluate, analyse and compare the immunohistochemical expression of COX-2 in normal oral mucosa, Oral Lichen Planus (OLP), Oral Submucous Fibrosis (OSMF) and OSCC. Also, to assess the role of COX 2 in carcinogenesis and in the progression of premalignant lesions to malignancy.

Materials and Methodology: Immunohistochemical analysis was conducted using 40 paraffin-embedded tissue blocks from histologically diagnosed cases of Oral Lichen Planus (OLP), oral submucous Fibrosis (OSMF), Oral Squamous Cell Carcinoma (OSCC), and normal oral mucosa as controls, with 10 samples in each category. For each stained specimen, f ive high-power fields were evaluated to determine the Immunoreactivity Score (IRS).

Results: Our study results showed increased expression of COX-2 from normal mucosa to OLP to OSMF to OSCC.

Conclusion: COX-2 expression may be a crucial factor in the malignant transformation of premalignant lesions and can serves as a significant prognostic marker. Use of COX-2 inhibitors can reduce inflammation, prevent tumor development and can potentially improve the patient survival rates. They can be used either as adjuvants to enhance response rates or they can be used for targeted therapies.

Neha Kumari is an enthusiastic and academically driven oral and maxillofacial pathologist with strong expertise in histopathology, cytology, and molecular diagnostics. She completed her MDS in oral and maxillofacial pathology from Government Dental College, Hyderabad, under KNRUHS in 2024, graduating with distinction and securing the position of university topper in oral pathology. She earned her BDS degree from Malla Reddy Dental College for Women, Hyderabad, affiliated with NTRUHS, in 2019, where she also graduated as a college topper in Oral Pathology. Currently, she serves as a senior resident in the department of oral pathology at Government Dental College, Hyderabad. Her research interests include molecular mechanisms and diagnostic advancements in oral diseases. She has investigated gene expression profiles of TGF-β1 and GSK3 in oral squamous cell carcinoma and performed immunohistochemical analysis of oral precancerous lesions. She is also actively involved in manuscript preparation and scientific data visualization for publication. In addition to her academic role, she works as a consultant oral pathologist at the centre for oral pathology & maxillofacial diagnostics (COPMD), Hyderabad. She is a member of POPMA and IAOMP, contributing to professional growth and collaboration.