Limits...
Prognostic significance of cyclooxygenase-2 expression in patients with hepatocellular carcinoma: a meta-analysis

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: Cyclooxygenase-2 (COX-2) is believed to be an important enzyme in the carcinogenesis of hepatocellular carcinoma (HCC). However, it is still controversial whether COX-2 expression can be regarded as a prognostic factor for HCC patients. We performed a systematic review and meta-analysis of studies assessing the clinical and prognostic significance of COX-2 expression in HCC.

Material and methods: Identification and review of publications assessing clinical or prognostic significance of COX-2 expression in HCC until November 1, 2014. A meta-analysis was performed to clarify the association between COX-2 expression and clinical outcomes.

Results: A total of 11 publications met the criteria and included 943 cases. Analysis of these data showed that COX-2 expression was not significantly correlated with capsular formation (OR = 0.84, 95% confidence interval (CI): 0.46–1.55, p = 0.58), tumor TNM stage (OR = 0.73, 95% CI: 0.23–2.33, p = 0.59), vascular invasion (OR = 1.04, 95% CI: 0.25–4.35, p = 0.96), tumor size (OR = 0.78, 95% CI: 0.21–2.86, p = 0.71), or tumor differentiation degree (OR = 1.08, 95% CI: 0.42–2.79, p = 0.87). However, in the identified studies, COX-2 expression was strongly associated with high alpha-fetoprotein level (OR = 1.83, 95% CI: 1.01–3.33, p = 0.05), HBsAg status (OR = 1.85, 95% CI: 1.13–3.03, p = 0.01), decreased overall survival (relative risk (RR): 1.54, 95% CI: 1.18–2.02, p = 0.001) and decreased disease-free survival (RR = 1.49, 95% CI: 1.22–1.81, p < 0.001).

Conclusions: This meta-analysis shows that COX-2 expression in HCC is associated with decreased overall and disease-free survival and thus marks a worse prognosis. Nevertheless, more large sample and well-designed studies are warranted to confirm this finding.

No MeSH data available.


Related in: MedlinePlus

Forest plot of OR was assessed for association between stem cell markers and clinical pathologic features, such as AFP level (A), HBsAg status (B), capsular formation (C), tumor TNM stage (D), Vascular invasion (E), tumor size (F), or tumor differentiation degree (G)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC5016591&req=5

Figure 0002: Forest plot of OR was assessed for association between stem cell markers and clinical pathologic features, such as AFP level (A), HBsAg status (B), capsular formation (C), tumor TNM stage (D), Vascular invasion (E), tumor size (F), or tumor differentiation degree (G)

Mentions: The association between COX-2 and several clinicopathological parameters is illustrated in Figure 2. COX-2 expression was significantly associated with high AFP level (pooled OR = 1.83, 95% CI: 1.01–3.33, p = 0.05 fixed-effect) and HBsAg status (pooled OR = 1.85, 95% CI: 1.13–3.03, p = 0.01 fixed-effect) (Figures 2 A and B).


Prognostic significance of cyclooxygenase-2 expression in patients with hepatocellular carcinoma: a meta-analysis
Forest plot of OR was assessed for association between stem cell markers and clinical pathologic features, such as AFP level (A), HBsAg status (B), capsular formation (C), tumor TNM stage (D), Vascular invasion (E), tumor size (F), or tumor differentiation degree (G)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5016591&req=5

Figure 0002: Forest plot of OR was assessed for association between stem cell markers and clinical pathologic features, such as AFP level (A), HBsAg status (B), capsular formation (C), tumor TNM stage (D), Vascular invasion (E), tumor size (F), or tumor differentiation degree (G)
Mentions: The association between COX-2 and several clinicopathological parameters is illustrated in Figure 2. COX-2 expression was significantly associated with high AFP level (pooled OR = 1.83, 95% CI: 1.01–3.33, p = 0.05 fixed-effect) and HBsAg status (pooled OR = 1.85, 95% CI: 1.13–3.03, p = 0.01 fixed-effect) (Figures 2 A and B).

View Article: PubMed Central - PubMed

ABSTRACT

Introduction: Cyclooxygenase-2 (COX-2) is believed to be an important enzyme in the carcinogenesis of hepatocellular carcinoma (HCC). However, it is still controversial whether COX-2 expression can be regarded as a prognostic factor for HCC patients. We performed a systematic review and meta-analysis of studies assessing the clinical and prognostic significance of COX-2 expression in HCC.

Material and methods: Identification and review of publications assessing clinical or prognostic significance of COX-2 expression in HCC until November 1, 2014. A meta-analysis was performed to clarify the association between COX-2 expression and clinical outcomes.

Results: A total of 11 publications met the criteria and included 943 cases. Analysis of these data showed that COX-2 expression was not significantly correlated with capsular formation (OR = 0.84, 95% confidence interval (CI): 0.46–1.55, p = 0.58), tumor TNM stage (OR = 0.73, 95% CI: 0.23–2.33, p = 0.59), vascular invasion (OR = 1.04, 95% CI: 0.25–4.35, p = 0.96), tumor size (OR = 0.78, 95% CI: 0.21–2.86, p = 0.71), or tumor differentiation degree (OR = 1.08, 95% CI: 0.42–2.79, p = 0.87). However, in the identified studies, COX-2 expression was strongly associated with high alpha-fetoprotein level (OR = 1.83, 95% CI: 1.01–3.33, p = 0.05), HBsAg status (OR = 1.85, 95% CI: 1.13–3.03, p = 0.01), decreased overall survival (relative risk (RR): 1.54, 95% CI: 1.18–2.02, p = 0.001) and decreased disease-free survival (RR = 1.49, 95% CI: 1.22–1.81, p < 0.001).

Conclusions: This meta-analysis shows that COX-2 expression in HCC is associated with decreased overall and disease-free survival and thus marks a worse prognosis. Nevertheless, more large sample and well-designed studies are warranted to confirm this finding.

No MeSH data available.


Related in: MedlinePlus