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The prognostic value of cyclooxygenase-2 expression in patients with esophageal cancer: evidence from a meta-analysis

Authors Hu Z, Yang Y, Zhao Y, Huang Y

Received 13 February 2017

Accepted for publication 28 March 2017

Published 9 June 2017 Volume 2017:10 Pages 2893—2901


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Tohru Yamada

Zaoxiu Hu,1,* Yanlong Yang,2,* Yonghe Zhao,3 Yunchao Huang2,4

1Department of Pathology, 2Department of Thoracic Surgery I, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital), 3Department of Pathology, The Forensic School of Kunming Medical University, 4Cancer Research Institute of Yunnan Province, The Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital), Kunming, Yunnan Province, People’s Republic of China

*These authors contributed equally to this work

Abstract: Published studies have investigated the prognostic role of cyclooxygenase-2 (COX-2) expression in patients with esophageal cancer (EC), but the result remains controversial. Thus, this meta-analysis was conducted to comprehensively evaluate the impact of COX-2 expression on the prognostic value in patients with EC. Relevant studies were identified from PubMed, EMBASE, and Web of Science databases. Studies that detected the COX-2 expression by immunohistochemistry and evaluated the relationship between COX-2 expression and overall survival (OS) or clinicopathological parameters were used in our analysis. The summary hazard ratios (HRs) or odds ratios were calculated to assess the risk or hazard association. A total of 25 studies, which included 2,465 patients, were included in our meta-analysis. Our analysis suggested that overexpression of COX-2 was associated with poor OS (HR =1.60, 95% CI =1.32–1.94, P<0.001). Subgroup analyses by race, percentage of high/positive COX-2 expression, histology type, treatment, and sample size all suggested significant association. Moreover, overexpression of COX-2 was significantly associated with depth of invasion, lymph node metastasis, distant metastasis, and TNM stage. This meta-analysis suggested that overexpression of COX-2 might serve as a prognostic biomarker for EC. Large well-designed prospective studies are needed to confirm our conclusion.

Keywords: esophageal cancer, cyclooxygenase-2, prognosis, meta-analysis

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