Clinicopathological and prognostic significance of cyclooxygenase-2 expression in head and neck cancer: A meta-analysis
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Bin Yang1,*, Lin Jia2,*, Qiaojuan Guo3, Hui Ren1, Yanping Hu1, Tao Xie4
1Department of Oncology, Hubei Cancer Hospital, Wuhan, Hubei 430079, China
2Department of Nephrology, The Central Hospital of Wuhan, Wuhan, Hubei 430014, China
3Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Provincial Clinical College of Fujian Medical University, Fuzhou, Fujian 350000, China
4Department of Radiation Oncology, Hubei Cancer Hospital, Wuhan, Hubei 430079, China
*These authors contribute equally to this work
Tao Xie, email: [email protected]
Keywords: head and neck cancer, cyclooxygenase-2, prognosis, biomarker, meta-analysis
Received: February 01, 2016 Accepted: June 04, 2016 Published: June 15, 2016
Several studies have assessed the clinicopathological and prognostic value of cyclooxygenase-2 (COX-2) expression in patients with head and neck cancer (HNC), but their results remain controversial. To address this issue, a meta-analysis was carried out. A total of 29 studies involving 2430 patients were subjected to final analysis. Our results indicated that COX-2 expression was not statistically associated with advanced tumor stage (OR, 1.23; 95% CI, 0.98–1.55) but correlated with high risk of lymph node metastasis (OR, 1.28; 95% CI, 1.03–1.60) and advanced TNM stage (OR, 1.33; 95% CI, 1.06–1.66). Moreover, COX-2 expression had significant effect on poor OS (HR, 1.93; 95% CI, 1.29–2.90), RFS (HR, 2.02; 95% CI, 1.00–4.08) and DFS (HR, 5.14; 95% CI, 2.84–9.31). The results of subgroup analyses revealed that COX-2 expression was related with high possibility of lymph node metastasis in oral cancer (OR, 1.49; 95% CI, 1.01–2.20) and advanced TNM stage in oral cancer (OR, 1.58; 95% CI, 1.05–2.37) and no site-specific HNC (OR, 1.64; 95% CI, 1.02–2.62). However, subgroup analyses only showed a tendency without statistically significant association between COX-2 expression and survival. Significant heterogeneity was not found when analyzing clinicopathological data, but it appeared when considering survival data. No publication bias was detected in this study. This meta-analysis suggested that COX-2 expression could act as a prognostic factor for patients with HNC.
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