Clinicopathological and prognostic significance of COX-2 immunohistochemical expression in breast cancer: a meta-analysis
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Feng Xu1,*, Mengxin Li1, Chao Zhang1, Jianxiu Cui1, Jun Liu1, Jie Li1, Hongchuan Jiang1
1Department of Breast Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China, 100020
Hongchuan Jiang, email: email@example.com
Keywords: breast cancer, COX-2, prognosis, meta-analysis
Received: July 04, 2016 Accepted: December 12, 2016 Published: December 16, 2016
The prognostic significance of COX-2 in patients with breast cancer remains controversial. The aims of our meta-analysis are to evaluate its association with clinicopathological characteristics and prognostic value in patients with breast cancer. PubMed, EMBASE, Web of Science, the Ovid Database and Grey literature were systematically searched up to May 2016. Twenty-one studies including 6739 patients with breast cancer were analyzed. The meta-analysis indicated that the incidence difference of COX-2 expression was significant when comparing the lymph node positive group to negative group (OR = 1.76, 95% CI [1.30, 2.39]) and the tumor size ≥ 2cm group to the tumor size < 2cm group (OR = 1.71, 95% CI [1.22, 2.39]). None of other clinicopathological parameters such as the ER status, PR status, HER2 status and the vascular invasion status were associated with COX-2 overexpression. The detection of COX-2 was significantly correlated with the disease-free survival (DFS) of patients (HR = 1.58, 95% CI [1.23, 2.03]) and the overall survival (OS) of patients (HR = 1.51, 95% CI [1.31, 1.72]). Our meta-analysis demonstrates that the presence of high levels of COX-2 is associated with poor prognosis for breast cancer patients and predicts bigger tumor size and lymph node metastasis.
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