于 洋,张翠萍,王淑霞.肝癌组织中COX-2蛋白表达及其与临床病理关系的Meta分析[J].中国肿瘤,2017,26(11):915-924.
肝癌组织中COX-2蛋白表达及其与临床病理关系的Meta分析
COX-2 Protein Expression and Its Relation to Clinicopathological Features of Hepatocellular Carcinoma:A Meta Analysis
投稿时间:2017-02-08  
DOI:10.11735/j.issn.1004-0242.2017.11.A014
中文关键词:  环氧化酶?鄄2  肝癌  临床病理学  分化程度  Meta分析
英文关键词:cyclooxygenase-2  hepatocellular carcinoma  clinicopathology  differentiation degree  Meta-analysis
基金项目:
作者单位
于 洋 青岛大学附属医院 
张翠萍 青岛大学附属医院 
王淑霞 青岛大学附属医院 
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中文摘要:
      摘 要:[目的] 通过Meta分析评价环氧化酶-2(COX-2)在肝癌中的表达及其与临床病理特征间的关系,以期寻找肝癌早期诊断、化学预防及治疗的新型分子靶点。[方法] 通过检索CNKI、万方、Cochrane图书馆、PubMed等数据库,搜集从建库至2016年10月国内外公开发表的有关COX-2在肝癌中表达的病例对照研究,纳入采用免疫组化法检测COX-2蛋白,并将染色范围及染色强度相结合评估其表达水平,且NOS评分量表≥5分的高质量研究。应用RevMan5.3进行系统评价及异质性分析,计算合并OR及95%CI,对存在异质性的研究进行亚组分析以探讨其来源,应用Stata12.0绘制漏斗图及Egger回归方程评估有无发表偏倚。[结果] 共有21篇文献纳入本次系统评价,Meta分析结果显示:COX-2在肝癌组中的表达高于正常组(OR=15.69,95%CI:9.73~25.32,P<0.00001),COX-2在癌旁组中的表达高于正常组(OR=9.47,95%CI:4.70~19.10,P<0.00001),COX-2在高分化肝癌组的表达高于中—低分化组(OR=1.97,95%CI:1.43~2.72,P<0.0001),差异均具有统计学意义。在COX-2与性别、肿瘤大小、TNM分期等其他9项肝癌临床病理特征关系的比较中,各组间差异并无统计学意义。[结论] COX-2在肝癌中表达增高,且主要在肝癌发生的早期阶段而非进展阶段发挥作用,COX-2有望成为肝癌早期诊断、化学预防及治疗的新型分子靶点。
英文摘要:
      Abstract:[Purpose]To evaluate the expression of COX-2 protein in hepatocellular carcinoma(HCC) and its relation to clinicopathologic features by Meta-analysis. [Methods] The published case-control studies about COX-2 expression in HCC were retrieved by searching CNKI,Wanfang,Cochrane library and PubMed database before October 2016. Studies were considered to be high quality if the NOS-scale score was 5 or more,including the reseaches by using immunohistochemical method to determine COX-2 and those by synthesizing staining range and staining intensity to evaluating expression level. Statistical heterogeneity evaluation and systematic review was performed by Revman 5.3,merged odds ratio(OR) and 95% confidence interval(95%CI) were calculated,subgroup analysis was performed to investigate the sources of heterogeneity. Publication bias was investigated through funnel plots and Egger’s regression model by Stata 12.0. [Results]A total of twenty-one studies were enrolled for systematic valuation. The expression level of COX-2 in HCC tissues was significantly higher than that in normal tissues(OR=15.69,95%CI:9.73~25.32,P<0.00001);significant differences were tested between cancer adjacent tissues and normal tissues(OR=9.47,95%CI:4.70~19.10,P<0.00001). The expression level of COX-2 in well differential HCC was higher than that in moderate-poor differentiation group(OR=1.97,95%CI:1.43~2.72,P<0.0001);but no significant differences were found in different gender,tumor sizes,tumor stages and other clinicopathologic features. [Conclusion] There is over-expression of COX-2 in HCC,COX-2 may play a role in the early stage of hepatocarcinogensis,but not advanced stage. The results indicate that COX-2 mightit be used as a new molecular target for early diagnosis,chemoprevention and treatment of HCC.
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