宫颈癌及其不同临床病理特征中COX-2表达的Meta分析

Cyclooxygenase (COX)-2 Expression and the Clinicopathologic Characteristic of Cervical Cancer: A Meta-analysis of Case-control Studies

目的系统评价国内有关COX-2表达与宫颈癌及其不同临床病理特征之间的关系。方法计算机检索CBMdisc(1979～2009)、CNKI(1979～2009)、VIP(1989～2009)、万方数据库(1982～2009),并辅以文献追溯的方法,收集国内公开发表的所有相关病例对照研究。按纳入排除标准筛选文献并评价纳入研究的质量。应用RevMan4.2.10软件进行Meta分析。结果共纳入9个病例对照研究,其中宫颈癌567例,正常宫颈对照134例。Meta分析结果显示,COX-2在宫颈癌组与正常宫颈对照组的表达差异有统计学意义[OR=28.03,95%CI(9.53,82.50)];COX-2在宫颈癌淋巴结转移组与宫颈癌非淋巴结转移组的表达差异有统计学意义[OR=5.16,95%CI(3.36,7.93)];COX-2在宫颈癌临床Ⅰ～Ⅱ期组与宫颈癌临床Ⅲ～Ⅳ期组的表达差异有统计学意义[OR=0.53,95%CI(0.33,0.84)];COX-2在宫颈癌高分化组与宫颈癌中低分化组的表达差异有统计学意义[OR=3.11,95%CI(1.86,5.22)];COX-2在宫颈腺癌组与宫颈鳞癌组的表达差异有统计学意义[OR=5.00,95%CI(2.68,9.35)]。结论现有国内证据证明,COX-2高表达与宫颈癌及其不同临床病理特征有显著相关性。但受纳入文献质量的影响,以上结论需要高质量的病例对照研究进一步证实。

Objective To investigate the expression of COX-2 in human cervical cancer and explore their relationship between the COX-2 expression and the clinicopathologic characteristic of cervical cancer. Methods The published studies were searched in the CBMdisc （1979 to 2009）, CNKI （1979 to 2009）, VIP （1989 to 2009） and WANFANG Database （1982 to 2009）, and other relevant journals were also hand searched, to identify all the relevant case-control trials. The quality of the included studies was assessed. The Cochrane Collaboration ’s software RevMan 4.2.10 was used to test the heterogeneity, overall effect and publication bias of the combined studies. Results A total of 9 studies were recruited. As for the positive rate of COX-2 expression, significant differences was tested between cervical cancer vs. normal cervical tissues, lymph node metastasi vs. non-lymph node metastasi, clinical stages I-II vs. clinical stages III-IV, cell differentiation G1 vs. cell differentiation G2-G3 and cervical squamous cell carcinoma vs. adenocarcinoma with OR （95%CI） at 28.03 （9.53 to 82.50）, 5.16 （3.36 to 7.93）, 0.53 （0.33 to 0.84）, 3.11 （1.86 to 5.22） and 5.00 （2.68 to 9.35） respectively. Conclusions According to the domestic evidence, higher COX-2 expression might be associated with cervical cancer. However, more high quality case-control studies are expected for further study.