环氧化酶-2在非小细胞肺癌中的表达及其与预后关系的Meta分析

Cox-2 expression and prognosis of no-small cell lung cancer: a meta-analysis involving 16 studies

目的采用Meta分析的方法,探讨环氧化酶-2(Cox-2)异常表达在非小细胞肺癌(NSCLC)预后中的作用。方法检索PubMed、Embase、Web of Science、CNKI中研究Cox-2表达与NSCLC预后关系的文献,收集每篇文献的相对危险比(HR)及95%可信区间(95%CI),应用Meta分析随机效应模型对文献进行定量综合分析。结果共入选16篇文献,累计NSCLC 1 892例,其中Cox-2阳性表达1 150例,阳性率60.8%。对入选文献进行一致性检验,文献具有异质性(Q=42.73,P=0.00),合并HR为0.90(95%CI:0.76～1.04),I期肺癌的合并HR为1.42(95%CI:1.02～1.81),腺癌的合并HR为0.63(95%CI:0.33～0.93)。结论对全部16个研究进行分析显示Cox-2的阳性表达与NSCLC的预后无明确相关性;同时对人种、腺癌、I期进行亚组分析,在不同种族中Cox-2的阳性表达与NSCLC的预后无关;在腺癌中,Cox-2的阳性表达提示预后良好;在I期NSCLC中,Cox-2的阳性表达提示预后不良。

Purpose To evaluate the relationship between Cox-2 expression and prognosis of non- small cell lung cancer（NSCLC） by a meta-analysis. Methods Articles on the correlation of Cox-2 expres- sion abnormality with prognosis of NSCLC were searched from PubMed, Embase, Web of Science and CNKI databases. Data were extracted and pooled hazard ratios（HR） with 95% confidence intervals（CI） were calculated. The results of 16 studies were analyzed by the random-effects model. Results 16 studies were allowed a meta-analysis of the survival, and the overall positive rate of Cox-2 was 60.8% in NSCLC. The pooled HR for all the 16 studies was 0.90 （95% CI = 0.76-I. 04）. For stage I NSCLC and adenocar- cinoma,the pooled HR was 1.42 and 0.63;,~respeetively. Conclusion All 16 studies analyzed show no correlation between Cox-2 expression and prognosis of NSCLC. Subgroup analysis were performed accord- ing to race,adenocareinoma and phase I. The positive expression of Cox-2 may be a good prognosis in ad＇ enoearcinoma,but a bad prognosis in stage I NSCLC.