COX-2表达与胃癌相关性的Meta分析

Relationship between COX-2 expression and gastric carcinoma: a meta-analysis

目的系统评价环氧化酶-2(COX-2)与胃癌及其临床病理特征的相关性。方法计算机检索Pub Med、CNKI、Wan Fang Data和VIP数据库,搜索国内外公开发表的关于COX-2与胃癌关系的病例-对照研究,检索时限均为从建库截至2017年1月。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果共纳入11个病例-对照研究,包括1 366例患者。Meta分析结果显示:COX-2在胃癌组织组与正常或癌旁组织组[RR=1.69,95%CI(1.39,2.06),P<0.000 01]、浆膜以外组与未及浆膜组[RR=1.37,95%CI(1.14,1.66),P=0.001]、临床Ⅰ~Ⅱ期组与Ⅲ~Ⅳ期组[RR=0.78,95%CI(0.69,0.90),P=0.000 3]及淋巴结转移与无淋巴结转移组[RR=1.48,95%CI(1.34,1.63),P<0.000 01]的表达差异均有统计学意义;而COX-2表达在胃癌高中分化组与低分化组[RR=0.84,95%CI(0.51,1.38),P=0.48]的差异无统计学意义。结论 COX-2表达与胃癌发生及其浸润深度、临床分期、淋巴结转移有关,提示COX-2在胃癌的发生与发展过程中起重要作用。受纳入研究的质量与数量的限制,上述研究尚需开展更多高质量的研究加以验证。

Objectives To evaluate the expression and clinical significance of COX-2 in gastric carcinoma. Methods Such databases as PubMed, CNKI, WanFang Data and VIP were searched for the studies on the association between COX-2 and gastric carcinoma from inception to January 2017. Two researchers independently screened literature, extracted data and evaluate the risk of bias of included studies. RevMan 5.3 software were used to analyze the data. Results Eleven case-control studies involving 1 366 patients were included. The results of meta-analysis showed that, there were significant differences of COX-2 expression in the following comparisons： gastric carcinoma vs. normal esophageal tissues （RR=l.69, 95%CI 1.39 to 2.06, P〈0 95%CI 1.14 to 1.66, P=0.001）, clinical stages I - lI vs 000 01）, with serosa invasive vs. without serosa invasive （RR= 1.37, clinical stages III-IV （RR=0.78, 95%CI 0.69 to 0.90, P=0.000 3）, as well as lymph node metastasis vs. non-lymph node metastasis （RR=l.48, 95%CI 1.34 to 1.63, P〈0.000 01）. While no significant difference was found between well/general differentiation group and poorly differentiation group （RR=0.84, 95%CI 0.51 to 1.38, P=0.48）. Conclusion COX-2 expression is associated with depth of invasion, clinical stage and lymph node metastasis, which prompts that COX-2 may play an important role in the occurrence and development of gastric carcinoma. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.