title: Clinicopathological and prognostic significance of COX-2 immunohistochemical expression in breast cancer: a meta-analysis.
abstract: 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.
authors.affiliation: Department of Breast Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China, 100020.
authors.forename: Feng
authors.initials: F
authors.lastname: Xu
authors.affiliation: Department of Breast Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China, 100020.
authors.forename: Mengxin
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Breast Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China, 100020.
authors.forename: Chao
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Breast Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China, 100020.
authors.forename: Jianxiu
authors.initials: J
authors.lastname: Cui
authors.affiliation: Department of Breast Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China, 100020.
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Breast Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China, 100020.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Breast Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China, 100020.
authors.forename: Hongchuan
authors.initials: H
authors.lastname: Jiang
mesh_terms: D001943:Breast Neoplasms / Q000378:metabolism* / Q000473:pathology*; D051546:Cyclooxygenase 2 / Q000378:metabolism*; D018572:Disease-Free Survival; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008207:Lymphatic Metastasis; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D016019:Survival Analysis; D047368:Tumor Burden; D015854:Up-Regulation
chemical_list: D051546:Cyclooxygenase 2; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C496540:PTGS2 protein, human; C508053:ERBB2 protein, human
keywords: COX-2; breast cancer; meta-analysis; prognosis