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

作　　者：于洋[1] 张翠萍[1] 王淑霞[1] 连慧芬 

机构地区：[1]青岛大学附属医院,山东青岛266000

出　　处：《中国肿瘤》2017年第11期915-924,共10页China Cancer

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、Pub Med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Rev Man5.3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。[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.

关 键 词：环氧化酶-2 肝癌 临床病理学 分化程度 META分析 

分 类 号：R735.7[医药卫生—肿瘤]