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.

COX2/PTGS2 Expression Is Predictive of Response to Neoadjuvant Celecoxib in HER2-negative Breast Cancer Patients

“…A recent meta-analysis including 21 studies and 6739 patients with breast cancer showed that the presence of high levels of COX2 predicts a greater tumor size and lymph node metastasis (11). The occurrence of COX2-overexpressing tumors in each study ranged from 27.9% to 81.4%.…”

“…The occurrence of COX2-overexpressing tumors in each study ranged from 27.9% to 81.4%. As illustrated by this meta-analysis (11), most published studies on prognostic or predictive value of COX2 were performed using immunohistochemistry. But the methods used for immunohistochemical analysis of COX2 were diverse, with various antibodies, lack of standardization of staining, and analysis of tumor COX2 expression.…”

Immunohistochemical detectability of cyclooxygenase‐2 expression in cells of human melanocytic skin lesions: A methodological review

“…In turn, the COX-2 peroxidase activity may contribute to production of mutagens ( Figure 1). [5][6][7][8] Enhanced COX-2 expression was demonstrated in various types of human malignancies: carcinomas of colon, 9,10 breast, 11,12 lung, 13,14 stomach, 15,16 esophagus, 17,18 pancreas, 19 bladder, 20 prostate, 21 ovary, 22,23 cervix, 24,25 osteosarcomas, 26,27 gliomas, 28,29 and Hodgkin lymphomas. 30 In most of the studies, it was shown that cancer progression is accompanied by an increase in COX-2 levels and may have prognostic potential.…”

Modulation of the prostaglandin-endoperoxide synthase 2 gene expression by variant haplotypes: influence of the 3′-untranslated region

“…Although up-regulated COX-2 contributes to tumor development ( 2 ), the extent of COX-2 distribution vary among individual studies ( 3 , 4 ). For instance, in invasive breast carcinoma, the reported frequencies of COX-2 detection by immunohistochemistry range from 17% to 84%, with a pooled estimate of 42% ( 3 ).…”