Prognostic significance of cyclooxygenase-2 in osteosarcoma: a meta-analysis

Jiao, Guangjun; Ren, Tingting; Lu, Qiong; Sun, Yifeng; Lou, Zhidong; Peng, Xiaojin; Liang, Weimin; Guo, Wei

doi:10.1007/s13277-013-0998-2

Cited by 20 publications

(13 citation statements)

References 19 publications

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“…COX-2 expression has been found to be associated with an increased risk of tumor recurrence, advanced cancer stage and/ or poor overall survival in a large number of cancers such as ovarian cancer [28,29], osteosarcoma [30,31], pancreatic cancer [32], gastric cancer [33][34][35], classical Hodgkin's lymphoma [36], oral squamous cell cancer [37], melanoma [38], non-small cell lung cancer [39] but not lung adenocarcinoma [40], clear cell renal carcinoma [41], cervical cancer [42] and esophageal adenocarcinoma [43]. The specific expression of COX-2 in breast and colon cancers is detailed later in this article.…”

Section: Cox-2 Expression In Cancermentioning

confidence: 99%

New Insights on COX-2 in Chronic Inflammation Driving Breast Cancer Growth and Metastasis

Hugo

Saunders

Ramsay

et al. 2015

J Mammary Gland Biol Neoplasia

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The medicinal use of aspirin stretches back to ancient times, before it was manufactured in its pure form in the late 19th century. Its accepted mechanistic target, cyclooxygenase (COX), was discovered in the 1970s and since this landmark discovery, the therapeutic application of aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) has increased dramatically. The most significant benefits of NSAIDs are in conditions involving chronic inflammation (CI). Given the recognized role of CI in cancer development, the use of long-term NSAID treatment in the prevention of cancer is an enticing possibility. COX-2 is a key driver of CI, and here we review COX-2 expression as a predictor of survival in various cancer types, including breast. Obesity and post-partum involution are natural inflammatory states that are associated with increased breast cancer risk. We outline the COX-2 mediated mechanisms contributing to the growth of cancers. We dissect the cellular mechanism of epithelial-mesenchymal transition (EMT) and how COX-2 may induce this to facilitate tumor progression. Finally we examine the potential regulation of COX-2 by c-Myb, and the possible interplay between c-Myb/COX-2 in proliferation, and hypoxia inducible factor-1 alpha (HIF1α)/COX-2 in invasive pathways in breast cancer.

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Section: Cox-2 Expression In Cancermentioning

confidence: 99%

New Insights on COX-2 in Chronic Inflammation Driving Breast Cancer Growth and Metastasis

Hugo

Saunders

Ramsay

et al. 2015

J Mammary Gland Biol Neoplasia

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“…The meta‐analysis of Jiao et al . involving 14 studies reported that COX‐2 expression was correlated with the clinical stage and metastasis of osteosarcoma. However, the meta‐analysis of Wang et al .…”

Section: Discussionmentioning

confidence: 99%

Cyclooxygenase‐2 expression correlates with development, progression, metastasis, and prognosis of osteosarcoma: a meta‐analysis and trial sequential analysis

et al. 2019

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Cyclooxygenase‐2 (COX‐2), a key enzyme in arachidonic acid metabolism, is involved in several cancers, including osteosarcoma. The prognostic significance of COX‐2 in osteosarcoma remains controversial. This study was to analyze the potential clinical and prognostic effects of COX‐2 protein expression in patients with osteosarcoma. Eligible articles were searched via online databases. The combined odds ratios (ORs) or hazard ratios (HRs) with their 95% confidence intervals (95% CIs) were calculated using the random‐effects model. Trial sequential analysis (TSA) was applied to analyze the required information size and determine the reliability of the evidence. Twenty‐three studies on COX‐2 expression were identified, which included a total of 1084 patients with malignant osteosarcoma and 247 patients with benign osteochondroma. COX‐2 protein expression in osteosarcoma was higher than in benign osteochondroma (OR = 7.66, P < 0.001). COX‐2 expression was not correlated with age, gender, tumor location, cancer histology, or necrosis (P > 0.1), but was significantly associated with tumor grade (high grade vs. low grade: OR = 4.81, P < 0.001), clinical stage (stage 3–4 vs. stage 1–2: OR = 4.89, P < 0.001), and metastasis (yes vs. no: OR = 3.53, P < 0.001). Based on TSA results, we suggest that additional studies are not required to examine osteosarcoma vs. benign osteochondroma, tumor grade, clinical stage, or metastasis. No heterogeneity was observed in these analyses. COX‐2 expression is linked to poor prognosis in metastasis‐free survival, overall survival, and relapse‐free survival, as indicated by multivariate analysis. Therefore, the expression of COX‐2 may correlate with the development, progression, metastasis, and poor prognosis of osteosarcoma.

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“…When the present manuscript was being written, a meta-analysis about COX-2 immunoexpression on the prognosis of osteosarcoma patients was published [38]. There are some shortcomings which may have a negative effect on the reliability of the final results.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Assessment of the Association of COX-2 (Cyclooxygenase-2) Immunoexpression with Prognosis in Human Osteosarcoma: A Meta-Analysis

Wang

Xiao

et al. 2013

PLoS ONE

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BackgroundNumerous studies examining the relationship between Cyclooxygenase-2 (COX-2) immunoexpression and clinical outcome in osteosarcoma patients have yielded inconclusive results. MethodsWe accordingly conducted a meta-analysis of 9 studies (442 patients) that evaluated the correlation between COX-2 immunoexpression and clinical prognosis (death). Pooled odds ratios (OR) and risk ratios (RR) with 95% confidence intervals (95% CI) were calculated using the random-effects or fixed-effects model. ResultsMeta–analysis showed no significant association between COX-2 positivity and age, gender, tumor location, histology, stage, metastasis or 90% necrosis. Conversely, COX-2 immunoexpression was associated with overall survival rate (RR=2.12; 95% CI: 1.10–3.74; P=0.009) and disease-free survival rate (RR=1.63; 95% CI: 1.17–2.28; P=0.004) at 2 years. Sensitivity analysis performed by omitting low quality studies showed that the pooled results were stable. ConclusionsCOX-2 positivity was associated with a lower 2-year overall survival rate and disease-free survival rate. COX-2 expression change is an independent prognostic factor in patients with osteosarcoma.

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Prognostic significance of cyclooxygenase-2 in osteosarcoma: a meta-analysis

Cited by 20 publications

References 19 publications

New Insights on COX-2 in Chronic Inflammation Driving Breast Cancer Growth and Metastasis

New Insights on COX-2 in Chronic Inflammation Driving Breast Cancer Growth and Metastasis

Cyclooxygenase‐2 expression correlates with development, progression, metastasis, and prognosis of osteosarcoma: a meta‐analysis and trial sequential analysis

Quantitative Assessment of the Association of COX-2 (Cyclooxygenase-2) Immunoexpression with Prognosis in Human Osteosarcoma: A Meta-Analysis

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