PTGS2 (Cyclooxygenase-2) Expression and Survival among Colorectal Cancer Patients: A Systematic Review

Abstract

Background: Studies have examined whether tumor expression of PTGS2 (also known as COX-2), an enzyme inhibited by nonsteroidal anti-inflammatory drugs such as aspirin, is associated with prognosis in patients with colorectal cancer. However, results to date have been mixed.Methods: Using terms for PTGS2 and colorectal cancer, the Medline, Embase, and Web of Science databases were systematically searched for studies published, in any language, until December 2011. Random effects meta-analyses were used to calculate pooled HRs [95% confidence intervals (CI)] for the association between PTGS2 expression and tumor recurrence, colorectal cancer-specific survival, and overall survival.Results: In total, 29 studies, which had prognostic data on 5,648 patients, met the inclusion criteria. PTGS2-positive patients were at an increased risk of tumor recurrence (n ¼ 9 studies; HR, 2.79; 95% CI, 1.76-4.41; P < 0.001) and had poorer colorectal cancer-specific survival (n ¼ 7; HR, 1.36; 95% CI, 1.02-1.82; P ¼ 0.04). However, there was funnel plot asymmetry, possibly due to publication bias, for the association with cancerspecific survival but less so for recurrence. PTGS2 expression was not associated with overall survival [(n ¼ 16; pooled unadjusted HR, 1.30; 95% CI, 0.94-1.79; P ¼ 0.11) and (n ¼ 9; pooled adjusted HR, 1.02; 95% CI, 0.72-1.45;Conclusions: PTGS2 expression was associated with an increased risk of tumor recurrence and poorer colorectal cancer-specific survival but not overall survival among patients with colorectal cancer. However, confounding by tumor characteristics such as tumor stage seems likely.Impact: There is insufficient evidence to recommend PTGS2 expression as a prognostic marker in patients with colorectal cancer. Furthermore, studies providing adjusted results are required. Cancer Epidemiol Biomarkers Prev; 22(9); 1490-7. Ó2013 AACR.

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

“…In CRC COX-2 was shown to be associated with a poor overall survival [48][49][50][51] and advanced CRC stage [52,53] however in another study no such correlation was found [54]. As outlined in Fig.…”

FosB transcription factor regulates COX-2 expression in colorectal cancer cells without affecting PGE2 expression

“…Cells were maintained in a humidified incubator at 37˚C and 5% CO 2 . Early passages (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) were used for the experiments.…”

“…There are two functional isoforms of COX: COX-1, whose expression is constitutive; and COX-2, which exhibits an inducible expression and whose products have been mainly associated with pathological processes (10). COX-1 expression has been reported to remain stable in cancer tissues, while COX-2 expression has been associated with advanced Dukes stage, poor long-term outcome and lymph node metastasis in CRC patients (11)(12)(13).…”

Comprehensive network analysis of genes expressed in human oropharyngeal cancer

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