| Objective: Currently, it is still controversial whether COX-2 expression can be regarded as a prognostic factor for HCC patients. We performed a systematic review and meta-analysis of studies assessing the clinical and prognostic significance of COX-2 expression in HCC..Methods: Identification and review of publications assessing clinical or prognostic significance of COX-2 expression in HCC until November 1, 2014. All analyses were completed with Review Mananger Software 5.3.A meta-analysis was performed to clarify the association between COX-2 expression and clinical outcomes.Results: A total of 11 publications met the criteria and comprised 943 cases. Analysis of these data showed that COX-2 expression was not significantly correlated with capsular formation(OR = 0.84, 95% confidence interval [CI]: 0.46–1.55, P = 0.58), tumor TNM stage(OR = 0.73, 95% CI 0.23–2.33, P = 0.59), vascular invasion(OR = 1.04, 95% CI 0.25–4.35, P = 0.96), tumor size(OR = 0.78, 95% CI 0.21–2.86, P = 0.71), or tumor differentiation degree(OR = 1.08, 95% CI 0.42–2.79, P = 0.87).However, in the identified studies, COX-2 expression was HBs Ag status(OR = 1.85, 95% CI 1.13–3.03, P = 0.01),decreased overall survival(relative risk [RR]: 1.54, 95% CI: 1.18–2.02, P =0.001) and decreased disease free survival(RR: 1.49, 95% CI: 1.22–1.81, P<0.001).Conclusion:This meta-analysis shows COX-2 expression in HCC is connected with decreased overall and disease free survival and thus marks a worse prognosis. |
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