Andrew T Kunzmann 1 , Liam J Murray , Chris R Cardwell , Charlene M McShane , Una C McMenamin , Marie M Cantwell Show Affiliations »
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 = 9 studies; HR, 2.79; 95% CI, 1.76-4.41; P < 0.001) and had poorer colorectal cancer-specific survival (n = 7; HR, 1.36; 95% CI, 1.02-1.82; P = 0.04). However, there was funnel plot asymmetry, possibly due to publication bias, for the association with cancer-specific survival but less so for recurrence. PTGS2 expression was not associated with overall survival [(n = 16; pooled unadjusted HR, 1.30; 95% CI, 0.94-1.79; P = 0.11) and (n = 9; pooled adjusted HR, 1.02; 95% CI, 0.72-1.45; P = 0.91)]. 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. ©2013 AACR.
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 = 9 studies; HR, 2.79; 95% CI, 1.76-4.41; P < 0.001) and had poorer colorectal cancer -specific survival (n = 7; HR, 1.36; 95% CI, 1.02-1.82; P = 0.04). However, there was funnel plot asymmetry, possibly due to publication bias , for the association with cancer -specific survival but less so for recurrence. PTGS2 expression was not associated with overall survival [(n = 16; pooled unadjusted HR, 1.30; 95% CI, 0.94-1.79; P = 0.11) and (n = 9; pooled adjusted HR, 1.02; 95% CI, 0.72-1.45; P = 0.91)]. 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. ©2013 AACR.
Entities: Chemical
Disease
Gene
Species
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Year: 2013
PMID： 23810915 DOI： 10.1158/1055-9965.EPI-13-0263
Source DB: PubMed Journal: Cancer Epidemiol Biomarkers Prev ISSN： 1055-9965 Impact factor: 4.254