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[目的]通过Meta分析评价环氧化酶-2(COX-2)在肝癌中的表达及其与临床病理特征间的关系,以期寻找肝癌早期诊断、化学预防及治疗的新型分子靶点。[方法]通过检索CNKI、万方、Cochrane图书馆、Pub Med等数据库,搜集从建库至2016年10月国内外公开发表的有关COX-2在肝癌中表达的病例对照研究,纳入采用免疫组化法检测COX-2蛋白,并将染色范围及染色强度相结合评估其表达水平,且NOS评分量表≥5分的高质量研究。应用Rev Man5.3进行系统评价及异质性分析,计算合并OR及95%CI,对存在异质性的研究进行亚组分析以探讨其来源,应用Stata12.0绘制漏斗图及Egger回归方程评估有无发表偏倚。[结果]共有21篇文献纳入本次系统评价,Meta分析结果显示:COX-2在肝癌组中的表达高于正常组(OR=15.69,95%CI:9.73~25.32,P<0.00001),COX-2在癌旁组中的表达高于正常组(OR=9.47,95%CI:4.70~19.10,P<0.00001),COX-2在高分化肝癌组的表达高于中—低分化组(OR=1.97,95%CI:1.43~2.72,P<0.0001),差异均具有统计学意义。在COX-2与性别、肿瘤大小、TNM分期等其他9项肝癌临床病理特征关系的比较中,各组间差异并无统计学意义。[结论]COX-2在肝癌中表达增高,且主要在肝癌发生的早期阶段而非进展阶段发挥作用,COX-2有望成为肝癌早期诊断、化学预防及治疗的新型分子靶点。
[Objective] To evaluate the expression of cyclooxygenase-2 (COX-2) in hepatocellular carcinoma (HCC) and its relationship with clinicopathological features by Meta-analysis in order to find new molecular targets for the early diagnosis, chemoprevention and treatment of HCC. [Methods] By searching CNKI, Wanfang, Cochrane Library, Pub Med and other databases, a case-control study about the COX-2 expression in hepatocellular carcinoma published from the establishment of the library to the end of October 2016 was collected and included in the immunization group COX-2 protein was detected by chemiluminescence assay. The expression of COX-2 protein was evaluated by combining the staining range and staining intensity, and the NOS score was ≥5. A systematic review and heterogeneity analysis were performed using RevMan5.3. A combined OR and 95% CI were calculated. Subgroup analyzes of heterogeneity were performed to investigate the origin. The funnel plot was performed using Stata 12.0 and the Egger regression equation was evaluated With or without publication bias [Results] A total of 21 articles were included in this systematic review. The results of Meta analysis showed that the expression of COX-2 in HCC was significantly higher than that in the normal group (OR = 15.69, 95% CI: 9.73-25.32, P <0.00001) -2 was higher in the paracancer group than in the normal group (OR = 9.47,95% CI: 4.70-19.10, P <0.00001). The expression of COX-2 in well-differentiated hepatocellular carcinoma was higher than that in the moderate- = 1.97, 95% CI: 1.43 ~ 2.72, P <0.0001), the differences were statistically significant. There was no significant difference between the two groups in the relationship between COX-2 and clinicopathological features of other nine HCCs such as sex, tumor size and TNM stage. [Conclusion] The expression of COX-2 is increased in hepatocellular carcinoma and mainly plays an important role in the early stage of hepatocarcinoma but not in the progression stage. COX-2 is expected to become a novel molecular target for early diagnosis, chemoprevention and treatment of hepatocellular carcinoma.