Has Cox-2 a prognostic role in non-small-cell lung cancer? A systematic review of the literature with meta-analysis of the survival results.

Fiche publication


Date publication

juillet 2006

Journal

British journal of cancer

Auteurs

Membres identifiés du Cancéropôle Est :
Pr MASCAUX Céline


Tous les auteurs :
Mascaux C, Martin B, Paesmans M, Berghmans T, Dusart M, Haller A, Lothaire P, Meert AP, Lafitte JJ, Sculier JP

Résumé

Cyclooxygenase-2 (COX-2) is overexpressed in lung cancer, especially in adenocarcinoma (ADC). Our aim was to determine the prognostic value of COX-2 on survival in patients with lung cancer. Studies evaluating the survival impact of COX-2 in lung cancer, published until December 2005, were selected. Data for estimation of individual hazard ratios (HR) for survival were extracted from the publications and combined in a pooled HR. Among 14 eligible papers, all dealing with non-small-cell lung cancer, 10 provided results for meta-analysis of survival data (evaluable studies). Cyclooxygenase-2 positivity was associated with reduced survival, improved survival or no statistically significant impact in six, one and seven studies, respectively. Combined HR for the 10 evaluable studies (1236 patients) was 1.39 (95% confidence intervals (CI): 0.97-1.99). In stage I lung cancer (six evaluable studies, 554 patients), it was 1.64 (95% CI: 1.21-2.24). No significant impact was shown in ADC. A slight detrimental effect on survival in patients with lung cancer is associated with COX-2 expression, but the statistical significance is not reached. This effect is statistically significant in stage I, suggesting that COX-2 expression could be useful at early stages to distinguish those with a worse prognosis.

Mots clés

Carcinoma, Non-Small-Cell Lung, diagnosis, Cyclooxygenase 2, genetics, Gene Expression Regulation, Neoplastic, genetics, Humans, Immunohistochemistry, Lung Neoplasms, diagnosis, Membrane Proteins, genetics, Meta-Analysis as Topic, Neoplasm Staging, Prognosis, Quality Assurance, Health Care, Survival Rate

Référence

Br. J. Cancer. 2006 Jul 17;95(2):139-45