Prognostic and Clinical Significance of COX-2 Overexpression in Laryngeal Cancer: A Meta-Analysis

Objective: Several studies were conducted to explore the clinical significance of cyclooxygenase-2 (COX-2) overexpression in laryngeal cancer. However, the associations between COX-2 overexpression and clinicopathological characteristics of laryngeal cancer patients remained unclear. Here, we performed a meta-analysis to eva-TY-40luate the role of COX-2 overexpression in the risk, clinical progression, and prognosis of laryngeal cancer. Methods: The eligible literature was obtained from PubMed, Embase, Web of Science, and China National Knowledge Infrastructure (CNKI) databases. Odds ratio (OR), risk ratio (RR), and 95% confidence interval (CI) were calculated to assess the strength of the associations, and I-2 statistics were used to evaluate heterogeneity among studies. Publication bias was detected with Begg's test and Egger's test. Results: A total of 47 eligible articles were included for the meta-analysis after screening. COX-2 expression levels in the laryngeal cancer patients were significantly higher than those in the normal controls (OR = 11.62, 95% CI: 6.96-19.40, P < 0.05). The pooled results also showed that there were significant correlations between COX-2 overexpression and clinicopathological characteristics (tumor stage, OR = 3.26, 95% CI: 2.13-4.98, P < 0.05; lymph node metastasis, in Asians, OR = 2.35, 95% CI: 1.53-3.60, P < 0.05; recurrence, OR = 10.71, 95% CI: 3.54-32.38, P < 0.05; T stage, in Asians, OR = 2.52, 95% CI: 1.66-3.83, P < 0.05). In addition, significant correlations between COX-2 overexpression and overall survival of laryngeal cancer were found both in Asians and in Caucasians (total, HR = 1.73, 95% CI: 1.23-2.24, P < 0.05; survival in Asians, HR = 2.59, 95% CI: 1.27-3.92, P < 0.05; survival in Caucasians, HR = 1.59, 95% CI: 1.03-2.14, P < 0.05). Conclusions: The meta-analysis results suggested that COX-2 overexpression was significantly associated with the increased risk, worse clinicopathological progression, and poorer prognosis of laryngeal cancer.