Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 28, 2017; 23(12): 2234-2245
Published online Mar 28, 2017. doi: 10.3748/wjg.v23.i12.2234
Association between COX-2 -1195G>A polymorphism and gastrointestinal cancer risk: A meta-analysis
Xiao-Wei Zhang, Jun Li, Yu-Xing Jiang, Yu-Xiang Chen
Xiao-Wei Zhang, Jun Li, Yu-Xiang Chen, Department of Gastrointestinal and Vascular Surgery, Deyang People’s Hospital, Deyang 618099, Sichuan Province, China
Yu-Xing Jiang, Department of General Surgery and Center for Minimal Invasive Gastrointestinal Surgery, Southwest Hospital, Third Military Medical University, Chongqing 400038, China
Author contributions: Zhang XW and Chen YX conceived and designed the study; Li J and Jiang YX designed the data extraction tool and conducted the literature search; Zhang XW and Li J interpreted and extracted the data; Zhang XW, Li J and Jiang YX performed the statistical analysis; Zhang XW and Li J wrote the first draft of the manuscript; Jiang YX and Chen YX contributed to the revision of the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Yu-Xiang Chen, Chief Physician, Department of Gastrointestinal and Vascular Surgery, Deyang People’s Hospital, Deyang 618099, Sichuan Province, China.
Telephone: +86-838-2418116 Fax: +86-838-2418116
Received: December 6, 2016
Peer-review started: December 8, 2016
First decision: February 9, 2017
Revised: February 26, 2017
Accepted: March 4, 2017
Article in press: March 4, 2017
Published online: March 28, 2017

To perform a meta-analysis to investigate the association between cyclooxygenase-2 (COX-2) -1195G>A gene polymorphism and gastrointestinal cancers.


Publications related to the COX-2 -1195G>A gene polymorphism and gastrointestinal cancers published before July 2016 were retrieved from PubMed, EMBASE, Web of Science, China Biological Medicine Database, China National Knowledge Infrastructure, and CQVIP Database. Meta-analysis was performed using Stata11.0 software. The strength of the association was evaluated by calculating the combined odds ratios (ORs) and the corresponding 95%CIs. The retrieved publications were excluded or included one by one for sensitivity analysis. In addition, the funnel plot, Begg’s rank correlation test, and Egger’s linear regression method were applied to analyse whether the included publications had publication bias.


A total of 24 publications related to the COX-2 -1195G>A gene polymorphism were included, including 28 studies involving 11043 cases and 18008 controls. The meta-analysis results showed that the COX-2 -1195G>A gene polymorphism significantly correlated with an increased risk of gastrointestinal cancers, particularly gastric cancer (A vs G: OR = 1.35; AA/AG vs GG: OR = 1.54; AA vs GG/AG: OR = 1.43; AA vs GG: OR = 1.80; AG vs GG: OR = 1.35). Compared to the Caucasian population in America and Europe, the COX-2 -1195G>A gene polymorphism in the Asian population (A vs G: OR = 1.30; AA/AG vs GG: OR = 1.50; AA vs GG/AG: OR = 1.35; AA vs GG: OR = 1.71; AG vs GG: OR = 1.37) significantly increased gastrointestinal cancer risk. The sensitivity analysis (P < 0.05) and the false positive report probability (P < 0.2) confirmed the reliability of the results.


The results showed that the COX-2 -1195G>A gene polymorphism might be a potential risk factor for gastrointestinal cancers. Further validation by a large homogeneous study is warranted.

Keywords: COX-2, -1195G>A, Polymorphism, Meta-analysis, Gastrointestinal cancer

Core tip: To explore the association of the cyclooxygenase-2 (COX-2) (-1195G>A) polymorphism with gastrointestinal cancers, we conducted this retrospective study. According to this meta-analysis, we discovered that the COX-2 (-1195G>A) polymorphism may be a risk factor for gastrointestinal cancers and may increase the risk of gastrointestinal cancers in the Asian population. Furthermore, we applied a false-positive report probability to make the results more credible. Our findings indicated that focusing on the COX-2 (-1195G>A) polymorphism to prevent gastrointestinal cancers may be viable.