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Abstract：
Gastric carcinoma (GC) is one of the most fatal human malignancies globally, with a median survival time less than 1 year. E-cadherin exerts a crucial role in the development and progression of GC as an adhesive, invasive suppressor gene. Whether reduced E-cadherin has an impact on prognosis, clinicopathological features for GC has been well studied, but no conclusive results has been obtained.
Eligible studies and relevant data were obtained from PubMed, Elsevier, Embase, Cochrane Library and Web of Science databases until June 30, 2023. A fixed- or random-effects model was used to calculate pooled odds ratios (OR) and 95% confidence intervals (CI). Correlation of E-cadherin expression with overall survival (OS), clinicopathological features and risk factors were evaluated.
36 studies fulfilled the selected criteria. 9048 cases were included. This meta-analysis showed that patients with GC with reduced E-cadherin had unfavourable clinicopathological features and poor OS. The pooled ORs of one-, three- and five-year OS were 0.38 (n = 25 studies, 95%CI: 0.25-0.57, Z = 4.61, P < 0.00001), 0.33 (n = 25 studies, 95% CI: 0.23-0.47, Z = 6.22, P < 0.00001), 0.27 (n = 22 studies, 95% CI: 0.18-0.41, Z = 6.23, P < 0.00001), respectively. Moreover, reduced E-cadherin expression significantly correlated with differentiation grade (OR = 0.29, 95% CI: 0.22-0.39, Z = 8.58, P < 0.00001), depth of invasion (OR = 0.49, 95% CI: 0.36-0.66, Z = 4.58, P < 0.00001), lymphatic node metastasis (OR = 0.49, 95% CI: 0.38-0.64, Z = 5.38, P < 0.00001), distant metastasis (OR = 2.24, 95% CI: 1.62-3.09, Z = 4.88, P < 0.00001), peritoneal metastasis (OR = 2.17, 95% CI: 1.39-3.39, Z = 3.40, P = 0.0007), TNM stage (OR = 0.41, 95% CI: 0.28-0.61, Z = 4.44, P < 0.00001), lymphatic vessel invasion (OR = 1.77, 95% CI: 1.11-2.82, Z = 2.39, P = 0.02), vascular invasion (OR = 1.55, 95% CI: 1.22-1.96, Z = 3.58, P = 0.0003), Lauren type (OR = 0.35, 95% CI: 0.21-0.57, Z = 4.14, P < 0.0001), Borrmann classification (OR = 0.50, 95% CI: 0.25-0.99, Z = 1.97, P = 0.048) and tumor size (≥5 cm vs. <5 cm: OR = 1.73, 95% CI: 1.34-2.23, Z = 4.19, P < 0.0001; ≥6 cm vs. <6 cm: OR = 2.29, 95% CI: 1.51-3.49, Z = 3.87, P = 0.0001). No significant association was observed between reduced E-cadherin expression and liver metastasis, perineural invasion, alcohol consumption, smoking status, familial history, Helicobacter pylori (HP) infection.
The reduced expression of E-cadherin is significantly correlated with poor OS and unfavourable clinicopathological features in GC. The expression level of E-cadherin not only serves as a predictor for disease progression and prognosis in GC but also emerges as a novel therapeutic target.
Eligible studies and relevant data were obtained from PubMed, Elsevier, Embase, Cochrane Library and Web of Science databases until June 30, 2023. A fixed- or random-effects model was used to calculate pooled odds ratios (OR) and 95% confidence intervals (CI). Correlation of E-cadherin expression with overall survival (OS), clinicopathological features and risk factors were evaluated.
36 studies fulfilled the selected criteria. 9048 cases were included. This meta-analysis showed that patients with GC with reduced E-cadherin had unfavourable clinicopathological features and poor OS. The pooled ORs of one-, three- and five-year OS were 0.38 (n = 25 studies, 95%CI: 0.25-0.57, Z = 4.61, P < 0.00001), 0.33 (n = 25 studies, 95% CI: 0.23-0.47, Z = 6.22, P < 0.00001), 0.27 (n = 22 studies, 95% CI: 0.18-0.41, Z = 6.23, P < 0.00001), respectively. Moreover, reduced E-cadherin expression significantly correlated with differentiation grade (OR = 0.29, 95% CI: 0.22-0.39, Z = 8.58, P < 0.00001), depth of invasion (OR = 0.49, 95% CI: 0.36-0.66, Z = 4.58, P < 0.00001), lymphatic node metastasis (OR = 0.49, 95% CI: 0.38-0.64, Z = 5.38, P < 0.00001), distant metastasis (OR = 2.24, 95% CI: 1.62-3.09, Z = 4.88, P < 0.00001), peritoneal metastasis (OR = 2.17, 95% CI: 1.39-3.39, Z = 3.40, P = 0.0007), TNM stage (OR = 0.41, 95% CI: 0.28-0.61, Z = 4.44, P < 0.00001), lymphatic vessel invasion (OR = 1.77, 95% CI: 1.11-2.82, Z = 2.39, P = 0.02), vascular invasion (OR = 1.55, 95% CI: 1.22-1.96, Z = 3.58, P = 0.0003), Lauren type (OR = 0.35, 95% CI: 0.21-0.57, Z = 4.14, P < 0.0001), Borrmann classification (OR = 0.50, 95% CI: 0.25-0.99, Z = 1.97, P = 0.048) and tumor size (≥5 cm vs. <5 cm: OR = 1.73, 95% CI: 1.34-2.23, Z = 4.19, P < 0.0001; ≥6 cm vs. <6 cm: OR = 2.29, 95% CI: 1.51-3.49, Z = 3.87, P = 0.0001). No significant association was observed between reduced E-cadherin expression and liver metastasis, perineural invasion, alcohol consumption, smoking status, familial history, Helicobacter pylori (HP) infection.
The reduced expression of E-cadherin is significantly correlated with poor OS and unfavourable clinicopathological features in GC. The expression level of E-cadherin not only serves as a predictor for disease progression and prognosis in GC but also emerges as a novel therapeutic target.
摘要：
背景：胃癌（GC）是全球最致命的人类恶性肿瘤之一，中位生存时间少于1年。E-cadherin作为粘合剂在GC的发展和发展中起着至关重要的作用，侵袭抑制基因.是否降低E-cadherin对预后有影响，GC的临床病理特征已经得到了很好的研究，但是没有得到结论性的结果。
方法：符合条件的研究和相关数据来自PubMed，Elsevier,Embase,Cochrane图书馆和WebofScience数据库，直到2023年6月30日。使用固定或随机效应模型来计算合并比值比（OR）和95％置信区间（CI）。E-cadherin表达与总生存期(OS)的相关性评估临床病理特征和危险因素。
结果：36项研究符合选定标准。纳入9048例。这项荟萃分析显示，E-cadherin减少的GC患者具有不利的临床病理特征和不良的OS。一个的汇集OR-，三年和五年OS为0.38(n=25项研究，95CI：0.25-0.57，Z=4.61，P<0.00001），0.33(n=25项研究，95%CI:0.23-0.47,Z=6.22,P<0.00001),0.27(n=22项研究，95%CI:0.18-0.41,Z=6.23,P<0.00001),分别。此外，E-cadherin表达降低与分化程度显著相关(OR=0.29,95%CI:0.22-0.39,Z=8.58,P<0.00001),侵袭深度(OR=0.49,95%CI:0.36-0.66,Z=4.58,P<0.00001),淋巴结转移(OR=0.49,95%CI:0.38-0.64,Z=5.38,P<0.00001),远处转移(OR=2.24,95%CI:1.62-3.09,Z=4.88,P<0.00001),腹膜转移(OR=2.17,95%CI:1.39-3.39,Z=3.40,P=0.0007),TNM分期(OR=0.41,95%CI:0.28-0.61,Z=4.44,P<0.00001),淋巴管浸润(OR=1.77,95%CI:1.11-2.82,Z=2.39,P=0.02),血管侵犯(OR=1.55,95%CI:1.22-1.96,Z=3.58,P=0.0003),劳伦型(OR=0.35,95%CI:0.21-0.57,Z=4.14,P<0.0001),Borrmann分类（OR=0.50，95％CI：0.25-0.99，Z=1.97，P=0.048）和肿瘤大小（≥5cmvs.<5cm：OR=1.73，95%CI：1.34-2.23，Z=4.19，P<0.0001；≥6cmvs.<6cm:OR=2.29,95%CI:1.51~3.49,Z=3.87,P=0.0001)。E-cadherin表达降低与肝转移之间没有显著关联，神经周浸润,酒精消费,吸烟状况,家族史,幽门螺杆菌（HP）感染。
结论：E-cadherin表达降低与GC不良OS和不良临床病理特征显著相关。E-cadherin的表达水平不仅可以作为GC中疾病进展和预后的预测因子，而且可以作为新的治疗靶标出现。
方法：符合条件的研究和相关数据来自PubMed，Elsevier,Embase,Cochrane图书馆和WebofScience数据库，直到2023年6月30日。使用固定或随机效应模型来计算合并比值比（OR）和95％置信区间（CI）。E-cadherin表达与总生存期(OS)的相关性评估临床病理特征和危险因素。
结果：36项研究符合选定标准。纳入9048例。这项荟萃分析显示，E-cadherin减少的GC患者具有不利的临床病理特征和不良的OS。一个的汇集OR-，三年和五年OS为0.38(n=25项研究，95CI：0.25-0.57，Z=4.61，P<0.00001），0.33(n=25项研究，95%CI:0.23-0.47,Z=6.22,P<0.00001),0.27(n=22项研究，95%CI:0.18-0.41,Z=6.23,P<0.00001),分别。此外，E-cadherin表达降低与分化程度显著相关(OR=0.29,95%CI:0.22-0.39,Z=8.58,P<0.00001),侵袭深度(OR=0.49,95%CI:0.36-0.66,Z=4.58,P<0.00001),淋巴结转移(OR=0.49,95%CI:0.38-0.64,Z=5.38,P<0.00001),远处转移(OR=2.24,95%CI:1.62-3.09,Z=4.88,P<0.00001),腹膜转移(OR=2.17,95%CI:1.39-3.39,Z=3.40,P=0.0007),TNM分期(OR=0.41,95%CI:0.28-0.61,Z=4.44,P<0.00001),淋巴管浸润(OR=1.77,95%CI:1.11-2.82,Z=2.39,P=0.02),血管侵犯(OR=1.55,95%CI:1.22-1.96,Z=3.58,P=0.0003),劳伦型(OR=0.35,95%CI:0.21-0.57,Z=4.14,P<0.0001),Borrmann分类（OR=0.50，95％CI：0.25-0.99，Z=1.97，P=0.048）和肿瘤大小（≥5cmvs.<5cm：OR=1.73，95%CI：1.34-2.23，Z=4.19，P<0.0001；≥6cmvs.<6cm:OR=2.29,95%CI:1.51~3.49,Z=3.87,P=0.0001)。E-cadherin表达降低与肝转移之间没有显著关联，神经周浸润,酒精消费,吸烟状况,家族史,幽门螺杆菌（HP）感染。
结论：E-cadherin表达降低与GC不良OS和不良临床病理特征显著相关。E-cadherin的表达水平不仅可以作为GC中疾病进展和预后的预测因子，而且可以作为新的治疗靶标出现。
