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.
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。