Xu X-L, Ling Z Q, Chen S-Z, Li B, Ji W-H, Mao W-M
Zhejiang Cancer Hospital, Zhejiang Cancer Research Institute, Hangzhou, China.
Dis Esophagus. 2014 Jan;27(1):79-86. doi: 10.1111/dote.12024. Epub 2013 Jan 14.
E-cadherin is a 120-KD transmembrane calcium-dependent cell adhesion protein that has been demonstrated drownregulated in a large amount of invasive tumors. However, its effect on the prognosis of esophageal cancer (EC) remains controversial. All the relevant English articles that reported survival data or clinicopathological parameters were enrolled in this meta-analysis. A total of 24 studies, including 2691 cases, were included in this study. Twelve studies containing 1669 cases were enrolled to synthesize with hazard ratio (HR) and its 95% confidence interval (CI). The pooled HR for all 12 studies enrolled in this meta-analysis was 1.33 (95% CI 1.16-1.52; z = 3.99, P = 0.00). When the study measured by enzyme-linked immunosorbent assay is excluded, the pooled HR-evaluated E-cadherin to reduce the expression in EC, and in esophageal squamous cell carcinoma was 1.39 (95% CI 1.22-1.58; z = 5.08, P = 0.00) and 1.38 (95% CI 1.21-1.56; z = 4.87, P = 0.00), respectively. The risk of reduced E-cadherin expression on poor differentiation degree was 1.636 (95% CI 1.33-2.02). The pooled odds ratio of reduced E-cadherin expression on deeper tumor invasion, lymph node metastasis, and higher clinical stage were 2.63 (95% CI 1.75-3.94), 1.77 (95% CI 1.06 -2.97), and 3.39 (95% CI 1.85-6.23). Reduced E-cadherin expression detected by immunohistochemistry could be a valid prognostic marker in patients with EC, especially in patients with esophageal squamous cell carcinoma. Reduced E-cadherin expression is significantly associated with poorer differentiation degree.
E-钙黏蛋白是一种120千道尔顿的跨膜钙依赖性细胞黏附蛋白，已证实在大量侵袭性肿瘤中表达下调。然而，其对食管癌（EC）预后的影响仍存在争议。所有报道生存数据或临床病理参数的相关英文文章均纳入本荟萃分析。本研究共纳入24项研究，包括2691例病例。12项研究（包含1669例病例）被纳入以综合危险比（HR）及其95%置信区间（CI）。本荟萃分析中纳入的所有12项研究的合并HR为1.33（95%CI 1.16 - 1.52；z = 3.99，P = 0.00）。当排除采用酶联免疫吸附测定法测量的研究后，综合评估E-钙黏蛋白在食管癌及食管鳞状细胞癌中表达降低的HR分别为1.39（95%CI 1.22 - 1.58；z = 5.08，P = 0.00）和1.38（95%CI 1.21 - 1.56；z = 4.87，P = 0.00）。E-钙黏蛋白表达降低与低分化程度相关的风险为1.636（95%CI 1.33 - 2.02）。E-钙黏蛋白表达降低与肿瘤深度浸润、淋巴结转移及更高临床分期相关的合并比值比分别为2.63（95%CI 1.75 - 3.94）、1.77（95%CI 1.06 - 2.97）和3.39（95%CI 1.85 - 6.23）。免疫组织化学检测到的E-钙黏蛋白表达降低可能是食管癌患者，尤其是食管鳞状细胞癌患者的有效预后标志物。E-钙黏蛋白表达降低与较差的分化程度显著相关。
