Yang Yan-Long, Chen Ming-Wu, Xian Lei
Department of Cardiothoracic Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, China.
PLoS One. 2014 Jun 30;9(6):e99763. doi: 10.1371/journal.pone.0099763. eCollection 2014.
Many studies have investigated the prognostic role of E-cadherin in patients with NSCLC; however, the result still remains inconclusive. An up-to data system review and meta-analysis was necessary to give a comprehensive evaluation of prognostic role of E-cadherin in NSCLC.
Eligible studies were searched in Pubmed, Embase and Web of Science databases. The inclusion criteria were studies that assessed the relationship between E-cadherin expression detected by immunohistochemistry (IHC) and the prognosis or clinicopathological features in patients with NSCLC. Subgroup analysis according to race, percentage of reduced/negative E-cadherin expression, histological type, and sample size were also conducted. Odds ratio (OR) or hazard ratio (HR) with 95% confidence interval (CI) were calculated to examine the risk or hazard association.
A total of 29 studies including 4010 patients were qualified for analysis. The analysis suggested that downregulated E-cadherin expression was significant associated with unfavorable overall survival (OS) and disease-free survival/progression-free survival (DFS/PFS) in patients with NSCLC. Subgroup analysis by race, percentage of reduced/negative E-cadherin expression, sample size also found the significant association in OS. When only the stage I NSCLC were considered, downregulated E-cadherin expression still had an unfavorable impact on OS. Additionally, downregulated E-cadherin expression was significantly associated with differentiation grade, lymphnode metastasis, vascular invasion, and TNM stage.
Downregulated E-cadherin expression detected by IHC seems to correlate with tumour progression and could serve as an important prognostic factor in patients with NSCLC.
许多研究探讨了E-钙黏蛋白在非小细胞肺癌（NSCLC）患者中的预后作用；然而，结果仍不明确。需要进行最新的系统评价和荟萃分析，以全面评估E-钙黏蛋白在NSCLC中的预后作用。
在PubMed、Embase和Web of Science数据库中检索符合条件的研究。纳入标准为评估通过免疫组织化学（IHC）检测的E-钙黏蛋白表达与NSCLC患者预后或临床病理特征之间关系的研究。还根据种族、E-钙黏蛋白表达降低/阴性的百分比、组织学类型和样本量进行了亚组分析。计算比值比（OR）或风险比（HR）及95%置信区间（CI），以检验风险或危害关联。
共有29项研究（包括4010例患者）符合分析条件。分析表明，E-钙黏蛋白表达下调与NSCLC患者不良的总生存期（OS）和无病生存期/无进展生存期（DFS/PFS）显著相关。按种族、E-钙黏蛋白表达降低/阴性的百分比、样本量进行的亚组分析也发现了OS中的显著关联。仅考虑I期NSCLC时，E-钙黏蛋白表达下调对OS仍有不良影响。此外，E-钙黏蛋白表达下调与分化程度、淋巴结转移、血管侵犯和TNM分期显著相关。
通过IHC检测到的E-钙黏蛋白表达下调似乎与肿瘤进展相关，可作为NSCLC患者的重要预后因素。
