Li T, Chen J, Liu Q-L, Huo Z-H, Wang Z-W
Department of Gastrointestinal Surgery, First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Eur Rev Med Pharmacol Sci. 2014;18(18):2693-703.
The prognostic potential of reduced E-cadherin expression is associated with an increased risk of gastric cancer. However, its role in gastric cancer remains poorly understood. This study was to quantitatively summarize available evidences for evaluating E-cadherin immunoexpression in Asian patients with gastric cancer as a prognostic indicator.
Searches were applied to MEDLINE, EMBASE, the Cochrane Library and Chinese Biomedicine Databases until June 2012, without language restrictions. Studies were pooled and summary risk ratio (RR) or odds ratio (OR) were calculated. Potential sources of heterogeneity were sought out via subgroup and sensitivity analyses, and publication bias were also conducted.
Our combined results showed that reduction of E-cadherin expression in Asian patients with gastric cancer was frequently observed as compared to the counterpart normal tissue (odds ratio [OR] = 64.16, 95% confidence interval [CI] = 24.53-167.80, p < 0.001). All the analyses estimated favored a stronger link between the reduced E-cadherin expression and the poor 5 year overall survival (risk ratio [RR] = 1.50, 95% CI = 1.36-1.66, p < 0.001). When stratifying the studies by the clinical variables, the depth of invasion (OR = 2.46, 95% CI = 1.70-3.57, p < 0.001), lymph node spread (OR = 1.83, 95% CI = 1.49-2.26, p < 0.001), distant metastasis (OR = 2.04, 95% CI = 1.45-2.87, p < 0.000), and TNM stage (OR = 2.11, 95% CI = 1.58-2.83, p < 0.001) provided significant prognostic information.
Our findings indicate that E-cadherin appears to predict the overall survival and mark metastasis in Asian patients with gastric cancer. Importantly, E-cadherin may be implemented in the routine clinical management of gastric cancer. However, further pursuit of this possibility is warranted.
E-钙黏蛋白表达降低的预后潜力与胃癌风险增加相关。然而，其在胃癌中的作用仍知之甚少。本研究旨在定量总结评估E-钙黏蛋白免疫表达作为亚洲胃癌患者预后指标的现有证据。
检索MEDLINE、EMBASE、Cochrane图书馆和中国生物医学数据库至2012年6月，无语言限制。汇总研究并计算汇总风险比（RR）或比值比（OR）。通过亚组分析和敏感性分析寻找潜在的异质性来源，并进行发表偏倚分析。
我们的综合结果显示，与相应的正常组织相比，亚洲胃癌患者中E-钙黏蛋白表达降低的情况较为常见（比值比[OR]=64.16，95%置信区间[CI]=24.53 - 167.80，p<0.001）。所有分析估计均支持E-钙黏蛋白表达降低与5年总生存率较差之间存在更强的关联（风险比[RR]=1.50，95%CI=1.36 - 1.66，p<0.001）。当按临床变量对研究进行分层时，浸润深度（OR=2.46，95%CI=1.70 - 3.57，p<0.001）、淋巴结转移（OR=1.83，95%CI=1.49 - 2.26，p<0.001）、远处转移（OR=2.04，95%CI=1.45 - 2.87，p<0.000）和TNM分期（OR=2.11，95%CI=1.58 - 2.83，p<0.001）提供了显著的预后信息。
我们的研究结果表明，E-钙黏蛋白似乎可以预测亚洲胃癌患者的总生存率并标记转移情况。重要的是，E-钙黏蛋白可能应用于胃癌的常规临床管理。然而，有必要进一步探讨这种可能性。
