Clinicopathological Significance of Mutation in Colorectal Cancer: An Updated Meta-Analysis.

Numerous studies have identified mutation as a predictive factor of anti-EGFR antibodies in colorectal cancer (CRC). However, the association between mutation and clinicopathological features remains unclear. Therefore, we aimed to conduct an updated and comprehensive meta-analysis to evaluate the above issues. We performed a systematic literature search from PubMed, Web of Science, Embase, and PMC database examining the association between mutation and clinicopathological features in CRC patients. Odds ratio with 95% confidence interval were used to estimate the effects of mutation on each clinicopathological parameter with fixed-effect model or random-effect model. Sixty-one studies published, including 32407 CRC patients from multiple countries, were included in the meta-analysis. The overall mutation rate was 11.38%, and mutation was positively related to high disease stage (OR=0.81; 95% CI=0.72-0.92; =0.001), high T stage (OR=0.51; 95% CI=0.40-0.65; <0.00001), proximal colon (OR=4.76; 95% CI=3.81-5.96; <0.00001) or right colon (OR=5.15; 95% CI=4.35-6.10, <0.00001) tumor location, poor tumor differentiation (OR=0.27; 95% CI=0.21-0.34; <0.00001), mucinous histology (OR=2.97; 95% CI=2.37-3.72; <0.00001), K-ras-wild type (OR=0.04; 95% CI=0.02-0.07; <0.00001), TP53-wild type (OR=0.50; 95% CI=0.31-0.78; =0.003), deficient DNA mismatch repair (OR=2.93; 95% CI=1.78-4.82; <0.00001), high microsatellite instability (OR=11.15; 95% CI=8.51-14.61; <0.00001) and high CpG island methylator phenotype (OR=0.04; 95% CI=0.03-0.08; <0.00001). Our updated meta-analysis demonstrated that mutation was related to poor prognosis of CRC and associated with the distinct molecular phenotypes.