Chang Kaibin, Jiang Lei, Sun Yifeng, Li He
Department of Stomach and Intestine, Yantai Affiliated Hospital of Binzhou Medical University, 717 Jinbu Street, Yantai, 264100, Shandong Province, China.
Mol Diagn Ther. 2022 Jul;26(4):397-409. doi: 10.1007/s40291-022-00593-3. Epub 2022 Jun 22.
The effect of E-cadherin on colorectal cancer is still controversial. In order to clarify the effect of E-cadherin on the prognosis and clinicopathological features of colorectal cancer, a meta-analysis was conducted.
PubMed, Embase and Cochrane Library were used to collect all relevant literature published before November 2021, and the corresponding data was extracted to analyze the correlation between the expression of E-cadherin and the prognosis and clinicopathological features of colorectal cancer. In addition, the Gene Expression Profiling Interactive Analysis (GEPIA) was used to validate our results.
Fifty-two studies, including 9591 patients, were included in this meta-analysis. According to the meta-analysis, low expression of E-cadherin was significantly associated with shorter overall survival (OS) (hazard ratio [HR] 2.09, 95% confidence interval [CI]1.67-2.62; Z = 6.42, p = 0.000) and disease-free survival (DFS) (HR 2.03, 95% CI 1.71-2.42; Z = 7.95, p = 0.000). In addition, low expression of E-cadherin resulted in higher risk of low differentiation (odds ratio [OR] 0.35, 95% CI 0.25-0.50; p = 0.000), high risk of distant metastasis (OR 0.45, 95% CI 0.35-0.58; p = 0.000), high risk of vascular invasion (OR 0.61, 95% CI 0.45-0.83; p = 0.002), higher risk of lymph node metastasis (OR 0.54, 95% CI 0.42-0.69; p = 0.000), high risk of lymphatic invasion (OR 0.56, 95% CI 0.40-0.80; p = 0.001), high risk of deep infiltration (OR 0.63, 95% CI 0.50-0.80; p = 0.000), later TNM stage (OR 0.60, 95% CI 0.46-0.78; p = 0.000) and late Dukes' stage (OR 0.35,95% CI 0.25-0.49; p = 0.000), but wasn't associated with tumor size (OR 0.90, 95% CI 0.71-1.15; p = 0.406).The results of GEPIA showed that E-cadherin mRNA expression in colorectal cancer tumor tissues and normal tissues had no difference, and had no effect on OS and DFS.
Although not supported by GEPIA, our meta-analysis provided abundant data to suggest that low expression of E-cadherin is associated with poor prognosis in colorectal cancer patients and is an important factor influencing adverse clinicopathological features. Therefore, E-cadherin may be used to predict the prognosis of colorectal cancer and provide guidance for clinical treatment.
E-钙黏蛋白对结直肠癌的影响仍存在争议。为阐明E-钙黏蛋白对结直肠癌预后及临床病理特征的影响,进行了一项荟萃分析。
使用PubMed、Embase和Cochrane图书馆收集2021年11月前发表的所有相关文献,并提取相应数据以分析E-钙黏蛋白表达与结直肠癌预后及临床病理特征之间的相关性。此外,使用基因表达谱交互分析(GEPIA)来验证我们的结果。
本荟萃分析纳入了52项研究,共9591例患者。根据荟萃分析,E-钙黏蛋白低表达与总生存期(OS)显著缩短相关(风险比[HR]2.09,95%置信区间[CI]1.67 - 2.62;Z = 6.42,p = 0.000)和无病生存期(DFS)显著缩短相关(HR 2.03,95% CI 1.71 - 2.42;Z = 7.95,p = 0.000)。此外,E-钙黏蛋白低表达导致低分化风险增加(比值比[OR]0.35,95% CI 0.25 - 0.50;p = 0.000)、远处转移风险增加(OR 0.45,95% CI 0.35 - 0.58;p = 0.000)、血管侵犯风险增加(OR 0.61,95% CI 0.45 - 0.83;p = 0.002)、淋巴结转移风险增加(OR 0.54,95% CI 0.42 - 0.69;p = 0.000)、淋巴管侵犯风险增加(OR 0.56,95% CI 0.40 - 0.80;p = 0.001)、深层浸润风险增加(OR 0.63,95% CI 0.50 - 0.80;p = 0.000)、TNM分期较晚(OR 0.60,95% CI 0.46 - 0.78;p = 0.000)和Dukes分期较晚(OR 0.35,95% CI 0.25 - 0.49;p = 0.000),但与肿瘤大小无关(OR 0.90,95% CI 0.71 - 1.15;p = 0.406)。GEPIA结果显示,结直肠癌肿瘤组织和正常组织中E-钙黏蛋白mRNA表达无差异,且对OS和DFS无影响。
尽管未得到GEPIA的支持,但我们的荟萃分析提供了大量数据表明,E-钙黏蛋白低表达与结直肠癌患者预后不良相关,是影响不良临床病理特征的重要因素。因此,E-钙黏蛋白可用于预测结直肠癌的预后并为临床治疗提供指导。