Zheng Cheng, Dai Min, Wang Dongying, Liu Xingchen, Xiang Zhiyi, Xu Anyi, Chen Ping, Wu Feng, Yuan Yuan, Ji Shengqiang, Gu Lihu
Department of General Surgery, Ningbo No. 2 Hospital, Ningbo, Zhejiang 315010, P.R. China.
The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang 310053, P.R. China.
Oncol Lett. 2025 Jul 4;30(3):427. doi: 10.3892/ol.2025.15173. eCollection 2025 Sep.
The prognosis of gastric cancer (GC) remains unsatisfactory despite advancements in diagnosis and treatment. Epithelial-mesenchymal transition-induced decreased cell-cell adhesion, often associated with E-cadherin deficiency, serves a crucial role in tumor invasion and metastasis. However, the relationship between E-cadherin deficiency and GC prognosis is unclear. The present study aimed to explore the association between E-cadherin deficiency and the prognosis of resectable GC. The nested case-control study involved prospective data collection and retrospective analysis. Between January 2013 and December 2022, a total of 1,574 patients treated for GC were eligible for prognostic analysis (104 in the E-cadherin deficiency group and 1,470 in the E-cadherin expression group). Logistic regression analysis was utilized to evaluate the univariate and multivariate associations between clinicopathological factors and E-cadherin deficiency. Propensity score matching analysis at a ratio of 1:4 was performed. Kaplan-Meier curves were employed to analyze the relationship between the prognosis of the E-cadherin deficiency group and the E-cadherin expression group. There were 104 cases of E-cadherin deficiency, accounting for an incidence of 6.6%. The results of the analysis revealed that a family history of GC [odds ratio (OR), 7.60; P<0.001], poorly differentiated tumors (OR, 8.67; P<0.001), perineural invasion (OR, 1.63; P=0.030) and elevated carcinoembryonic antigen (CEA) (OR, 1.83; P=0.034) were independent risk factors for E-cadherin deficiency in all enrolled patients. Following propensity score matching analysis, 86 cases in the E-cadherin deficiency group and 344 cases in the E-cadherin expression group were included. Survival analysis demonstrated no statistically significant difference in 5-year disease-free survival rates between the E-cadherin deficiency and expression groups (P=0.590). Similarly, the 5-year overall survival rates were comparable between the two groups (P=0.863). In summary, E-cadherin deficiency is associated with a family history of GC, poorly differentiated tumors, perineural invasion and elevated CEA levels. However, E-cadherin deficiency does not impact the prognosis of resectable GC.
尽管在胃癌（GC）的诊断和治疗方面取得了进展，但其预后仍然不尽人意。上皮-间质转化导致细胞间粘附力下降，这通常与E-钙粘蛋白缺乏有关，在肿瘤侵袭和转移中起关键作用。然而，E-钙粘蛋白缺乏与GC预后之间的关系尚不清楚。本研究旨在探讨E-钙粘蛋白缺乏与可切除GC预后之间的关联。这项巢式病例对照研究涉及前瞻性数据收集和回顾性分析。在2013年1月至2022年12月期间，共有1574例接受GC治疗的患者符合预后分析条件（E-钙粘蛋白缺乏组104例，E-钙粘蛋白表达组1470例）。采用逻辑回归分析评估临床病理因素与E-钙粘蛋白缺乏之间的单因素和多因素关联。进行了比例为1:4的倾向评分匹配分析。采用Kaplan-Meier曲线分析E-钙粘蛋白缺乏组和E-钙粘蛋白表达组的预后关系。有104例E-钙粘蛋白缺乏病例，发病率为6.6%。分析结果显示，GC家族史[比值比（OR），7.60；P < 0.001]、低分化肿瘤（OR，8.67；P < 0.001）神经周围侵犯（OR，1.63；P = 0.030）和癌胚抗原（CEA）升高（OR，1.83；P = 0.034）是所有纳入患者中E-钙粘蛋白缺乏的独立危险因素。倾向评分匹配分析后，E-钙粘蛋白缺乏组纳入86例，E-钙粘蛋白表达组纳入344例。生存分析表明，E-钙粘蛋白缺乏组和表达组之间的5年无病生存率无统计学显著差异（P = 0.590）。同样，两组之间五年总生存率相当（P = 0.863）。总之，E-钙粘蛋白缺乏与GC家族史、低分化肿瘤、神经周围侵犯和CEA水平升高有关。然而，E-钙粘蛋白缺乏并不影响可切除GC的预后。
