Research Paper Advance Articles
Reduced expression of E-cadherin correlates with poor prognosis and unfavorable clinicopathological features in gastric carcinoma: a meta-analysis
- 1 Department of General Surgery (Key Disciplines of Medicine in Quzhou City), Longyou County People’s Hospital, Longyou People’s Hospital Affiliated with Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Quzhou 324400, China
- 2 Department of General Surgery, Zhujiang Hospital of Southern Medical University, Guangzhou 510280, China
- 3 Department of Hepatobiliary Surgery, Quzhou People’s Hospital, Quzhou 324000, China
- 4 Department of Gastroenterology, Longyou County People’s Hospital, Longyou People’s Hospital Affiliated with Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Quzhou 324400, China
Received: November 14, 2023 Accepted: May 3, 2024 Published: June 12, 2024
https://doi.org/10.18632/aging.205929How to Cite
Copyright: © 2024 Lu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Backgrounds: Gastric carcinoma (GC) is one of the most fatal human malignancies globally, with a median survival time less than 1 year. E-cadherin exerts a crucial role in the development and progression of GC as an adhesive, invasive suppressor gene. Whether reduced E-cadherin has an impact on prognosis, clinicopathological features for GC has been well studied, but no conclusive results has been obtained.
Methods: Eligible studies and relevant data were obtained from PubMed, Elsevier, Embase, Cochrane Library and Web of Science databases until June 30, 2023. A fixed- or random-effects model was used to calculate pooled odds ratios (OR) and 95% confidence intervals (CI). Correlation of E-cadherin expression with overall survival (OS), clinicopathological features and risk factors were evaluated.
Results: 36 studies fulfilled the selected criteria. 9048 cases were included. This meta-analysis showed that patients with GC with reduced E-cadherin had unfavourable clinicopathological features and poor OS. The pooled ORs of one-, three- and five-year OS were 0.38 (n = 25 studies, 95%CI: 0.25–0.57, Z = 4.61, P < 0.00001), 0.33 (n = 25 studies, 95% CI: 0.23–0.47, Z = 6.22, P < 0.00001), 0.27 (n = 22 studies, 95% CI: 0.18–0.41, Z = 6.23, P < 0.00001), respectively. Moreover, reduced E-cadherin expression significantly correlated with differentiation grade (OR = 0.29, 95% CI: 0.22–0.39, Z = 8.58, P < 0.00001), depth of invasion (OR = 0.49, 95% CI: 0.36–0.66, Z = 4.58, P < 0.00001), lymphatic node metastasis (OR = 0.49, 95% CI: 0.38–0.64, Z = 5.38, P < 0.00001), distant metastasis (OR = 2.24, 95% CI: 1.62–3.09, Z = 4.88, P < 0.00001), peritoneal metastasis (OR = 2.17, 95% CI: 1.39–3.39, Z = 3.40, P = 0.0007), TNM stage (OR = 0.41, 95% CI: 0.28–0.61, Z = 4.44, P < 0.00001), lymphatic vessel invasion (OR = 1.77, 95% CI: 1.11–2.82, Z = 2.39, P = 0.02), vascular invasion (OR = 1.55, 95% CI: 1.22–1.96, Z = 3.58, P = 0.0003), Lauren type (OR = 0.35, 95% CI: 0.21–0.57, Z = 4.14, P < 0.0001), Borrmann classification (OR = 0.50, 95% CI: 0.25–0.99, Z = 1.97, P = 0.048) and tumor size (≥5 cm vs. <5 cm: OR = 1.73, 95% CI: 1.34–2.23, Z = 4.19, P < 0.0001; ≥6 cm vs. <6 cm: OR = 2.29, 95% CI: 1.51–3.49, Z = 3.87, P = 0.0001). No significant association was observed between reduced E-cadherin expression and liver metastasis, perineural invasion, alcohol consumption, smoking status, familial history, Helicobacter pylori (HP) infection.
Conclusions: The reduced expression of E-cadherin is significantly correlated with poor OS and unfavourable clinicopathological features in GC. The expression level of E-cadherin not only serves as a predictor for disease progression and prognosis in GC but also emerges as a novel therapeutic target.
Abbreviations
GC: gastric carcinoma; OR: odds ratio; CI: confidence intervals; OS: overall survival; HP: Helicobacter pylori; NOS: Newcastle-Ottawa scale; RE: reduced E-cadherin expression, PE: preserved E-cadherin expression; IHC: immunohistochemistry test; D: differentiation grade; T: depth of invasion; M: metastasis; TNM stage: depth of tumor invasion, lymphatic node, metastasis staging classification; NR: not reported.