title: The prognostic value of E-cadherin in gastric cancer: a meta-analysis.
abstract: The prognostic impact of E-cadherin downregulation in gastric cancer has been assessed for years while the results are controversial and heterogeneous. We thus comprehensively reviewed the evidence for evaluation of E-cadherin expression in gastric cancer to determine this effect. We searched PubMed and Embase to identify eligible studies, and 26 studies comprising 4,383 gastric cancer patients were included to assess the association between E-cadherin immunohistochemical expression and overall survival (OS) and clinicopathological characteristics. Summary hazard ratios (HRs) or odds ratios (ORs) with 95% confidence interval (95% CI) were calculated to estimate the effect. We also performed meta-regression and subgroup analysis according to study location, publication year, number of patients, quality score of studies and cut-off value. Reduced E-cadherin expression was significantly correlated with poor OS of gastric cancer patients (HR 1.62, 95% CI 1.34-1.96). Subgroup analysis indicated that E-cadherin low-expression had an unfavorable impact on OS in Asian patients (HR 1.87, 95% CI 1.45-2.41). Moreover, downregulation of E-cadherin was significantly associated with TNM stage (OR 2.52, 95% CI 1.85-3.43), the depth of invasion (OR 2.01, 95% CI 1.39-2.90), lymph node metastasis (OR 2.39, 95% CI 1.68-3.40), distant metastasis (OR 2.23, 95% CI 1.21-4.11), grade of differentiation (OR 2.26, 95% CI 1.60-3.21), vascular invasion (OR 1.86, 95% CI 1.10-3.13) and histological type of gastric cancer (OR 4.22, 95% CI 2.96-6.02). This meta-analysis revealed that E-cadherin expression might be a predicative factor of poor prognosis for gastric cancer particularly in Asia.
authors.affiliation: Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: XiangBin
authors.initials: X
authors.lastname: Xing
authors.forename: Yong-Bo
authors.initials: YB
authors.lastname: Tang
authors.forename: Gang
authors.initials: G
authors.lastname: Yuan
authors.forename: Yongfei
authors.initials: Y
authors.lastname: Wang
authors.forename: JinHui
authors.initials: J
authors.lastname: Wang
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.forename: MinHu
authors.initials: M
authors.lastname: Chen
mesh_terms: D015820:Cadherins / Q000378:metabolism*; D016022:Case-Control Studies; D006801:Humans; D008207:Lymphatic Metastasis; D011379:Prognosis; D013274:Stomach Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D015996:Survival Rate
chemical_list: D015820:Cadherins