title: Abnormal β-catenin immunohistochemical expression as a prognostic factor in gastric cancer: a meta-analysis.
abstract: OBJECTIVE
  To evaluate the effect of β-catenin immunohistochemical expression on the prognosis of gastric cancer (GC).
  
  
  METHODS
  We searched Pubmed and Embase to identify eligible studies. The search ended on November 10, 2013, with no lower date limit. The citation lists associated with the studies were used to identify additional eligible studies. We included studies reporting sufficient information to estimate the HR and 95%CI, and information to estimate the OR in the analysis of clinicopathological features. The qualities of these studies were assessed using the Newcastle-Ottawa Quality Assessment Scale. HRs and ORs and their variance were calculated and pooled using Review Manager Version 5.2.
  
  
  RESULTS
  A total of 24 studies were identified and comprised 3404 cases. β-catenin expression was significantly correlated with poor overall survival (OS) in GC patients (HR = 1.85, 95%CI: 1.39-2.46), but showed a significant degree of heterogeneity (I (2) = 71%, P < 0.0001). Subgroup analysis indicated that an abnormal pattern of β-catenin expression had an unfavorable effect on OS (HR = 1.79, 95%CI: 1.39-2.32). However, accumulation in the nucleus or loss of membrane did not influence the survival of GC patients independently. Moreover, the combined OR of β-catenin indicated that β-catenin expression was associated with Lauren classification (OR = 1.98, 95%CI: 1.19-3.29), lymph node metastasis (OR = 2.00, 95%CI: 1.44-2.77), distant metastasis (OR = 2.69, 95%CI: 1.35-5.38) and grade of differentiation (OR = 2.68, 95%CI: 1.66-4.34). β-catenin expression did not correlate with TNM stage (OR = 1.34 95%CI: 0.96-1.86), the depth of invasion (OR = 1.48, 95%CI: 0.94-2.33) or vascular invasion (OR = 1.11, 95%CI: 0.70-1.76).
  
  
  CONCLUSIONS
  Abnormal β-catenin immunohistochemical expression may be associated with tumor progression and could be a predictive factor of poor prognosis in patients with GC.
authors.affiliation: Li-Fu Li, Zheng-Jie Wei, Hong Sun, Bo Jiang, Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
authors.forename: Li-Fu
authors.initials: LF
authors.lastname: Li
authors.affiliation: Li-Fu Li, Zheng-Jie Wei, Hong Sun, Bo Jiang, Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
authors.forename: Zheng-Jie
authors.initials: ZJ
authors.lastname: Wei
authors.affiliation: Li-Fu Li, Zheng-Jie Wei, Hong Sun, Bo Jiang, Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Sun
authors.affiliation: Li-Fu Li, Zheng-Jie Wei, Hong Sun, Bo Jiang, Guangdong Provincial Key Laboratory of Gastroenterology, Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Jiang
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D016009:Chi-Square Distribution; D018450:Disease Progression; D006801:Humans; D007150:Immunohistochemistry; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D013997:Time Factors; D051176:beta Catenin / Q000032:analysis*
chemical_list: D014408:Biomarkers, Tumor; C495270:CTNNB1 protein, human; D051176:beta Catenin
keywords: Gastric cancer; Immunohistochemistry; Meta-analysis; Prognosis; β-catenin