Meta-analysis: E-cadherin immunoexpression as a potential prognosis biomarker related to gastric cancer metastasis in Asian patients.

OBJECTIVE

The prognostic potential of reduced E-cadherin expression is associated with an increased risk of gastric cancer. However, its role in gastric cancer remains poorly understood. This study was to quantitatively summarize available evidences for evaluating E-cadherin immunoexpression in Asian patients with gastric cancer as a prognostic indicator.

MATERIALS AND

METHODS

Searches were applied to MEDLINE, EMBASE, the Cochrane Library and Chinese Biomedicine Databases until June 2012, without language restrictions. Studies were pooled and summary risk ratio (RR) or odds ratio (OR) were calculated. Potential sources of heterogeneity were sought out via subgroup and sensitivity analyses, and publication bias were also conducted.

RESULTS

Our combined results showed that reduction of E-cadherin expression in Asian patients with gastric cancer was frequently observed as compared to the counterpart normal tissue (odds ratio [OR] = 64.16, 95% confidence interval [CI] = 24.53-167.80, p < 0.001). All the analyses estimated favored a stronger link between the reduced E-cadherin expression and the poor 5 year overall survival (risk ratio [RR] = 1.50, 95% CI = 1.36-1.66, p < 0.001). When stratifying the studies by the clinical variables, the depth of invasion (OR = 2.46, 95% CI = 1.70-3.57, p < 0.001), lymph node spread (OR = 1.83, 95% CI = 1.49-2.26, p < 0.001), distant metastasis (OR = 2.04, 95% CI = 1.45-2.87, p < 0.000), and TNM stage (OR = 2.11, 95% CI = 1.58-2.83, p < 0.001) provided significant prognostic information.

CONCLUSIONS

Our findings indicate that E-cadherin appears to predict the overall survival and mark metastasis in Asian patients with gastric cancer. Importantly, E-cadherin may be implemented in the routine clinical management of gastric cancer. However, further pursuit of this possibility is warranted.