Reduced E-cadherin expression is correlated with poor prognosis in patients with bladder cancer: a systematic review and meta-analysis
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Yongpeng Xie1,2,*, Pin Li1,2,*, Yu Gao1,*, Liangyou Gu1, Luyao Chen3, Yang Fan1, Fan Zhang1 and Xu Zhang1
1Department of Urology, State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, Beijing, People’s Republic of China
2School of Medicine, Nankai University, Tianjin, People’s Republic of China
3Department of Urology, First Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China
*Authors contributed equally to this work
Xu Zhang, email: firstname.lastname@example.org
Keywords: E-cadherin, prognosis, bladder cancer, biomarker, immunohistochemistry
Received: April 21, 2017 Accepted: July 25, 2017 Published: August 04, 2017
The prognostic significance of E-cadherin expression in bladder cancer (BC) has been elevated for years, but published results remain controversial and inconsistent. We thus performed a systematic review and meta-analysis to determine the association between E-cadherin expression and BC prognosis. We systematically searched PubMed, Embase, Cochrane Library, and Web of Science databases to identify eligible studies published until March 2017. On the basis of our inclusion and exclusion criteria, a total of 2,089 patients from 19 studies were eligible for final analysis. Our results showed that reduced E-cadherin expression in BC was associated with poor overall survival (hazard ratio [HR] = 2.73, 95% CI: 1.74–4.27, p < 0.001), poor progression-free survival (HR = 6.39, 95% CI: 3.48–11.73, p < 0.001), and poor recurrence-free survival (HR = 2.48, 95% CI: 1.68–3.64, p < 0.001). Moreover, reduced E-cadherin expression was significantly correlated with pathological T stage (T2-4 vs. Ta-1: risk ratio [RR] = 2.14, 95% CI: 1.70–2.71), metastasis (yes vs. no: RR = 1.68, 95% CI: 1.17–2.40), grade (3 vs. 1/2: RR = 1.58, 95% CI: 1.29–1.93), and carcinoma in situ (yes vs. no: RR = 1.68, 95% CI: 1.09–2.58). This meta-analysis suggested that reduced E-cadherin expression was associated with poor prognosis and advanced clinicopathological characteristics and can serve as a useful biomarker for the clinical management of BC.
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