Association of Ezrin expression with the progression and prognosis of gastrointestinal cancer: a meta-analysis
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Feng Liang1,*, Yangxin Wang2,*, Ligen Shi1 and Jianmin Zhang1
1Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, ZheJiang University, HangZhou, ZheJiang 310009, China
2Department of Orthopaedic Surgery, Second Affiliated Hospital, School of Medicine, ZheJiang University, HangZhou, ZheJiang 310009, China
*These authors contributed equally to this work
Jianmin Zhang, email: [email protected]
Keywords: ezrin, gastrointestinal, cancer, prognosis
Received: February 01, 2017 Accepted: September 21, 2017 Published: October 04, 2017
Background: Ezrin, a cytoskeletal protein, is involved in cell adhesion. Several studies have been performed to explore the association between Ezrin and gastrointestinal cancers, but the results are inconclusive. This meta-analysis aims to assess the prognostic value of Ezrin.
Materials and Methods/Findings: PubMed and EMBASE were searched. Pooled hazard ratio (HR), odds ratio (OR) and 95% confidence intervals (CI) were utilized to evaluate the association between Ezrin expression and various clinical parameters. 2701 patients from 19 studies were included in the meta-analysis. For gastric cancer, Ezrin expression was associated with tumor grade (OR 2.32, 95% CI 1.53–3.52), TNM stage (OR 4.69, 95% CI 1.38–15.89), lymph node involvement (OR 3.96, 95% CI 1.47–10.70) and overall survival (HR 1.88, 95% CI 1.33–2.66). In colorectal cancer, Ezrin expression was associated with tumor grade (OR 3.94, 95% CI 2.10–3.78), TNM stage (OR 5.66, 95% CI 1.41–22.67), lymph node metastasis (OR 9.52, 95% CI 3.93–23.02), distant metastasis (OR 3.06, 95% CI 1.77–5.31), disease free survival (HR 2.48, 95% CI 1.44–4.28). For esophageal cancer, Ezrin expression was associated with lymph node metastasis (OR 2.07, 95% CI 1.00–4.28) and overall survival (HR 1.49, 95% CI 1.17–1.89).
Conclusions: Ezrin expression is significantly associated with tumor grade, TNM stage, and lymph node metastasis in gastric and colorectal cancers. For gastric cancers, Ezrin is useful in predicting distant metastasis. Survival data showed that high Ezrin expression is associated with poor prognosis in gastric, colorectal and esophageal cancers. Our findings suggest that Ezrin might be a potential biomarker in several gastrointestinal cancers.
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