Abstract
Decreased epithelial cadherin (E-cadherin) expression is hypothesized to be related to poor prognosis of ovarian cancer, but the predictive value is still inconsistent. We conducted an updated meta-analysis with a total of 16 studies enrolling 1720 patients to estimate the prognostic value of decreased E-cadherin expression in ovarian cancer. Reduced expression of E-cadherin was significantly associated to poor overall survival (HR = 1.74, 95% CI: 1.40–2.17) and progression-free survival (HR = 1.45, 95% CI: 1.12–1.86) with a large heterogeneity for overall survival. In addition, we found that decreased expression of E-cadherin was significantly correlated with International Federation of Gynecology and Obstetrics grade (HR = 3.74, 95% CI: 2.24–6.23), E-cadherin membranous (HR = 1.47, 95% CI: 1.01–2.14), pathologic grade (HR = 1.41, 95% CI: 1.01–1.97), residual tumor size (HR = 2.72, 95% CI: 1.99–3.72), and surgery (HR = 3.21, 95% CI: 1.19–8.67). Our finding suggests that decreased E-cadherin expression may be a predictor of poor ovarian cancer prognosis.
Highlights
Ovarian cancer threatens women’s health worldwide as a lethal disease that is challenging to diagnose in early stages [1, 2]
The results indicated that decreased expression of E-cadherin was significantly associated with Federation of Gynecology and Obstetrics (FIGO) stage (III–IV vs. I–II: hazard ratio (HR) = 3.74, 95% confidence intervals (CIs): 2.24– 6.23), surgery, residual tumor (≥ 1cm vs. < 1 cm, HR = 2.72, 95% CI: 1.99–3.72), and E-cadherin membranous
The results indicated that decreased expression of E-cadherin was significantly associated with poor overall survival (OS) (HR = 1.74, 95% CI: 1.40–2.17, I2 = 57.0%, p = 0.003) and poor progression-free survival (PFS) (HR = 1.45, 95% CI: 1.12–1.86, I2 = 20.6%, p = 0.273), suggesting that patients with decreased expression of E-cadherin have poor prognosis in ovarian cancer
Summary
Ovarian cancer threatens women’s health worldwide as a lethal disease that is challenging to diagnose in early stages [1, 2]. Previous studies have suggested that decreased expression of E-cadherin is closely related to the occurrence, differentiation, invasion, metastasis, and prognosis of tumors in ovarian, breast, gastric, and prostate cancer [9,10,11,12,13]. Studies suggested that decreased E-cadherin expression was associated with high histological grade and deep myometrial invasion [16, 17]. Some other studies drew different conclusions [18,19,20], so associations between decreased expression of E-cadherin and ovarian cancer prognosis are still debated. Previous reviews, including meta-analyses, did not explore associations between decreased expression of E-cadherin and progression-free survival (PFS) and histological grade www.impactjournals.com/oncotarget in depth [21, 22]. Considerable progress has been made in this area [23,24,25,26], so we conducted an updated metaanalysis to evaluate the relationship between E-cadherin and ovarian cancer prognosis comprehensively
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