Effect of E-cadherin on Prognosis of Colorectal Cancer: A Meta-Analysis Update.

Abstract

The effect of E-cadherin on colorectal cancer is still controversial. In order to clarify the effect of E-cadherin on the prognosis and clinicopathological features of colorectal cancer, a meta-analysis was conducted. PubMed, Embase and Cochrane Library were used to collect all relevant literature published before November 2021, and the corresponding data was extracted to analyze the correlation between the expression of E-cadherin and the prognosis and clinicopathological features of colorectal cancer. In addition, the Gene Expression Profiling Interactive Analysis (GEPIA) was used to validate our results. Fifty-two studies, including 9591 patients, were included in this meta-analysis. According to the meta-analysis, low expression of E-cadherin was significantly associated with shorter overall survival (OS) (hazard ratio [HR] 2.09, 95% confidence interval [CI]1.67-2.62; Z=6.42, p=0.000) and disease-free survival (DFS) (HR 2.03, 95%CI 1.71-2.42; Z=7.95, p=0.000). In addition, low expression of E-cadherin resulted in higher risk of low differentiation (odds ratio [OR] 0.35, 95% CI 0.25-0.50; p=0.000), high risk of distant metastasis (OR 0.45, 95% CI 0.35-0.58; p=0.000), high risk of vascular invasion (OR 0.61, 95% CI 0.45-0.83; p=0.002), higher risk of lymph node metastasis (OR 0.54, 95% CI 0.42-0.69; p=0.000), high risk of lymphatic invasion (OR 0.56, 95% CI 0.40-0.80; p=0.001), high risk of deep infiltration (OR 0.63, 95% CI 0.50-0.80; p=0.000), later TNM stage (OR 0.60, 95% CI 0.46-0.78; p=0.000) and late Dukes' stage (OR 0.35,95% CI 0.25-0.49; p=0.000), but wasn't associated with tumor size (OR 0.90, 95% CI 0.71-1.15; p=0.406).The results of GEPIA showed that E-cadherin mRNA expression in colorectal cancer tumor tissues and normal tissues had no difference, and had no effect on OS and DFS. Although not supported by GEPIA, our meta-analysis provided abundant data to suggest that low expression of E-cadherin is associated with poor prognosis in colorectal cancer patients and is an important factor influencing adverse clinicopathological features. Therefore, E-cadherin may be used to predict the prognosis of colorectal cancer and provide guidance for clinical treatment.