Prognostic and Clinicopathological Significance of Downregulated E-Cadherin Expression in Patients with Non-Small Cell Lung Cancer (NSCLC): A Meta-Analysis

Abstract

BackgroundMany studies have investigated the prognostic role of E-cadherin in patients with NSCLC; however, the result still remains inconclusive. An up-to data system review and meta-analysis was necessary to give a comprehensive evaluation of prognostic role of E-cadherin in NSCLC.MethodsEligible studies were searched in Pubmed, Embase and Web of Science databases. The inclusion criteria were studies that assessed the relationship between E-cadherin expression detected by immunohistochemistry (IHC) and the prognosis or clinicopathological features in patients with NSCLC. Subgroup analysis according to race, percentage of reduced/negative E-cadherin expression, histological type, and sample size were also conducted. Odds ratio (OR) or hazard ratio (HR) with 95% confidence interval (CI) were calculated to examine the risk or hazard association.ResultsA total of 29 studies including 4010 patients were qualified for analysis. The analysis suggested that downregulated E-cadherin expression was significant associated with unfavorable overall survival (OS) and disease-free survival/progression-free survival (DFS/PFS) in patients with NSCLC. Subgroup analysis by race, percentage of reduced/negative E-cadherin expression, sample size also found the significant association in OS. When only the stage I NSCLC were considered, downregulated E-cadherin expression still had an unfavorable impact on OS. Additionally, downregulated E-cadherin expression was significantly associated with differentiation grade, lymphnode metastasis, vascular invasion, and TNM stage.ConclusionDownregulated E-cadherin expression detected by IHC seems to correlate with tumour progression and could serve as an important prognostic factor in patients with NSCLC.

RETRACTED ARTICLE: Repression of lncRNA-SVUGP2 mediated by EZH2 contributes to the development of non-small cell lung cancer via brisking Wnt/β-catenin signal

“…EMT is pointed out to be crucial in tumour invasion and metastasis [42]. E-cadherin, an EMT marker, is found to be significantly associated with lymphnode metastasis and vascular invasion in patients with NSCLC [43]. In this study, overexpression of lncRNA-SVUGP2 dramatically suppressed EMT by enhancing the level of E-cadherin but depressing the levels of N-cadherin, vimentin, and snail.…”

SNAI2 and TWIST1 in lymph node progression in early stages of NSCLC patients

“…The present results showed that the majority of tumors had conserved expression of the epithelial markers CDH1 (92%) and CTNNB1 (92%). Previous studies on E‐Cadherin expression in NSCLC tested by immunohistochemistry report conserved protein expression ranging from 32% to 88% in tumors depending on the IHC cutoff value . Moreover, an association of E‐Cadherin loss of IHC expression and the N+ status of patients was reported in several stages I to IV NSCLC cohorts .…”

Frequent aerogenous spread with decreased E-cadherin expression of ROS1- rearranged lung cancer predicts poor disease-free survival

“…Aerogenous spread is a phenomenon of a tumor that metastasizes through the alveolar spaces and must be achieved through cancer cells detached from the basement membrane [25]. High association with these findings with ROS1 rearranged tumors would intrigue us to investigate E-cadherin protein expression because loss of E-cadherin, a crucial cell-cell adhesion molecule, breaks down cell-cell contact, thereby malignant cells detach from the epithelialcell layer, result in tumor motility [26]. In this study, we also performed IHC of other epithelial-mesenchymal transition (EMT) markers including vimentin, snail, ␤-catenin, and matrix metalloproteinase (MMP) protein expression.…”