E-cadherin蛋白表达与中国人群前列腺癌风险相关性的Meta分析

Correlation between E-cadherin Expression and Prostate Cancer Risk in Chinese Population:A Meta-analysis

目的系统评价E-cadherin蛋白表达与中国人群前列腺癌发生风险及其不同临床病理特征的相关性。方法计算机检索Pub Med、EMbase、CBM、CNKI、VIP和Wan Fang Data数据库,搜集关于E-cadherin蛋白表达与中国人群前列腺癌发生风险及其不同临床病理特征相关性的病例-对照研究,检索时限均为从建库至2015年12月。由2位评价者独立进行文献筛选、资料提取和偏倚风险评价,然后采用Rev Man 5.3软件进行Meta分析。结果最终纳入21个研究,其中前列腺癌患者920例,前列腺增生患者415例,正常前列腺患者48例。Meta分析结果显示:前列腺癌患者E-cadherin蛋白的表达量低于前列腺增生患者[OR=0.07,95%CI(0.05,0.11),P<0.000 01]和正常前列腺患者[OR=0.04,95%CI(0.01,0.18),P<0.000 01],差异均有统计学意义。前列腺癌中低分化组E-cadherin蛋白的表达量低于高分化组[OR=0.13,95%CI(0.08,0.23),P<0.000 01],前列腺癌J-W-P分期C+D期E-cadherin蛋白的表达量低于A+B期组[OR=0.23,95%CI(0.15,0.34),P<0.000 01],前列腺癌伴转移组E-cadherin蛋白的表达量低于不伴转移组[OR=0.46,95%CI(0.27,0.79),P=0.005],差异均有统计学意义。结论E-cadherin蛋白表达与中国人群前列腺癌发病风险及其临床病理特征有显著相关性。受纳入研究样本量和质量的限制,上述结论需进一步开展高质量研究加以验证。

Objective To systematically review the correlation between E-cadherin expression and prostate cancer, as well as its clinicopathologic features in Chinese population. Methods Such databases as PubMed, EMbase, CBM, CNKI, VIP and WanFang Data were electronically searched from their inception to December, 2015 to collect case- control studies about the correlation between E-cadherin expression and prostate cancer, as well as its c/inically pathologic features in Chinese population. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results A total of 21 studies were included, involving 920 prostate cancer cases, 415 benign prostatic hyperplasia cases, and 48 controls. The results of meta-analysis showed that the prostate cancer group had a lower E-cadherin expression level when compared with the benign prostatic hyperplasia group （OR=O.07, 95%CI 0.05 to 0.11, P〈0.000 01） or the control group （OR=0.04, 95%CI 0.01 to 0.18, P〈0.000 01）. Moreover, the expression level of E-cadherin was lower in the low and medium differentiation group than in the high differentiation group （OR=0.13, 95%CI 0.08 to 0.23, P〈0.000 01）, lower in the stage of C＋D than in the stage of A＋B （OR=0.23, 95%CI 0.15 to 0.34, P〈0.000 01）, and lower in the prostate cancer with metastasis （OR=0.46, 95%CI 0.27 to 0.79, P=O.005） and it was decreased gradually with the increment of pathological differentiation and clinical stage of prostate cancer and with the decrement of lymph node or bone metastasis and serum PSA level. Conclusion Current evidence indicates that the expression level of E-cadherin is significantly correlated with prostate cancer and its clinicopathologic features in Chinese population. Due to limited sample size and quality of included studies, the conclusion needs to be verified by conducting more high quality studies.