Reduced E-cadherin expression is correlated with poor prognosis in patients with bladder cancer: a systematic review and meta-analysis

// Yongpeng Xie 1, 2, * , Pin Li 1, 2, * , Yu Gao 1, * , Liangyou Gu 1 , Luyao Chen 3 , Yang Fan 1 , Fan Zhang 1 and Xu Zhang 1 1 Department of Urology, State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, Beijing, People’s Republic of China 2 School of Medicine, Nankai University, Tianjin, People’s Republic of China 3 Department of Urology, First Affiliated Hospital of Nanchang University, Nanchang, People’s Republic of China * Authors contributed equally to this work Correspondence to: Xu Zhang, email: xzhang@tjh.tjmu.edu.cn Keywords: E-cadherin, prognosis, bladder cancer, biomarker, immunohistochemistry Received: April 21, 2017      Accepted: July 25, 2017      Published: August 04, 2017 ABSTRACT The prognostic significance of E-cadherin expression in bladder cancer (BC) has been elevated for years, but published results remain controversial and inconsistent. We thus performed a systematic review and meta-analysis to determine the association between E-cadherin expression and BC prognosis. We systematically searched PubMed, Embase, Cochrane Library, and Web of Science databases to identify eligible studies published until March 2017. On the basis of our inclusion and exclusion criteria, a total of 2,089 patients from 19 studies were eligible for final analysis. Our results showed that reduced E-cadherin expression in BC was associated with poor overall survival (hazard ratio [HR] = 2.73, 95% CI: 1.74–4.27, p < 0.001), poor progression-free survival (HR = 6.39, 95% CI: 3.48–11.73, p < 0.001), and poor recurrence-free survival (HR = 2.48, 95% CI: 1.68–3.64, p < 0.001). Moreover, reduced E-cadherin expression was significantly correlated with pathological T stage (T2-4 vs. Ta-1: risk ratio [RR] = 2.14, 95% CI: 1.70–2.71), metastasis (yes vs. no: RR = 1.68, 95% CI: 1.17–2.40), grade (3 vs. 1/2: RR = 1.58, 95% CI: 1.29–1.93), and carcinoma in situ (yes vs. no: RR = 1.68, 95% CI: 1.09–2.58). This meta-analysis suggested that reduced E-cadherin expression was associated with poor prognosis and advanced clinicopathological characteristics and can serve as a useful biomarker for the clinical management of BC.