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Clinicopathological significance of claudin 4 expression in gastric carcinoma: a systematic review and meta-analysis

Authors Chen X, Zhao J, Li A, Gao P, Sun J, Song Y, Liu J, Chen P, Wang Z

Received 29 October 2015

Accepted for publication 4 March 2016

Published 27 May 2016 Volume 2016:9 Pages 3205—3212


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 3

Editor who approved publication: Professor Min Li

Xiaowan Chen,1,* Junhua Zhao,1,* Ailin Li,1,2 Peng Gao,1 Jingxu Sun,1 Yongxi Song,1 Jingjing Liu,1 Ping Chen,1 Zhenning Wang1

1Department of Surgical Oncology and General Surgery, 2Department of Radiation Oncology, First Hospital of China Medical University, Shenyang, People’s Republic of China

*These authors contributed equally to this work

Background: The prognostic significance of claudin 4 (CLDN4) in patients with gastric cancer (GC) is controversial. This meta-analysis aims to assess the correlation between CLDN4 expression and clinicopathological characteristics and assess the prognostic significance of CLDN4 in GC.
Methods: We searched the PubMed and Embase databases. We performed the meta-analysis with odds ratio (OR), hazard ratio (HR), and 95% confidence interval (CI) as effect values.
Results: Fourteen studies containing 2,106 patients with GC were analyzed. The overall analysis showed that CLDN4 expression was associated with increasing pT category, tumor size, and lymph node metastasis in patients with GC (pT3–T4 vs pT1–T2: OR =1.56, 95% CI =1.13–2.16; P<0.01; large tumor size vs small tumor size: OR =1.64, 95% CI =1.15–2.34; P<0.01; positive lymph node metastasis vs negative lymph node metastasis: OR =1.49, 95% CI =1.12–1.97; P<0.01). CLDN4 expression was associated with histological differentiation (differentiated type vs undifferentiated type: OR =2.90, 95% CI =1.32–6.37; P=0.01; Lauren intestinal type vs diffuse type: OR =3.51, 95% CI =1.48–8.28; P<0.01). CLDN4 expression was also strongly associated with sex and age. This meta-analysis found no significant association between CLDN4 expression and prognosis for overall survival in patients with GC (HR =0.74, 95% CI =0.43–1.27; P=0.28).
Conclusion: Present study indicates that aberrant CLDN4 expression plays an important role in the clinicopathological characteristics of GC.

Keywords: CLDN4, gastric cancer, biomarker, meta-analysis, prognosis, metastasis, stage

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