E-cadherin expression and prognosis of head and neck squamous cell carcinoma: evidence from 19 published investigations
Authors Ren X, Wang J, Lin X, Wang X
Received 19 October 2015
Accepted for publication 16 February 2016
Published 26 April 2016 Volume 2016:9 Pages 2447—2453
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Chang Liu
Peer reviewer comments 3
Editor who approved publication: Professor Jianmin Xu
Xusheng Ren,1,2 Jianning Wang,2 Xuefen Lin,1,3 Xuxia Wang1,3
1Department of Oral and Maxillofacial Surgery, Stomatological Hospital of Shandong University, 2Department of Oral and Maxillofacial Surgery, Jinan Stomatological Hospital, 3Shandong Province Key Laboratory of Oral Tissue Regeneration, Stomatological Hospital of Shandong University, Jinan, Shandong Province, People’s Republic of China
Objective: The objective of this study was to review the published literature and investigate whether E-cadherin gene is a prognostic factor in head and neck squamous cell carcinoma by conducting a meta-analysis.
Methods: Studies were identified from the databases Embase, Medline, and Cochrane Library by using the keywords “E-cadherin gene” and “head and neck cancer”. Overall survival (OS) and disease-free survival (DFS) were the primary outcome measurements.
Results: Our literature review identified 1,458 articles; 19 studies with a total number of 2,012 cases were eligible for inclusion in the meta-analysis. The hazard ratio (HR) for OS of patients with decreased expression of E-cadherin gene was 0.57 (95% CI =0.37, 0.89; P=0.000). However, statistical heterogeneity was unacceptably high (I2=74.5%, P=0.000). After sensitivity analysis, heterogeneity became acceptable, and the effect measure was still significant (I2=7.0%; HR =0.52; 95% CI =0.40, 0.66; P=0.000). The HR for DFS was 0.53 (95% CI =0.42, 0.67; P=0.000).
Conclusion: This meta-analysis showed clear evidence that high E-cadherin gene expression is a positive prognostic factor of head and neck squamous cell carcinoma, resulting in better OS and DFS. However, this conclusion must be interpreted with caution due to a few limitations.
Keywords: E-cadherin gene, prognosis, head and neck squamous cell carcinoma, immunohistochemistry
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