Meta-Analysis
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Feb 26, 2016; 4(1): 1-9
Published online Feb 26, 2016. doi: 10.13105/wjma.v4.i1.1
Expression of epithelial cellular adhesion molecule in gastric cancer: A meta-analysis
Yi-Bin Xiao, Hong-Qing Xi, Ji-Yang Li, Lin Chen
Yi-Bin Xiao, Hong-Qing Xi, Ji-Yang Li, Lin Chen, Department of General Surgery, Chinese People’s Liberation Army General Hospital, Beijing 100853, China
Author contributions: Xiao YB and Xi HQ contributed equally to this work; Xiao YB and Chen L designed the research; Xiao YB and Xi HQ collected and analyzed the data; Xiao YB wrote and revised the manuscript; Li JY provided analytic tools and checked the accuracy of the data.
Supported by The National High Technology Research and Development Program of China, No. 2012AA02A504.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Lin Chen, MD, Professor, Department of General Surgery, Chinese People’s Liberation Army General Hospital, 28 Fuxing Road, Haidian District, Beijing 100853, China. chenlinbj@sina.com
Telephone: +86-10-66938128 Fax: +86-10-68181689
Received: August 23, 2015
Peer-review started: September 3, 2015
First decision: November 13, 2015
Revised: December 1, 2015
Accepted: January 29, 2016
Article in press: January 31, 2016
Published online: February 26, 2016
Processing time: 168 Days and 3.8 Hours
Abstract

AIM: To obtain an accurate evaluation of the association between high expression of epithelial cellular adhesion molecule (EpCAM) and gastric cancer (GC) risk.

METHODS: Studies that had examined the association between high expression of EpCAM and GC risk were identified by searching electronic databases PubMed, EMBASE, Cochrane library and Chinese Biomedical Literature database. Risk ratios (RRs) together with their 95%CIs were used to assess the association between high expression of EpCAM and GC risk. We selected eligible studies based on inclusion criteria. RevMan 5.3 software was used to calculate the pooled values.

RESULTS: A total of 14 studies were included in this meta-analysis. EpCAM-positive cases were significantly associated with tumor size (RR: 1.68, 95%CI: 1.47-1.91, P < 0.00001 fixed-effect), depth of invasion (RR: 1.37, 95%CI: 1.11-1.68, P = 0.003 random-effect), TNM stage (RR: 2.02, 95%CI: 1.35-3.02, P = 0.0007 random-effect), tumor location (RR: 0.80, 95%CI: 0.71-0.91, P = 0.0007 fixed-effect), histologic differentiation (RR: 1.23, 95%CI: 1.13-1.33, P < 0.00001 fixed-effect) and lymph node metastasis (RR: 1.89, 95%CI: 1.28-2.80, P = 0.001 random-effect). However, we did not observe any significant association between the presence of EpCAM with age, gender, distant metastasis, Borrmann type or Lauren classification. Additionally, EpCAM expression was not associated with the overall survival rate. The pooled HR of the overall effect was 1.39 (95%CI: 0.30-6.48, P = 0.67 random-effect).

CONCLUSION: Our meta-analysis indicates that EpCAM contributes to GC risk, which acts as a prognostic factor and a marker of poor outcome.

Keywords: Epithelial cellular adhesion molecule; Gastric cancer; Prognosis; Progression; Meta-analysis

Core tip: This meta-analysis aimed to obtain an accurate evaluation of the association between high expression of epithelial cellular adhesion molecule (EpCAM) and gastric cancer (GC) risk. EpCAM-positive cases were significantly associated with tumor size, depth of invasion, TNM stage, tumor location, histologic differentiation and lymph node metastasis. EpCAM contributed to GC risk, and acted as a prognostic factor and a marker of poor outcome.