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Meta-Analysis
. 2015 Mar 30;10(3):e0121448.
doi: 10.1371/journal.pone.0121448. eCollection 2015.

Down-regulated E-cadherin expression is associated with poor five-year overall survival in bone and soft tissue sarcoma: results of a meta-analysis

Ning Wang  1 , Yong-Lai He  2 , Li-Juan Pang  1 , Hong Zou  1 , Chun-Xia Liu  1 , Jin Zhao  1 , Jian-Ming Hu  1 , Wen-Jie Zhang  1 , Yan Qi  1 , Feng Li  1
Affiliations
Meta-Analysis

Down-regulated E-cadherin expression is associated with poor five-year overall survival in bone and soft tissue sarcoma: results of a meta-analysis

Ning Wang et al. PLoS One. .

Abstract

Purpose: To conduct a meta-analysis to evaluate the prognostic role of E-cadherin expression in bone and soft tissue sarcomas.

Methods: The PubMed, EMBASE, and Web of Science databases were searched using terms related to E-cadherin, sarcoma, and prognosis for all articles published in English before March 2014. Pooled effect was calculated from the available data to evaluate the association between negative E-cadherin expression and 5-year overall survival and tumor clinicopathological features in sarcoma patients. Pooled odds ratios (OR) and risk ratios (RR) with 95% confidence intervals (CI) were calculated using a fixed-effects model.

Result: Eight studies met the selection criteria and reported on 812 subjects. A total of 496 subjects showed positive E-cadherin expression (59.9%). Negative E-cadherin expression in bone and soft tissue sarcomas was correlated with lower 5-year overall survival (OR = 3.831; 95% CI: 2.246-6.534), and was associated with higher clinical stage (RR = 1.446; 95% CI: 1.030-2.028) and with male sex (RR = 0.678; 95% CI: 0.493-0.933).

Conclusion: In the E-cadherin negative group, 5-year overall survival was significantly worse than in the E-cadherin positive group. However, further studies are required to confirm these results.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Process of study selection.
Fig 2
Fig 2. Odd ratios (OR) and 95% confidence intervals (CIs) in 7 studies assessing the relationship between negative E-cadherin expression and overall survival (OS) in patients with sarcomas.
(P = 0.000, OR = 3.831; 95%CI: 2.246–6.534). (fixed-effect model analysis).
Fig 3
Fig 3. Forest plot (fixed effects model) about the association between E-cadherin expression with overall survival in patients with soft tissue sarcomas and bone sarcomas respectively.
(P = 0.000, OR = 4.047; 95%CI: 2.127–7.700) (P = 0.01, OR = 3.447; 95%CI: 1.336–8.893). (fixed-effects model analysis).
Fig 4
Fig 4. Risk ratio (RR) and 95% confidence intervals (CIs) in studies assessing the relationship between E-cadherin expression and male patients in sarcoma.
(P = 0.017, RR = 0.678; 95%CI: 0.493–0.933).
Fig 5
Fig 5. Risk ratios (RRs) and 95% confidence intervals (CIs) in studies assessing the relationship between E-cadherin negative expression and the higher stage (III–IV).
(RR: 1.446, 95% CI: 1.030–2.028, P = 0.033); large tumor (>5cm) (RR: 1.226, 95% CI: 0.941–1.597, P = 0.130); and old age (>20 year-old) (RR: 1.138, 95% CI: 0.927–1.398, P = 0.216).
Fig 6
Fig 6. Funnel plots of Begg’s were used to Evaluate Publication Bias on odd ratios.
Studies is symmetrically distributed which suggest lack of publication bias.
See this image and copyright information in PMC

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