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目的评价软组织肉瘤中E-Cadherin的表达与预后的关系。方法采用Cochrane系统评价方法,计算机检索MEDLINE(1966年至2015年8月)、EMbase(1984年至2015年8月)、OVID database(1980年至2015年8月)、Cochrane Library临床对照试验数据库(2008年第1期)和中国生物医学文献光盘数据库(1980年至2015年8),并追索所有纳入文献的参考文献,手工检索《中华肿瘤杂志》、《中国肿瘤临床》、《肿瘤》(均自创刊至2015年8月)等。由两名评价者共同评价纳入研究质量,进行Meta分析,并分析meta分析森林图。结果共纳入7项研究、共计409例原发软组织肉瘤患者。E-Cadherin正常表达患者共131例(32.03%),表达下调278例(67.97%),E-Cadherin与预后有较好的相关性,E-Cadherin表达下调的患者五年总生存率较低(HR=1.66,95%CI:1.25-2.22,P=0.0006),E-Cadherin表达下调与软组织肉瘤患者分期及组织学分级有关,在E-Cadherin表达下调的软组织肉瘤患者中,病期较晚患者较多(OR=1.86,95%CI:1.06-3.28,P=0.03),且分化较差患者较多,肿瘤组织学分级较高(OR=2.71,95%CI:1.50-4.92,P=0.001)。E-Cadherin表达下调与患者的性别和肿瘤最大直径无关(P=0.27,P=0.58)。结论:E-Cadherin表达下调的软组织肉瘤患者的总生存率较正常表达患者低,且分化较差或病期较晚的患者表达下调,E-Cadherin表达下调可能是软组织肉瘤患者预后不良的独立危险因素。
Objective To evaluate the relationship between E-Cadherin expression and prognosis in soft tissue sarcomas. Methods The Cochrane systematic review method was used to search MEDLINE (1966 to August 2015), EMbase (1984 to August 2015), OVID database (1980 to August 2015), Cochrane Library clinical trial database 2008, No. 1, 2008) and China Biomedical Literature Disc Database (1980 to 2015) 8, and retrieved all the references included in the literature, and manually searched the Chinese Journal of Oncology, Chinese Journal of Clinical Oncology, Cancer ( All from the beginning of August 2015) and so on. Two reviewers jointly assessed the quality of the included study, conducted a meta-analysis, and analyzed the meta-analysis of the forest picture. Results A total of seven studies were enrolled, a total of 409 patients with primary soft tissue sarcoma. There were 131 cases (32.03%) of normal expression of E-Cadherin, 278 cases (67.97%) were down-regulated while E-Cadherin was associated with prognosis. The overall 5-year overall survival of patients with E-Cadherin expression was lower HR = 1.66, 95% CI: 1.25-2.22, P = 0.0006). The down-regulation of E-Cadherin expression was related to the staging and histological grade of soft tissue sarcoma. Among patients with soft tissue sarcoma with decreased E-Cadherin expression, (OR = 1.86, 95% CI: 1.06-3.28, P = 0.03), and there were more patients with poor differentiation and higher histological grade (OR = 2.71, 95% CI: 1.50-4.92, P = 0.001 ). The down-regulation of E-Cadherin expression was not associated with the patient’s gender and tumor maximum diameter (P = 0.27, P = 0.58). Conclusions: The overall survival rate of patients with soft tissue sarcoma with decreased expression of E-Cadherin is lower than that of patients with normal expression, and the expression of E-Cadherin is down-regulated in patients with poorly differentiated or late-stage disease. The decreased E-Cadherin expression may be an independent risk of poor prognosis in patients with soft tissue sarcoma factor.