Is Ep-CAM Expression a Diagnostic and Prognostic Biomarker for Colorectal Cancer? A Systematic Meta-Analysis

Abstract

BackgroundCancer stem cell (CSC) epithelial cell adhesion molecule (Ep-CAM) is frequently expressed in colorectal cancer (CRC). However, the clinical significance of Ep-CAM expression in CRC is not clear. This study evaluated whether Ep-CAM provided valuable insight as a molecular biomarker for CRC diagnosis and prognosis and the potential of Ep-CAM as a novel therapeutic target in CRC.MethodsPublications were selected online using electronic databases. The pooled odds ratios (ORs) or hazard ratios (HRs) with their 95% confidence intervals (95% CIs), and the combined sensitivity, specificity, and area under the curve (AUC) were calculated and summarized.ResultsEleven eligible articles published in English involving 4561 cases were analyzed in this study. Ep-CAM expression was significantly higher in CRC compared with normal controls, and its overexpression was negatively linked to tumor differentiation, tumor stage, vascular invasion, depth of tumor invasion, lymph node metastasis, distant metastasis, and tumor budding in CRC patients. The loss of Ep-CAM expression positively correlated with these characteristics. Multivariate analysis of loss of Ep-CAM expression correlated with a poor prognosis in disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS). The pooled sensitivity, specificity and AUC values of Ep-CAM expression in patients with CRC vs. normal controls were 0.93, 0.90, and 0.94, respectively.ConclusionsThe present findings suggest that Ep-CAM expression may be associated with CRC carcinogenesis, while the loss of Ep-CAM expression is correlated with the progression, metastasis, and poor prognosis of CRC. Ep-CAM expression may be a useful biomarker for the clinical diagnosis of CRC.

Association Between Hypoxia-Inducible Factor-2α (HIF-2α) Expression and Colorectal Cancer and Its Prognostic Role: a Systematic Analysis

“…Numerous studies have shown the molecular mechanisms linked to CRC [6][7][8][9]. Tumor hypoxia is a pathological hallmark that may be correlated with metabolism, the activation of cell signaling, angiogenesis, differentiation, necrosis or cell apoptosis, tumor development and aggressiveness, etc [10][11][12].. Additionally, tumor hypoxia can have an adverse impact on the prognosis of some cancers (i.e., invasive breast cancer or cervical cancer) and the efficacy of chemo-and radiotherapy [13,14].…”

Epigenetic Silencing of the MLH1 Promoter in Relation to the Development of Gastric Cancer and its use as a Biomarker for Patients with Microsatellite Instability: a Systematic Analysis

“…The pooled hazard ratio (HR) and the 95% CI were also calculated to analyze the clinical outcome of MLH1 promoter methylation in GC patients where possible. Heterogeneity of this meta-analysis was detected using the Cochran’s Q statistic [22, 23]. A random-effects model was used for the meta-analysis.…”

Relationship between RAS Association Domain Family Protein 1A Promoter Methylation and the Clinicopathological Characteristics in Patients with Ovarian Cancer: A Systematic Meta-Analysis

“…In addition, the pooled ORs and the corresponding (95% CIs) were also calculated for estimating the correlation between RASSF1A promoter methylation and ovarian cancer in cancer versus LMP tumors. Heterogeneity across the studies was detected based on the Cochran’s Q and I 2 tests [23, 24]. An I 2 value of more than 50% and a p value of <0.1 were considered significant heterogeneity; the random-effects model was used; otherwise, a fixed-effects model was selected in this meta-analysis, suggesting no substantial evidence of heterogeneity [25, 26].…”