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Breast cancer prognosis and P-cadherin expression: systematic review and study-level meta-analysis
  1. Runzhi Qi1,
  2. Jinyin Lin2,
  3. Shuntai Chen3,
  4. Juling Jiang1,
  5. Xing Zhang1,
  6. Bo Yao4,
  7. Honggang Zheng1,
  8. Zhichao Jin5,
  9. Yuan Yuan6,
  10. Wei Hou1,
  11. Baojin Hua1 and
  12. Qiujun Guo1
  1. 1 Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
  2. 2 Administrative Department, Beijing Tongren Hospital Affiliated to Capital Medical University, Beijing, China
  3. 3 Beijing University of Chinese Medicine, Beijing, China
  4. 4 First Clinical Medical College, Heilongjiang University of Chinese Medicine, Heilongjiang, China
  5. 5 Department of Oncology, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China
  6. 6 Department of Pneumology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
  1. Correspondence to Dr Qiujun Guo, Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China; drguoqiujun{at}; Professor Baojin Hua, Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China; huabaojinxs{at}


Objective P-cadherin can act both as a tumour suppressor and an oncogene. The clinical prognostic value of P-cadherin overexpression in breast cancer (BC) remains unclear. We conducted a study-level meta-analysis to determine whether P-cadherin expression can help predict prognosis in BC.

Methods A systematic literature search was performed to review eligible studies and clarify the relationship between P-cadherin overexpression and overall survival (OS), disease-free survival (DFS), pathological features, molecular subtypes and molecular phenotypes in BC.

Results Thirty-one studies including 12 332 patients were included. P-cadherin overexpression was correlated with significantly worse OS (HR=1.77, p<0.00001) and DFS (HR=1.96, p<0.00001) than P-cadherin-negative. P-cadherin overexpression could lead to high histological grade (OR=3.33, p<0.00001) and lymph node metastasis (OR=1.62, p<0.00001). Moreover, P-cadherin overexpression was associated with low odds of the luminal A subtype and high odds of the human epidermal growth factor receptor-2 (HER2)-positive and triple-negative subtypes. P-cadherin expression led to low expression of oestrogen and progesterone receptor (OR=0.37 and OR=0.36, respectively, both p<0.00001) and high expression of HER2 (OR=2.31, p<0.00001), Ki-67 (OR=2.79, p<0.00001), epidermal growth factor receptor (OR=5.85, p<0.00001) and cytokeratin 5/6 (OR=6.79, p<0.00001).

Conclusions P-cadherin was found to be associated with invasiveness and metastasis. P-cadherin expression can probably be a useful biomarker for predicting poor survival and may act as an independent prognostic predictor.

  • cancer
  • breast
  • prognosis

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  • RQ, JL, SC, JJ and XZ contributed equally.

  • BH and QG contributed equally.

  • Correction notice This article has been updated since it was first published. The article type has been changed to Systematic review.

  • Contributors QG and RQ contributed to study concepts. BH, JL, QG, RQ, SC, JJ and XZ contributed to study design. RQ, SC, JJ, BY and XZ contributed to data acquisition. BH, RQ, JL and QG contributed to quality control of data and algorithms. RQ, JL, BY, YY, QG, SC and ZJ contributed to data analysis and interpretation. RQ, SC, JJ and BY contributed to statistical analysis. RQ, JJ, SC, BY, QG, BH and XZ contributed to manuscript preparation. RQ, JJ, SC, ZJ, QG, YY, BH and XZ contributed to manuscript editing. YY, BH and ZJ contributed to manuscript review. All authors gave final approval for submission of the manuscript.

  • Funding This study was funded by Specialized Training for Outstanding Young Scientific and Technological Talents (Innovation) of the China Academy of Chinese Medical Sciences.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.