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.
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RQ, JL, SC, JJ and XZ contributed equally.
BH and QG contributed equally.
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.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
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