A cumulative analysis of current evidence for association between expression of epithelial-mesenchymal transition markers and clinicopathological outcomes in patients after radical prostatectomy

Abstract

Background. Epithelial-mesenchymal transition (EMT) was reported to have an important effect on malignant metastasis; however, it remained largely unknown if EMT marker expression of neoplastic tissue had predictive value for prognosis of prostate cancer. Methods. We searched for published studies which measured EMT marker expression and analyzed its association with clinical outcomes of patients after Radical Prostatectomy (RP). We reviewed and pooled-analyzed the association of EMT marker expression and biochemical recurrence-free survival (BFS), as well as the difference in strong or weak expression of EMT markers in tumors of high Gleason score (≥8). Results. A total of 25 studies with 14 EMT markers were included for review and meta-analysis. Only mesenchymal markers of N-cadherin, snail, twist, vimentin, and slug seemed to be significantly associated with decreased BFS in strongly expressed patients. Weak expression of epithelial markers (E-cadherin and α-catenin) and strong expression of mesenchymal markers (N-cadherin, snail, twist, and vimentin) seemed to be more frequent in tumors of Gleason ≥8. Conclusion. Strong expression of mesenchymal markers (N-cadherin, snail, twist, and vimentin) seemed to have significant predictive value for decreased BFS in patients after RP.