World J Mens Health.  2014 Dec;32(3):167-175. 10.5534/wjmh.2014.32.3.167.

Meta-Analysis of the Relationship between CXCR4 Expression and Metastasis in Prostate Cancer

Affiliations
  • 1Department of Urology, Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
  • 2Department of Urology, Yangpyeong Health Center, Yangpyeong, Korea.
  • 3Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea.
  • 4Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 5Department of Urology, Gangnam Severance Hospital, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea. kscho99@yuhs.ac

Abstract

PURPOSE
Experimental studies have suggested that the stromal-derived factor-1 (SDF-1)/CXCR4 axis is associated with tumor aggressiveness and metastasis in several malignancies. We performed a meta-analysis to elucidate the relationship between CXCR4 expression and the clinicopathological features of prostate cancer.
MATERIALS AND METHODS
Data were collected from studies comparing Gleason score, T stage, and the presence of metastasis with CXCR4 levels in human prostate cancer samples. The studies were pooled, and the odds ratio (OR) of CXCR4 expression for clinical and pathological variables was calculated.
RESULTS
Five articles were eligible for the current meta-analysis. We found no relationship between CXCR4 expression and Gleason score (<7 vs. > or =7). The forest plot using the fixed-effects model indicated an OR of 1.585 (95% confidence interval [CI]: 0.793~3.171; p=0.193). Further, CXCR4 expression was not associated with the T stage ( or =T3), and the relevant meta-analysis showed OR=1.803 (95% CI: 0.756~4.297, p=0.183). However, increased CXCR4 expression was strongly associated with metastatic disease with a fixed-effects pooled OR of 7.459 (95% CI: 2.665~20.878, p<0.001).
CONCLUSIONS
Our meta-analysis showed that the higher CXCR4 protein expression in prostate cancer specimens is significantly associated with the presence of metastatic disease. This supports previous experimental data supporting the role played by the SDF-1/CXCR4 axis in metastasis.

Keyword

Receptors, CXCR4; Meta-analysis; Neoplasm metastasis; Prostatic neoplasms

MeSH Terms

Axis, Cervical Vertebra
Humans
Neoplasm Grading
Neoplasm Metastasis*
Odds Ratio
Prostatic Neoplasms*
Receptors, CXCR4
Receptors, CXCR4

Figure

  • Fig. 1 Study selection flow chart. The full texts of articles were reviewed, and 11 articles were selected as potential candidates for the meta-analysis. Subsequently, six articles that did not fit the eligibility criteria of this meta-analysis were removed. Finally, five articles were included in the analysis of the relationship between CXCR4 and the clinicopathological features of prostate cancer.

  • Fig. 2 Forest plot of high versus low expression of CXCR4. (A) There is no relationship between CXCR4 expression and Gleason scores (GS; <7 vs. ≥7) according to the meta-analysis. (B) CXCR4 expression is not associated with T stage (

  • Fig. 3 Radial plots indicated no heterogeneity after selection of effects models for all studies. CXCR4 expression and Gleason score (A), CXCR4 expression and T stage (B), and CXCR4 expression and metastasis (C).

  • Fig. 4 Funnel plots demonstrated no publication bias in this meta-analysis for all studies. CXCR4 expression and Gleason score (A), CXCR4 expression and T stage (B), and CXCR4 expression and metastasis (C).


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