A Cumulative Analysis of Current Evidence for Association between Expression of Epithelial-Mesenchymal Transition Markers and Clinicopathological Outcomes in Patients after Radical Prostatectomy.

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.