Claudin-1 Is a Valuable Prognostic Biomarker in Colorectal Cancer: A Meta-Analysis

BACKGROUND: Claudin-1 plays an important part in maintaining the mucosal structures and physiological functions. Several studies showed a relationship between claudin-1 and colorectal cancer (CRC), but its prognostic significance is inconsistent. This meta-analysis assessed the prognostic value and clinical significance of claudin-1 in CRC. MATERIALS AND METHODS: We retrieved eligible studies from PubMed, Cochrane Library, Embase, and Web of Science databases before February 10, 2020. The hazard ratio (HR) with 95% confidence interval (CI) was applied to assess the correlation between claudin-1 and prognosis and clinical features. Heterogeneity was assessed by the Cochran Q test and I-square (I(2)), while publication bias was evaluated by the Begg test and Egger test. Test sequence analysis (TSA) was used to estimate whether the included studies' number is sufficient. The stability of the results was judged by sensitivity analysis. Metaregression was utilized to explore the possible covariance which may impact on heterogeneity among studies. RESULTS: Eight studies incorporating 1704 patients met the inclusion criteria. Meta-analysis showed that the high expression of claudin-1 was associated with better overall survival (HR, 0.46; 95% CI, 0.28–0.76; P = 0.002) and disease-free survival (HR, 0.44; 95% CI, 0.29–0.65; P = 0.003) in CRC. In addition, we found that claudin-1 was related to the better tumor type (n = 6; RR, 0.60; 95% CI, 0.49–0.73; P < 0.00001), negative venous invasion (n = 4; RR, 0.81; 95% CI, 0.70–0.95; P = 0.001), and negative lymphatic invasion (n = 4; RR, 0.83; 95% CI, 0.74–0.92; P = 0.0009). CONCLUSION: The increased claudin-1 expression in CRC is associated with better prognosis. In addition, claudin-1 was related to the better tumor type and the less venous invasion and lymphatic invasion.