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

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. >= 7). The forest plot using the fixed-effects model indicated an OR of 1.585 (95% confidence interval [CI]: 0.793 similar to 3.171; p=0.193). Further, CXCR4 expression was not associated with the T stage (= T3), and the relevant meta-analysis showed OR=1.803 (95% CI: 0.756 similar to 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 similar to 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.