The association of CXCR 4 expression with prognosis and clinicopathological indicators in colorectal carcinoma patients: a meta‐analysis

Aims The clinical relevance of expression of chemokine receptor 4 ( CXCR 4) in colorectal carcinoma ( CRC ) remains controversial; our aim was to identify the precise relationship of CXCR 4 to prognosis and clinicopathological features. Methods and results A meta‐analysis was performed. Original data included the hazard ratios ( HR s) of recurrence‐free survival ( RFS ), overall survival ( OS ) and odds ratio ( OR ) in CRC patients. We pooled HR / OR with 95% confidence intervals ( CI s) to estimate the hazard. A total of 20 published studies (including 2253 patients) were eligible. RFS and OS were related significantly to CXCR 4 expression, with HR s 1.62 (95% CI 1.24–2.11; P  <   0.0001) and 1.68 (95% CI 1.31–2.14; P  <   0.0001), respectively. In addition, a significant association was revealed between positive CXCR 4 expression and age (less than median age: OR 0.78, 95% CI 0.62–0.98; P  =   0.03), stage ( I and II : OR 0.46, 95% CI 0.32–0.66; P  <   0.0001), grade (well/moderately differentiated: OR 0.74, 95% CI 0.56–0.98; P  =   0.04), location (colon: OR : 0.73, 95% CI 0.57–0.95; P  =   0.02), lymph node invasion (present: OR 2.14, 95% CI 1.36–3.37; P  =   0.001),and distant metastasis (present: OR 2.40; 95% CI 1.36–4.23; P  =   0.003). Heterogeneity was observed among the included studies with regard to stage ( I 2  = 58 %), lymph node invasiveness ( I 2  = 74%) and distant metastasis ( I 2  = 56%). No publication bias was observed. Conclusions Chemokine receptor 4 expression indicates poorer prognosis in older patients and advanced stage or poor differentiation in CRC , and also serves as an indicator of lymph node and distal organ metastasis. Surprisingly, high CXCR 4 expression may indicate that the location of the tumour is the rectum. Thus, CXCR 4 could help to predict outcome and guide clinical therapy.