Clinicopathological significance and prognostic role of chemokine receptor CXCR4 expression in pancreatic ductal adenocarcinoma, a meta-analysis and literature review

Background: C-X-C chemokine receptor type 4 (CXCR4) protein level was highly detected in a number of cancer types including pancreatic ductal adenocarcinoma (PDAC). The correlation of CXCR4 expression in PDAC and its clinicopathological characteristics remains inconclusive. This study aims at investigating the relationship of CXCR4 expression and clinicopathological characteristics of PDAC patients using a meta-analysis. Methods: PubMed, Web of Science, Cochrane Library, EMBASE, and EBSCO databases and Google Scholar from January 2000 to August 2018 were searched. The Review Manager 5.2 was used in the analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were measured. This study included a total of 11 relevant articles which involved 1439 PDAC patients. Results: CXCR4 was more frequently overexpressed in PDAC tissues than normal pancreatic samples, OR=132.07, P=0.03. The frequency of high CXCR4 expression significantly increased in high grade PDAC than low grade, OR was 1.50, P=0.03. High CXCR4 expression was more frequently observed in late stage of PDAC than those in early stage, OR was 2.82, P=0.0009. High CXCR4 expression significantly increased the risk of lymph node and distant metastases in PDAC, OR=2.69, p < 0.00001, and OR=1.86, p=0.009 respectively. In addition, high CXCR4 expression was correlated with poor survival in PDAC patients, HR=1.27, P=0.05. Conclusions: CXCR4 overexpression is a valuable risk factor for PDAC. CXCR4 overexpression is a strong prognostic marker correlated with the risk of lymph node involvement and distant metastasis in PDAC patients.