The Role of NM23 in Patients with Colorectal Cancer: A Systematic Review and Meta-Analysis

This meta-analysis was carried out to evaluate the relationship between NM23 expression and the prognosis of patients with colorectal cancer. We searched Pub Med, EMBASE and Web of Science for relevant articles. The pooled odd ratios(ORs) and corresponding 95%CI were calculated to evaluate the prognostic value of NM23 expression in patients with colorectal cancer, and the association between NM23 expression and clinicopathological factors. In total, 2289 patients were pooled from 24 available studies. The incorporative OR combined by 16 studies with overall survival showed that high NM23 expression was associated with better overall survival(OR=0.67, 95%CI: 0.49–0.93, P=0.02, I2=56%, Ph=0.004). And a new estimate without heterogeneity was produced when only combining high-quality studies(OR=0.70, 95%CI: 0.56–0.86, P=0.0007, I2=46%). In disease free survival(DFS), we also obtained a good prognosis(OR=0.30, 95%CI: 0.14–0.68, P=0.004). Although we failed to find any significance in N status(P=0.10), elevated NM23 expression was related to well tumor differentiation(OR=0.60, 95%CI: 0.44–0.820, P=0.001) and Dukes’ A&B(OR=0.55, 95%CI: 0.32–0.95, P=0.03). These results indicated that over-expressed NM23 might be an indicator of good prognosis, well tumor differentiation and Dukes’ A&B of patients with colorectal cancer, but no significance was found in N status.