Prognostic role of urokinase plasminogen activator receptor in gastric and colorectal cancer: a systematic review and meta-analysis

Purpose: Although the urokinase plasminogen activator receptor (uPAR) is expressed in gastric cancer (GC) and colorectal cancer (CRC), its evaluation as a prognostic biomarker remains controversial. In this study, we performed a literature review and meta-analysis to evaluate the association of uPAR expression with the prognosis of patients with GC and CRC. Method: The PubMed database was searched for material published in English, and data were then extracted and assessed by two reviewers independently. Correlations between uPAR expression and clinicopathological features and overall survival (OS) of patients with GC or CRC were analyzed. Results: A total of 2,082 patients with GC and CRC from ten studies were included. The results of the meta-analysis showed that the uPAR expression rate in GC and CRC tissues was higher than that in normal tissues (odds ratio [OR] =3.385; 95% confidence interval [CI] 2.605-4.400; P=0.000). Our meta-analysis also revealed a significant association between uPAR expression and lymph node metastasis (OR = 1.366; 95% CI = 1.086-1.718; P=0.008) and tumor stage (OR =3.076; 95% CI = 2.330-4.061; P=0.000). Furthermore, we found that high uPAR expression correlated with poor OS (OR = 1.937; 95% CI = 1.570-2.930; P=0.000). Conclusion: The uPAR expression may serve as a novel disease marker in GC and CRC, as well as a therapeutic target.