多项研究探讨了前列腺癌(PCa)肿瘤内微血管密度(MVD)与术后生化复发(BCR)风险之间的关系,虽然结果是矛盾的。因此,我们进行了一项荟萃分析,以探讨MVD对PCa中BCR的影响.
我们搜索了PubMed,MEDLINE,科学直接/爱思唯尔,Cochrane图书馆,CNKI,和EMBase数据库从成立到2022年1月,没有年份或语言限制,并使用NOS指南评估19项符合条件的研究的质量。得出的风险比(HR)和95%置信区间(95CI)用于评估每个终点。使用RevMan进行数据合成以评估MVD在PCa中的预后价值及其异质性,而发表偏倚使用STATA16.0进行检查。
我们的荟萃分析包括19篇关于PCa术后生化复发的文章(T1-2为4篇,T1-3为6篇,T1-4为9篇),其中,合并3933例患者。肿瘤内MVD对PCa不同分期对BCR的预测能力为T1-2(HR,2.46;95%CI,1.08-5.58;p=0.03;I2=83%),T1-3(HR,2.38,95%CI,1.41-4.01;p=0.001;I2=82%),T1-4(HR,1.61;95%CI,1.19-2.19;p=0.002;I2=61%)。基于欧洲和免疫组织化学抗体无因子VII的亚组分析与主要分析一致。敏感性分析排除那些被判断为在T1-2中存在高偏倚风险的研究,显示HR为2.99[1.70,5.27](I2=38%,p=0.0001),证明MVD风险估计用于评估生化复发的稳健性。
微血管密度是PCa患者BCR的预测因子,MVD较强的T期PCa与BCR有关。需要进一步的研究来研究PCa不同T阶段的新血管生成,以及MVD是否对EAU推荐的生化复发风险评估工具有益。
Several studies have explored the relationship between intratumoral microvessel density (MVD) and the risk of postoperative biochemical recurrence (BCR) in prostate cancer (PCa), although the results are contradictory. Therefore, we conducted a meta-analysis to investigate the effect of MVD on BCR in PCa.
We searched PubMed, MEDLINE, Science Direct/Elsevier, the Cochrane Library, CNKI, and EMBase databases from inception through January 2022, with no year or language restrictions, and used NOS guidelines to evaluate the quality of the 19 eligible studies. The derived hazard ratio (HR) and 95% confidence interval (95%CI) were used to assess each endpoint. Data synthesis was performed with RevMan to assess the prognostic value of MVD in PCa and its heterogeneity, while the publication bias was examined using STATA 16.0.
Our meta-analysis included 19 articles (4 for T1-2, 6 for T1-3, and 9 for T1-4) on postoperative biochemical recurrence of PCa, among which, 3933 patients were pooled. The predictive ability of intratumoral MVD for different stages of PCa on BCR was T1-2 (HR, 2.46; 95% CI, 1.08-5.58; p = 0.03; I2 = 83%), T1-3 (HR, 2.38, 95% CI, 1.41-4.01; p = 0.001; I2 = 82%), T1-4 (HR, 1.61; 95% CI, 1.19-2.19; p = 0.002; I2 = 61%).The subgroup analyses based on European and immunohistochemical antibody none-factor VII were consistent with primary one. Sensitivity analysis excluding those studies judged to be at high risk of bias in T1-2 showed a HR of 2.99[1.70,5.27] (I2 = 38%, p = 0.0001), demonstrating the robustness of risk estimates of MVD for the assessment of biochemical recurrence.
Microvessel density is a predictor of BCR among patients with PCa, and earlier T stage PCa with a stronger MVD is associated with BCR. Further studies are needed to investigate neoangiogenesis in different T stages of PCa and whether MVD will be of benefit to the EAU-recommended tool for biochemical recurrence risk assessment.