背景:血管生成拟态(VM)由侵袭性肿瘤新形成的非内皮细胞组成的微血管系统,已被提出作为恶性黑色素瘤(MM)的重要治疗靶点。我们进行了系统的文献综述,以评估VM状态对MM患者总生存期的诊断和预后准确性。
方法:使用QUADAS-2工具评估纳入研究的质量。VM变量的诊断能力,包括灵敏度,特异性,正似然比(PLR),负似然比(NLR),诊断优势比(DOR),和汇总接收机工作特性(SROC)下的面积,使用Meta-DiSc软件进行汇总。
结果:一项回顾性观察性研究基于12项临床研究,包括978例临床确诊的黑色素瘤患者,比例(P)。在38%的MM组中,VM黑色素瘤细胞与不良预后相关(P=0.35,95%置信区间(CI):0.27-0.42,p<0.001)。合并的敏感性和特异性分别为0.82(95%CI:0.79-0.84)和0.69(95%CI:0.66-0.71),分别。此外,汇集的PLR,NLR,DOR为2.56(95%CI:1.94-3.93),0.17(95%CI:0.07-0.42),和17.75(95%CI:5.30-59.44),分别。此外,SROC的AUC为0.63,表明VM状态作为生物标志物的可靠性较高.重要的是,亚组结果表明,在亚洲MM样本中通过CD31-/PAS+染色方法诊断时,VM+状态是一个显著准确的预后生物标志物(p<0.001).
结论:我们的研究结果支持肿瘤的VM状态作为一个有前景的预后生物标志物的潜力,并强调在亚洲MM患者的预后中有效的辅助治疗策略。
BACKGROUND: Vasculogenic mimicry (VM) a microvascular system consisting of non-endothelial cells that is newly formed by aggressive tumors, has been proposed as an important therapeutic target in malignant melanoma (MM). We performed a systematic literature
review to evaluate the diagnostic and prognostic accuracy of VM status for overall survival of MM patients.
METHODS: The quality of the included studies was evaluated using the QUADAS-2 tool. Diagnostic capacity of VM variables, including sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under summary receiver operating characteristic (SROC), were pooled using Meta-DiSc software.
RESULTS: A retrospective observational study was conducted based on twelve clinical studies including 978 clinically confirmed melanoma patients with proportion (P). VM+ melanoma cells were associated with poor prognosis in 38% of MM group (P = 0.35, 95% confidence intervals (CI): 0.27-0.42, p < 0.001). The pooled sensitivity and specificity were 0.82 (95% CI: 0.79-0.84) and 0.69 (95% CI: 0.66-0.71), respectively. Furthermore, the pooled PLR, NLR, and DOR were 2.56 (95% CI: 1.94-3.93), 0.17 (95% CI: 0.07-0.42), and 17.75 (95% CI: 5.30-59.44), respectively. Furthermore, the AUC of SROC was 0.63, indicating high reliability of VM status as a biomarker. Importantly, subgroup results suggested that VM+ status is a significantly accurate prognostic biomarker when diagnosed by the CD31-/PAS+ staining methods in Asian MM samples (p < 0.001).
CONCLUSIONS: Our findings support the potential of VM status of tumors as a promising prognostic biomarker and emphasize an effective adjuvant therapeutic strategy in the prognosis of Asian MM patients.