Schoenleber S J, Kurtz D M, Talwalkar J A, Roberts L R, Gores G J
Mayo Medical School, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Br J Cancer. 2009 May 5;100(9):1385-92. doi: 10.1038/sj.bjc.6605017.
Hepatocellular carcinoma (HCC) is a highly vascular tumour that expresses vascular endothelial growth factor (VEGF). Various studies have evaluated the prognostic value of VEGF levels in HCC. Its overall test performance remains unclear, however. The aim was to perform a systematic review and meta-analysis of prognostic cohort studies evaluating the use of VEGF as a predictor of survival in patients with treated HCC. Eligible studies were identified through multiple search strategies. Studies were assessed for quality using the Newcastle-Ottawa Tool. Data were collected comparing disease-free and overall survival in patients with high VEGF levels as compared to those with low levels. Studies were pooled and summary hazard ratios were calculated. A total of 16 studies were included for meta-analysis (8 for tissue and 8 for serum). Methodological analysis indicated a trend for higher study quality with serum studies as compared to tissue-based investigations. Four distinct groups were pooled for analysis: tissue overall survival (n=251), tissue disease-free survival (n=413), serum overall survival (n=579), and serum disease-free survival (n=439). High tissue VEGF levels predicted poor overall (HR=2.15, 95% CI: 1.26-3.68) and disease-free (HR=1.69, 95% CI: 1.23-2.33) survival. Similarly, high serum VEGF levels predicted poor overall (HR=2.35, 95% CI: 1.80-3.07) and disease-free (HR=2.36, 95% CI 1.76-3.16) survival. A high degree of inter-study consistency was present in three of four groups analysed. Tissue and serum VEGF levels appear to have significant predictive ability for estimating overall survival in HCC and may be useful for defining prognosis in HCC.
肝细胞癌（HCC）是一种高血管性肿瘤，表达血管内皮生长因子（VEGF）。多项研究评估了VEGF水平在HCC中的预后价值。然而，其总体检测性能仍不明确。目的是对评估VEGF作为治疗后HCC患者生存预测指标的预后队列研究进行系统评价和荟萃分析。通过多种检索策略确定符合条件的研究。使用纽卡斯尔-渥太华工具评估研究质量。收集数据比较高VEGF水平患者与低VEGF水平患者的无病生存期和总生存期。汇总研究并计算汇总风险比。共有16项研究纳入荟萃分析（8项组织研究和8项血清研究）。方法学分析表明，与基于组织的研究相比，血清研究的质量有更高的趋势。将四个不同的组进行汇总分析：组织总生存期（n = 251）、组织无病生存期（n = 413）、血清总生存期（n = 579）和血清无病生存期（n = 439）。高组织VEGF水平预示总体（HR = 2.15，95%CI：1.26 - 3.68）和无病（HR = 1.69，95%CI：1.23 - 2.33）生存期较差。同样，高血清VEGF水平预示总体（HR = 2.35，95%CI：1.80 - 3.07）和无病（HR = 2.36，95%CI 1.76 - 3.16）生存期较差。在分析的四组中的三组中存在高度的研究间一致性。组织和血清VEGF水平似乎对估计HCC的总体生存期具有显著的预测能力，可能有助于确定HCC的预后。
