血管内皮生长因子表达在肺癌患者中的预后价值：一项荟萃分析的系统评价

Prognostic value of vascular endothelial growth factor expression in patients with lung cancer: a systematic review with meta-analysis.

作者信息

Zhan Ping, Wang Jing, Lv Xiao-jing, Wang Qin, Qiu Li-xin, Lin Xin-qing, Yu Li-ke, Song Yong

机构信息

Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.

出版信息

J Thorac Oncol. 2009 Sep;4(9):1094-103. doi: 10.1097/JTO.0b013e3181a97e31.

DOI:10.1097/JTO.0b013e3181a97e31

PMID:19687765

Abstract

BACKGROUND

Vascular endothelial growth factor (VEGF) has been implicated in tumorigenesis and metastasis, and it presumably mediates the proliferation of endothelial cells and promotes vascular permeability. However, the prognostic value of VEGF overexpression in patients with lung cancer remains controversial.

METHODS

Survival data from published studies were aggregated following a methodological assessment. A systematic review of eligible studies with meta-analysis was performed to quantitatively review the correlation of VEGF overexpression with survival in patients with lung cancer.

RESULTS

We conducted a final analysis of 5386 patients from 51 studies. The studies were categorized by histology, disease stage, patient race, VEGF isoform, and laboratory techniques used. Combined hazard ratios suggested that VEGF overexpression had an unfavorable impact on survival of patients with non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). However, VEGFC and vascular endothelial growth factor receptor 3 (VEGFR3)/flt-1 overexpression did not significantly correlate with survival in patients with NSCLC. In stage I-III NSCLC with VEGF, the hazard ratio (95% confidence interval) was 1.46 (1.38-1.54) overall, 1.35 (1.24-1.46) in Asian patients, 1.61 (1.49-1.73) in non-Asian patients, 1.41 (1.17-1.65) in SCLC, 1.27 (1.06-1.47) in adenocarcinoma, 1.57 (1.43-1.70) in stage I NSCLC, 1.46 (1.38-1.55) in NSCLC by immunohistochemistry, 1.52 (1.23-1.81) in NSCLC by reverse transcription-polymerase chain reaction, 1.22 (0.96-1.47) in NSCLC with VEGFC, and 1.58 (0.96-2.20) in NSCLC with VEGFR3/flt-1. The data collected were not sufficient to determine the prognostic value of VEGF in patients with squamous cell lung carcinomas.

CONCLUSION

VEGF overexpression indicates a poor prognosis for patients with NSCLC and SCLC; VEGFC and VEGFR3/flt-1 overexpression was not significantly correlated with survival for patients with NSCLC.

摘要

背景

血管内皮生长因子（VEGF）与肿瘤发生和转移有关，可能介导内皮细胞增殖并促进血管通透性。然而，VEGF过表达在肺癌患者中的预后价值仍存在争议。

方法

在进行方法学评估后，汇总已发表研究的生存数据。对符合条件的研究进行系统评价并进行荟萃分析，以定量综述VEGF过表达与肺癌患者生存的相关性。

结果

我们对来自51项研究的5386例患者进行了最终分析。这些研究按组织学、疾病分期、患者种族、VEGF亚型和所使用的实验室技术进行分类。合并风险比表明，VEGF过表达对非小细胞肺癌（NSCLC）和小细胞肺癌（SCLC）患者的生存有不利影响。然而，VEGFC和血管内皮生长因子受体3（VEGFR3）/flt-1过表达与NSCLC患者的生存无显著相关性。在I-III期伴有VEGF的NSCLC中，总体风险比（95%置信区间）为1.46（1.38-1.54），亚洲患者为1.35（1.24-1.46），非亚洲患者为1.61（1.49-1.73），SCLC为1.41（1.17-1.65），腺癌为1.27（1.06-1.47），I期NSCLC为1.57（1.43-1.70），免疫组化检测的NSCLC为1.46（1.38-1.55），逆转录-聚合酶链反应检测的NSCLC为1.52（1.23-1.81），伴有VEGFC的NSCLC为1.22（0.96-1.47），伴有VEGFR3/flt-1 的NSCLC为1.58（0.96-2.20）。收集的数据不足以确定VEGF在肺鳞状细胞癌患者中的预后价值。