Department of Family Medicine, Queen's University, Kingston, Ontario, ON, Canada.
BJU Int. 2012 Nov;110(10):1507-14. doi: 10.1111/j.1464-410X.2012.11115.x. Epub 2012 Apr 13.
To synthesize the results of studies including lymphovascular invasion (LVI) in the multivariate analyses of potential prostate cancer prognostic factors. To determine the role of LVI as an independent prognostic factor for biochemical recurrence in prostate cancer.
We performed a comprehensive systematic literature review of studies examining the association between LVI in prostatectomy specimens and prostate cancer recurrence. Ovid MEDLINE, Embase, Web of Knowledge, Cochrane Database of Systematic Reviews, Database of Abstracts of Review of Effects (DARE) and Google Scholar were searched from January 2000 to February 2009. The primary outcome of interest was biochemical recurrence measured by serum prostate specific antigen (PSA).
One thousand two hundred and forty-eight papers met our search criteria. Of these, 19 articles meeting our selection criteria reported results of a multivariate analysis to evaluate LVI as an independent prognostic factor of biochemical recurrence. Eleven (58%) of these studies concluded that LVI was an independent prognostic factor. Significant heterogeneity in the study population, disease characteristics and quality of the studies prevented meta-analysis of the results. In the nine studies in which the magnitude of independent association of LVI with recurrence was reported, it ranged from an odds ratio or relative risk of 1.37 to 4.39.
The existing literature is conflicting and of insufficient homogeneity to definitively establish LVI as an important independent prognostic factor of biochemical recurrence in prostate cancer prostatectomy specimens. Additional adequately powered studies are required to determine the clinical value of reports of LVI involvement. In the meantime, the use of LVI status as an independent prognostic factor for clinical prognostication and medical decision making is not recommended.
综合包括淋巴血管侵犯（LVI）在内的多变量分析前列腺癌潜在预后因素的研究结果。确定 LVI 作为前列腺癌生化复发的独立预后因素的作用。
我们对检查前列腺切除术标本中 LVI 与前列腺癌复发之间关联的研究进行了全面的系统文献回顾。从 2000 年 1 月到 2009 年 2 月，我们在 Ovid MEDLINE、Embase、Web of Knowledge、Cochrane 系统评价数据库、疗效评价文摘数据库（DARE）和 Google Scholar 上进行了搜索。主要观察终点是通过血清前列腺特异性抗原（PSA）测量的生化复发。
1248 篇论文符合我们的检索标准。其中，19 篇符合我们的选择标准的文章报告了多变量分析的结果，以评估 LVI 作为生化复发的独立预后因素。其中 11 项（58%）研究的结论是 LVI 是独立的预后因素。研究人群、疾病特征和研究质量的显著异质性使得无法对结果进行荟萃分析。在 LVI 与复发的独立相关性幅度报告的 9 项研究中，其范围从优势比或相对风险的 1.37 到 4.39。
现有文献存在矛盾，且缺乏一致性，无法明确确定 LVI 是前列腺癌前列腺切除术标本生化复发的一个重要独立预后因素。需要进一步开展足够大的、有影响力的研究来确定 LVI 参与的报告的临床价值。在此期间，不建议将 LVI 状态作为独立的预后因素用于临床预后和医疗决策。
