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预测黑色素瘤转移的微血管密度、淋巴管微血管密度和淋巴管浸润:系统评价和荟萃分析。

Blood microvessel density, lymphatic microvessel density and lymphatic invasion in predicting melanoma metastases: systematic review and meta-analysis.

机构信息

Department of Dermatology, Hospital Clínico Universitario 'Lozano Blesa', Calle San Juan Bosco 15, Zaragoza, 50009, Spain.

出版信息

Br J Dermatol. 2014 Jan;170(1):66-77. doi: 10.1111/bjd.12688.

Abstract

In malignant melanoma (MM) there is an urgent need to identify new markers with predictive value superior to the traditional clinical and histological parameters. Angiogenesis and lymphangiogenesis have been recognized as critical processes in tumour growth and metastasis development, and numerous studies have evaluated the significance of these parameters in predicting the prognosis in solid tumours, including MM. We set out to determine whether angiogenesis, lymphangiogenesis and lymphatic invasion (LI) are valuable prognostic markers in MM. We systematically reviewed the available literature and subsequently performed a meta-analysis on the compiled data. To be eligible for the systematic review, a study had to provide the microvessel density (MVD), the lymphatic vessel density (LVD) or information about LI, assessed by immunohistochemistry on the primary site in patients with MM. To be evaluable for the meta-analysis, a study also had to provide information on clinical outcome. We approached selected studies with the Reporting recommendations for tumour marker (REMARK) criteria, verifying whether they had followed the recommendations. In total, nine angiogenesis, seven lymphangiogenesis and 10 LI studies were included in our meta-analysis, representing 419, 474 and 802 patients, respectively. Using meta-analysis, we showed that peritumoral LVD and the presence of LI have prognostic value for patients with MM. In contrast, MVD and intratumoral LVD did not have prognostic value in these patients. LVD and LI seem to have prognostic value for patients with MM.

摘要

在恶性黑色素瘤 (MM) 中,迫切需要确定具有优于传统临床和组织学参数的预测价值的新标志物。血管生成和淋巴管生成已被认为是肿瘤生长和转移发展的关键过程,许多研究已经评估了这些参数在预测包括 MM 在内的实体瘤预后中的意义。我们旨在确定血管生成、淋巴管生成和淋巴管浸润 (LI) 是否是 MM 的有价值的预后标志物。我们系统地回顾了现有文献,随后对汇编的数据进行了荟萃分析。为了有资格进行系统评价,研究必须提供微血管密度 (MVD)、淋巴管密度 (LVD) 或通过免疫组织化学在 MM 患者的原发部位评估的 LI 信息。为了进行荟萃分析,研究还必须提供有关临床结果的信息。我们根据肿瘤标志物报告建议 (REMARK) 标准与选定的研究进行了接触,验证它们是否遵循了这些建议。共有 9 项血管生成、7 项淋巴管生成和 10 项 LI 研究被纳入我们的荟萃分析,分别代表 419、474 和 802 名患者。通过荟萃分析,我们表明肿瘤周围 LVD 和 LI 的存在对 MM 患者具有预后价值。相比之下,MVD 和肿瘤内 LVD 在这些患者中没有预后价值。LVD 和 LI 似乎对 MM 患者具有预后价值。

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