Zhang Song, Zhang Dong, Yi Shanhong, Gong Mingfu, Lu Caibao, Cai Yuanqing, Tang Xuefeng, Zou Liguang
Department of Radiology, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China.
Department of Urology, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China.
Oncotarget. 2017 Jan 10;8(2):2863-2873. doi: 10.18632/oncotarget.13752.
Lymph node status is one of the key parameters used for determining the stage of breast cancer progression. The relationship of lymphatic vessel density (LVD), lymphovascular invasion (LVI), and lymph node metastasis (LNM) has not been clearly demonstrated yet. Databases of PubMed, Embase, and Web of Science were searched from inception up to 25 May 2016. Spearman correlation coefficient (r) and 95% confidence interval (CI) were used to determine the relationship within each group. Based on pre-established inclusion criteria, 28 studies involving 2920 breast cancer patients were included in this study. The r values of LVD-LVI, LVD-LNM, and LVI-LNM were 0.45 (95% CI: 0.31 to 0.57), 0.32 (95% CI: 0.23 to 0.40), and 0.24 (95% CI: 0.19 to 0.28), respectively. Compared with intratumoral LVD, peritumoral LVD showed more robust correlation with LVI (r = 0.53, 95% CI: 0.27 to 0.72) and LNM (r = 0.33, 95% CI: 0.18 to 0.46). The patients in LNM positive group presented with higher LVI detection rate of 45.85%, while in LNM negative group with detection rate of 23.85%. The results describe a triangle relationship between LVD, LVI, and LNM in breast cancer. Both LVD and LVI are indicated to be valuable predictors of LNM occurrence. Compared with intratumoral lymphatic vessels, peritumoral lymphatics might be the main disseminate route for breast tumor cells.
淋巴结状态是用于确定乳腺癌进展阶段的关键参数之一。淋巴管密度(LVD)、淋巴管浸润(LVI)和淋巴结转移(LNM)之间的关系尚未得到明确证实。检索了PubMed、Embase和Web of Science数据库,检索时间从建库至2016年5月25日。采用Spearman相关系数(r)和95%置信区间(CI)来确定每组内的关系。根据预先设定的纳入标准,本研究纳入了28项研究,涉及2920例乳腺癌患者。LVD-LVI、LVD-LNM和LVI-LNM的r值分别为0.45(95%CI:0.31至0.57)、0.32(95%CI:0.23至0.40)和0.24(95%CI:0.19至0.28)。与肿瘤内LVD相比,肿瘤周围LVD与LVI(r = 0.53,95%CI:0.27至0.72)和LNM(r = 0.33,95%CI:0.18至0.46)的相关性更强。LNM阳性组患者的LVI检出率较高,为45.85%,而LNM阴性组的检出率为23.85%。结果描述了乳腺癌中LVD、LVI和LNM之间的三角关系。LVD和LVI均被表明是LNM发生的有价值预测指标。与肿瘤内淋巴管相比,肿瘤周围淋巴管可能是乳腺肿瘤细胞的主要播散途径。