Shen Hongliang, Liu Qingjun, Li Mingyi, Yang Peiqian
Department of Urology, Beijing Friendship Hospital, Capital Medical Science, Beijing, China 100050.
Clin Invest Med. 2017 Apr 26;40(2):E40-E48. doi: 10.25011/cim.v40i2.28194.
Vascular endothelial growth factor (VEGF) serum level or tumor expression may be prognostic in renal cell carcinoma (RCC). The purpose of this meta-analysis was to examine the prognostic value of serum VEGF level and tumor expression in patients with RCC.
PubMed and EMBASE databases were searched until September 26, 2016. Prospective and retrospective studies of RCC patients that had VEGF levels measured were included. Outcome measures were overall survival (OS), disease-specific survival (DSS), and progression-free survival (PFS).
A total of 14 studies were included in the meta-analysis. In patients with RCC, elevated serum VEGF level was not associated with OS (pooled hazard ratio [HR] = 1.16; 95% confidence interval [CI]: 0.52 to 2.60; p = 0.716), but was associated with poor DSS (pooled HR = 4.22; 95% CI: 2.02 to 8.79; p < 0.001) and PFS (pooled HR = 1.50; 95% CI: 1.22 to 1.85; p < 0.001). Removal of one study, however, resulted in elevated serum level being associated with poorer OS. Tumor VEGF expression was not associated with OS (pooled HR = 1.48; 95% CI: 0.74 to 2.95; p = 0.263), but was associated with worse DSS (pooled HR = 1.83; 95% CI: 1.24 to 2.71; p = 0.003).
In patients with RCC, elevated serum VEGF level is associated with worse OS, DSS, and PFS, while tumor expression is only associated with worse DSS. The number of studies, however, was limited and the results should be interpreted with caution.
血管内皮生长因子（VEGF）的血清水平或肿瘤表达情况可能对肾细胞癌（RCC）具有预后指示作用。本荟萃分析的目的是研究血清VEGF水平和肿瘤表达情况对RCC患者的预后价值。
检索PubMed和EMBASE数据库至2016年9月26日。纳入对RCC患者VEGF水平进行测量的前瞻性和回顾性研究。观察指标为总生存期（OS）、疾病特异性生存期（DSS）和无进展生存期（PFS）。
荟萃分析共纳入14项研究。在RCC患者中，血清VEGF水平升高与OS无关（合并风险比[HR]=1.16；95%置信区间[CI]：0.52至2.60；p=0.716），但与较差的DSS（合并HR=4.22；95%CI：2.02至8.79；p<0.001）和PFS（合并HR=1.50；95%CI：1.22至1.85；p<0.001）相关。然而，剔除一项研究后，血清水平升高与较差的OS相关。肿瘤VEGF表达与OS无关（合并HR=1.48；95%CI：0.74至2.95；p=0.263），但与较差的DSS相关（合并HR=1.83；95%CI：1.24至2.71；p=0.003）。
在RCC患者中，血清VEGF水平升高与较差的OS、DSS和PFS相关，而肿瘤表达仅与较差的DSS相关。然而，研究数量有限，结果应谨慎解读。
