Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Medical Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Sci Rep. 2017 May 8;7(1):1527. doi: 10.1038/s41598-017-01845-7.
Visceral pleural invasion (VPI) has been known to be an adverse prognostic factor in non-small cell lung cancer (NSCLC). However, the prognostic significance of extent of VPI (PL0, PL1 and PL2) remains controversial. We conduct a meta-analysis to summarize available evidence on this topic. PubMed, EMBASE, OVID and The Cochrane Library were searched for published studies from inception to May 9, 2016. A total of 16 studies were included in meta-analysis. Our results showed that patients with PL1 or PL2 had poorer overall survival compared with PL0 (HR = 1.555, 95% CI 1.399, 1.730; HR = 2.447, 95% CI 1.913, 3.130) and patients with PL2 had even poorer overall survival than PL1 (HR = 1.287, 95% CI 1.114, 1.487). Patients with PL1 or PL2 had lower 5-year survival rate than PL0 patients (OR = 0.515, 95% CI 0.415, 0.640; OR = 0.441, 95% CI 0.336, 0.579) and patients with PL2 had even lower 5-year survival rate than PL1 (OR = 0.706, 95% CI 0.545, 0.915). In conclusion, extent of VPI impacts the prognosis of resected NSCLC and VPI should be categorized as PL1 and PL2 in the terms of clinical practice and trials.
脏层胸膜侵犯（VPI）已被证实是非小细胞肺癌（NSCLC）的不良预后因素。然而，VPI 程度（PL0、PL1 和 PL2）的预后意义仍存在争议。我们进行了一项荟萃分析，以总结该主题的现有证据。从成立到 2016 年 5 月 9 日，我们在 PubMed、EMBASE、OVID 和 The Cochrane Library 中搜索了已发表的研究。共有 16 项研究纳入荟萃分析。我们的结果表明，与 PL0 相比，PL1 或 PL2 的患者总生存较差（HR=1.555，95%CI 1.399，1.730；HR=2.447，95%CI 1.913，3.130），PL2 的患者总生存甚至更差（HR=1.287，95%CI 1.114，1.487）。PL1 或 PL2 的患者 5 年生存率低于 PL0 患者（OR=0.515，95%CI 0.415，0.640；OR=0.441，95%CI 0.336，0.579），PL2 的患者 5 年生存率甚至更低（OR=0.706，95%CI 0.545，0.915）。总之，VPI 的程度影响可切除 NSCLC 的预后，在临床实践和试验中，VPI 应分为 PL1 和 PL2。
