Ntellas Panagiotis, Perivoliotis Konstantinos, Dadouli Katerina, Koukoulis Georgios K, Ioannou Maria
Department of Pathology, Faculty of Medicine, University of Thessaly, Larissa, Greece.
Acta Haematol. 2017;138(2):77-84. doi: 10.1159/000478085. Epub 2017 Aug 11.
BACKGROUND/AIMS: Bone marrow (BM) angiogenesis is considered a hallmark of multiple myeloma (MM) development and progression, and can be quantified with the use of microvessel density (MVD). The purpose of this study is to provide a review and a meta-analysis of the current literature regarding the prognostic value of MVD in the overall survival (OS) of MM patients.
MEDLINE was screened for studies evaluating the OS of MM patients with regard to their MVD count in BM trephine. The pooled hazard ratio (HR) and its associated 95% confidence interval (CI) among MM patients with a high and low MVD count was the primary end point. Secondary outcomes included odds ratios (OR) for 12-, 36-, and 60-month survival.
Ten eligible trials were identified for the analysis of the primary end point and 9 for the secondary end points. Pooled HR for OS was 1.85 (95% CI: 1.25-2.73, p = 0.002). The pooled OR of survival were 1.59 (95% CI: 1.02-2.46, p = 0.04) at 12 months, 2.90 (95% CI: 1.68-5.03, p = 0.0001) at 36 months, and 3.42 (95% CI: 2.41-4.85, p < 0.00001) at 60 months, in favor of the low MVD group.
This meta-analysis provides persuasive evidence that MVD has significant impact on the clinical outcome of MM patients.
背景/目的：骨髓血管生成被认为是多发性骨髓瘤（MM）发生和进展的一个标志，并且可以通过微血管密度（MVD）进行量化。本研究的目的是对当前关于MVD在MM患者总生存期（OS）中的预后价值的文献进行综述和荟萃分析。
在MEDLINE中筛选评估MM患者骨髓活检中MVD计数与OS关系的研究。高MVD计数和低MVD计数的MM患者之间的合并风险比（HR）及其相关的95%置信区间（CI）是主要终点。次要结局包括12个月、36个月和60个月生存率的比值比（OR）。
确定了10项符合条件的试验用于主要终点分析，9项用于次要终点分析。OS的合并HR为1.85（95%CI：1.25 - 2.73，p = 0.002）。12个月时生存的合并OR为1.59（95%CI：1.02 - 2.46，p = 0.04），36个月时为2.90（95%CI：1.68 - 5.03，p = 0.0001），60个月时为3.42（95%CI：2.41 - 4.85，p < 0.00001），有利于低MVD组。
这项荟萃分析提供了有说服力的证据，表明MVD对MM患者的临床结局有显著影响。
