Shin Young-Min, Pyo Jung-Soo, Park Mee Ja
Eulji University, Daejeon, Republic of Korea.
Eulji University Hospital, Eulji University, Daejeon, Republic of Korea.
Int J Surg Pathol. 2020 Apr;28(2):120-127. doi: 10.1177/1066896919874493. Epub 2019 Sep 22.
This study aimed to elucidate the prognostic implications of extramural venous invasion (EMVI) in colorectal cancer (CRC) through a meta-analysis. Eighteen eligible studies were included in this meta-analysis. Data on the prevalence of EMVI and the correlation between EMVI and survival were collected from these studies. In addition, a subgroup analysis was conducted based on tumor location and evaluation methods. The estimated prevalence of EMVI was 28.3% (95% confidence interval [CI] = 23.1% to 34.0%) in patients with CRC. The estimated prevalence of EMVI in patients with colon cancer and rectal cancer was 23.0% (95% CI = 17.6% to 29.6%) and 35.7% (95% CI = 22.3% to 51.6%), respectively. Based on the evaluation method, the estimated prevalence of EMVI were 28.3% (95% CI = 23.2% to 34.1%) and 27.3% (95% CI = 8.4% to 60.6%) in pathologic and radiologic examinations, respectively. The correlation of EMVI with worse overall and disease-free survival rates was significant (hazard ratio = 1.773, 95% CI = 1.483-2.120, and hazard ratio = 2.059, 95% CI = 1.683-2.520, respectively). However, in the subgroup analysis with radiologic examination, there was no significant difference in survival rates between patients with and without EMVI. Our study showed that EMVI was frequently detected in 28.3% of patients with CRC and was correlated to worse survival. The detection of EMVI can be useful for predicting the prognosis of patients with CRC.
本研究旨在通过荟萃分析阐明结直肠癌（CRC）中外膜静脉侵犯（EMVI）的预后意义。本荟萃分析纳入了18项符合条件的研究。从这些研究中收集了EMVI的患病率数据以及EMVI与生存率之间的相关性数据。此外，还根据肿瘤位置和评估方法进行了亚组分析。CRC患者中EMVI的估计患病率为28.3%（95%置信区间[CI]=23.1%至34.0%）。结肠癌和直肠癌患者中EMVI的估计患病率分别为23.0%（95%CI=17.6%至29.6%）和35.7%（95%CI=22.3%至51.6%）。基于评估方法，病理检查和放射学检查中EMVI的估计患病率分别为28.3%（95%CI=23.2%至34.1%）和27.3%（95%CI=8.4%至60.6%）。EMVI与较差的总生存率和无病生存率之间的相关性显著（风险比分别为1.773，95%CI=1.483 - 2.120；风险比为2.059，95%CI=1.683 - 2.520）。然而，在放射学检查的亚组分析中，有EMVI和无EMVI的患者生存率无显著差异。我们的研究表明，28.3%的CRC患者中经常检测到EMVI，且其与较差的生存率相关。EMVI的检测有助于预测CRC患者的预后。
